When you make a claim for workers compensation insurance benefits such as taxi transport, surgery, physiotherapy etc, the insurer will often request that you undergo (yet again) what it calls an “Independent Medical Examination”, but which I prefer to call an “WorkCover insurer’s Medical Exam”, because the doctor is far from independent.
Disabuse yourself of any idea that the examiner (doctor) is there to help you. He is hired to destroy your case, for example:
- find some cause of your problem the workcover insurer won’t have to pay for,
- deny the existence of your problem,
- find that your problem falls within some policy exclusion,
- show that you’re malingering, or disobeying medical advice,
- deny the severity of your complaints,
- list all the activities you’re capable of,
- smear you by showing you lied or concealed other accidents, etc.,
- challenge the prognosis,
- show that no further treatment is needed,
- minimise the disability and inability to work,
- criticise the treating doctor’s care,
- find inconsistencies in your medical history.
Some more tips on how to deal with (yet another) independent medical examination under workers compensation
Only state-registered doctors can conduct a physical examination. Check out the examiner (doctor) on the internet for licensing or disciplinary problems. For example use the Australian Medical Association to see if they are registered. Or the Australian Society of Orthopaedic Surgeons, etc. Another useful site is the Australian Health and Medical Law Website. Another useful site is ratemd where you can find doctors that have been rated by others – this notorious Dr Terace, the psychiatrist IME is rated on this site – have a peek
Many of these IME doctors are rejects who can’t hold a real job, or can’t get one because of prior discipline. Object if you find any problems!
You must carefully prepare for this exam! (Please refer to our previous post “More about WorkCover Independent Medical Examination (IME)” on how to prepare and protect yourself for the IME)
Get ALL and carefully review all the records from your treating doctor(s). Or obtain copies of all relevant reports from the workcover insurance company under the Freedom of Information Act.
Make sure that no important material is omitted. Even rehearse your entire medical history is needed, so you are fully prepared.
The WorkCover insurer must also give you adequate notice and discuss with you a suitable time to attend the examination. They must also provide you with an explanation for the reason for the IME, and this, together with the details of the date and name of the IME and location must be in formal writing (post) and not via email or phone.
Take a witness to the IME with you and have him/her audiotape the proceedings (conceal it if necessary).
Sign nothing except the sign-in sheet when you arrive. Don’t fill out any forms, or sign any waivers. Written statements or answers to written interrogatories are not part of the IME. In particular, refuse to fill out any “history forms” the office staff may say are “routine”.
Don’t allow anyone but the agreed-upon doctor to conduct the exam. Allow no one else in the room except a nurse, your witness, and, if needed, an interpreter.
The questions and physical examination must be limited to the area which is “in controversy”. If you’re complaining of a knee injury, there is no need to do a pelvic exam. And you may refuse to discuss parts of your medical history which are irrelevant.
IME doctors are trained to observe patients even when the formal exam is not taking place, as getting on and off the examining table. They have been known to leave a dollar bill on the floor to try to catch a patient bending over to pick it up, but perhaps not mentioning the accompanying grimace of pain. Some will even observe the way you get in and out of your car and walk across the parking lot. Be aware.
Always be friendly and polite. Never express anger, but be firm. Don’t tolerate any abuse.
Make sure the oral medical history you give the doctor is complete. If he cuts you off, tell him “Doctor, I have not finished my answer to your question. May I please complete my answer? Don’t you want to know the truth?”. You should answer only those questions that are directed to medical issues. Remember: THIS IS NOT YOUR DOCTOR. Anything you tell this doctor will not be confidential and can be used by the insurer against you.
There is another school of thought which holds that you should give NO oral or written medical history to the examining doctor, since this amounts to a deposition without statutory safeguards.
If something the doctor does causes pain, be sure to say so. Don’t be afraid to say “Ouch!”. The witness should record what was being done and the results. If he observes your gait, have the witness mark the number of steps and the condition of the floor. If he measured grip, did he just have you squeeze his fingers, or did he use a dynamometer? If he measured symmetric muscle circumferences, did he measure up from the floor or a finger-tip to assure symmetric locations? Did he measure bending angles with a goniometer, or did he estimate them?
After the exam, revert to helpless patient mode, and ask the doctor for his prognosis, recommendations for future treatment, etc.
After the exam, pick up all the cards, brochures, etc. available in the doctors office. If other patients appear to be waiting for IMEs, talk to them, and get their names and phone numbers. They may well be useful witnesses later on!
It may be useful to schedule an appointment with your own doctor later that day, in case a rebuttal of any adverse findings is needed. Have him send for a copy of the IME’s report as well, to check for errors and problems.
As of 14 Oct 2014, this post has been viewed 1139 times.