Workcover only provides very selective material to independent medical doctors and medical panels

selective-evidence-workcover

Workcover hides evidence

It is extremely important that you are aware that the workcover agent (i.e. your case manager/injury adviser) will only send very selective material in support for your injury(ies) to independent medical doctors and the medical panel.

When you have to attend an independent medical examination or the medical panel, always make sure you ask them to see the Shedule of Attachments, that is a list of the material (medical reports, letters, radiology results etc), that the workcover agent or injury adviser has submitted with their letter of appointment.

True story

I was recently sent (yet again) to an independent medical examination for an “objective” (excuse me!) assessment of my physical injury. The IME showed me a list of the material workcover had sent him and guess what? They only submitted a very old report from my treating surgeon dated 2006 and, unbelievably, a copy of a report from my treating psychiatrist!!!

How on earth is this IME supposed to provide an “objective” assessment of a complex orthopedic injury, without a copy of all surgical reports, no MRI or x-ray results, no recent reports or letters from my treating specialist who between brackets requested approval for very major surgery just a few weeks ago, no bone scan test results, just nothing! Are they really stupid or what! Do they honestly think that (most) IME’s can’t see through their little schemes? It’s absolutely disgusting to what length workcover agents go to cover up your injuries or the extent of your injuries.

Be warned

The value of a workcover claim is based upon the medical evidence the major part of which consists of the medical report supplied by an ‘independent’ medical assessor who just happens to have been paid for by the insurers who will be responsible for settling your claim and for paying out any financial compensation. It is worth remembering that an insurance company is a commercial business whose first responsibility is to shareholders, who expect to receive profits shared out by way of dividend every year.

The insurers are not doing you any favours and you are not high on their list of priorities when they consider the content of your claim form and genuine medical reports from your own treaters who know you best. In almost every case it is recommended that you obtain your own medical evidence from an ‘independent’ medical consultant of your choice and/or that you always ensure that you provide your own copies of all medical related reports/letters/results to the IME or the Medical Panel.

 



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5 Responses to “Workcover only provides very selective material to independent medical doctors and medical panels”

  1. Did you know that Allianz has been linked to the Nazis? Perhaps this explains the toxic culture within the organisation!

    Whilst as an employee you don’t get a choice as to who your employer uses for workers compensation insurance, as an individual you can choose who provides you with home, car and other insurance.

    Avoid Allianz (and the many other “friendly” brands it operates under. That’s my advice to anyone who may read this — no matter where in the world you are located.

    On the topic of the post: it is very important to seek access to everything the insurer provides to the so-called Independent Medical Examiner, including copies of any file notes relating to telephone calls they may have had.

    If no notes (or other recordings) were kept of any such telephone calls then the insurer is likely in breach of its recordkeeping obligations to WorkCover/WorkSafe.

    Pursue all avenues against the insurers — they will certainly persue any avenue against you.

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    • I have had to deal with Allianz for quite a few years and then my employer changed over to Xchanging (aka Cambridge integrated). I tell you what, Xchanging is even worse than Allianz. They are just a bunch of lying thieves and they will do everything to demolish you and to deny you every ‘benefit’ possible. They even ignore legal ACCS certificates of ruling. I heard that some of their companies have gone bust overseas…

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  2. WorkCover/WorkSafe guidelines stipulate the information that should be provided to an IME. If the insurer fails to meet these minimum requirements then a formal complaint should be made to WorkCover/WorkSafe.

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    The question is... September 8, 2011 at 11:29 am
    • Any chance you have a copy of these guidelines? Every time I ask my stupid donkey (case manager) for a copy of their policies/ guides she of course refuses to disclose them…

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      • Xchanging doesn’t make up the rules of the system and it should cease from pretending it does. The rules apply to them just as much as they apply to injured workers.

        If the case manager refuses to supply you with the IME Guidelines then use the formal complaint escalation procedures to have the CM’s manager provide them.

        Or, simply write to WorkSafe asking them to provide you with a copy.

        I’m sorry,I’m not very familiar with the Vic system, but as for NSW, you can find them here http://www.workcover.nsw.gov.au/formspublications/publications/Pages/independantmedicalexamintationsreports.aspx

        Note from that page:

        “The Guidelines set out WorkCover’s policy in respect of independent medical examinations as well as the mandatory obligations for employers/insurers when referring a worker for a medical. They also provide guidance for all parties, including referrers, examining medical practitioners, and injured workers.”

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        The question is... September 8, 2011 at 6:32 pm