Most the Independent medical examination doctors are nothing more than medical whores
It is an unfortunate fact of life that medical whores exist, and in alarming abundance. They are an embarrassment to the profession and should be routed from it; yet, they are not. They are, of course, the spawn of workcover insurance companies.
If you are sent, by a workcover insurance company, to an “Independent Medical Examination” (IME) – that’s what they call it – nine times out of ten you will be sent to one of the insurance company’s medical whores. The purpose of the alleged “examinations” is to provide the insurance company with a good excuse not to make good on it’s “contract” or obligation.
The workcover insurance scam means basically that your state essentially puts a gun to your head, forcing your employer to purchase workcover insurance. The workcover insurance companies then collect the payments (aka premiums) but then try to find every way, legal or illegal, but dishonest, *not* to pay you (the injured worker who works for the employer) in the event of an accident. It used to be called “highway robbery“, now in doublethink, it’s called “insurance”. Yep.
Government and various insurances have forced their way into every aspect of your life (think car insurance, house and content insurance, health insurance, life insurance…). Doctors also have to carry malpractice insurance which is often outrageously overpriced. Many “doctors” of middle or low grade, or those who have been banned to practice or operate, or those who are way too old to practice (i.e.85 years +) will find extremely lucrative positions functioning as the whores for workcover insurance companies. No matter how personable they may appear, they are not your friends. They are the worst of scum, not even deserving of the title “physician or doctor”.
Did you know that in some countries, like the US (and I am not sure whether this is also happening in Australia) workcover (and other) insurance companies can buy off doctors or groups of doctors providing them with the names of people with claims against the given insurance company. You, then, are referred to some specialist or group of specialists quite unwittingly by a known and perfectly fine doctor. You go to the specialist who then, because your name is on the list, writes a typical whore’s report. Note that you have gone to this specialist as a patient, and been betrayed professionally; this is *not* an IME. The insurance company now has something better than its own IME, to use against you: your own physician.
How to defend and protect yourself against the medical whore during an IME
You MUST protect yourself, since the laws of our supposedly free and fine country are designed to aid and abet the outright thievery by the workcover insurance industry, whose only interest is greed, and coupled with it, a complete disregard for human life.
Please note that the following is only a set of suggestions which I have compiled from my own experience, my own research and the experience(s) of other injured workers.
- [Check with your lawyer] In most states (like in Victoria) you may not refuse a medical examination (*) out of hand, but you may refuse a SPECIFIC doctor. Check around. The medical profession pretty well knows who the whores are. Nurses are often more knowledgeable and forthcoming than doctors. I have personally been successful at refusing to see a certain IME psychiatrist and was given permission to see another IME psychiatrist instead. (Also see post “Do I have to attend an Independent Medical Examination with the doctor chosen by work cover?“). For example, some IMEs may write in their report that you should be reviewed/reassessed in 6 months time (hey – more big bucks for them!), and if that IME writes a real good whore’s report, it is likely that the insurance company will want to send you to that same IME. You can REFUSE! (I did it, and Oh boy, what a difference it made!). (*) The Act unfortunately is very vague and only states that the workcover insurer can send you to an IME from time to time or at reasonable intervals. It is therefore very difficult to determine what reasonable means, but most lawyers agree that it is on average about one (1) IME per year to one (1) IME every two (2) years. It can be more often if your injury deteriorates or if you required surgery. If you feel that the requests for IMEs are unreasonable you should raise a complaint with WorkSafe. In my case, for example, I was sent to six (6) IMEs over a period of 14 months and every single IME has stated that I was unfit for work and all reports were consistent – WorkSafe was actually gobsmacked and an investigation is underway, especially considering that when my case manager requested that I attend again an Psychiatry IME, whilst she had been informed of an acute and severe deterioration of the physical injury (by my treating surgeon and myself) and that she had written in an email to me that ” you have made several comments about your deteriorated shoulder but I am not interested in your physical condition and only want you psychiatrically assessed to assess your ability to engage in rehab and return to work“. I kid you not!
- Bring with you all relevant medical ‘material‘ (= irrefutable evidence) such as reports from your specialist, GP, MRI reports, CT scan report, X-Rays etc and always remember that the workcover insurance company will have sent extremely selective material to the IME. Also always ask the IME in question to see the “list of attached material” that has been forwarded by the insurance company. Often, you will be stunned to see how little information (if any at all) workcover has actually forwarded to the IME. For example, recently workcover sent me to an orthopedic surgeon IME for an “objective assessment AND surgical opinion” of my very complex shoulder and arm injury. I was shocked to see that not one surgical report had been forwarded to the IME whilst I had undergone 7 major surgeries, including transplants! They however did send one (1) psychiatric report and one (1) ergonomic assessment report… So, how on earth is this orthopedic surgeon, who by the way is not even registered as a shoulder surgeon, supposed to give a surgical opinion without a complete surgical history? His proposed “surgery” was not only outrageously inappropriate (a procedure that has been abandoned over 20 years ago),but he failed to realise that this procedure was not even possible for me due to the previous surgeries, their complications and the fact that I also have severe vitamin D deficiency which would make this procedure a guaranteed failure as my bones cannot heal or grow together. But hey, this surgery is the CHEAPEST solution… hence in his whore opinion this IS the BEST solution and would undoubtedly make workcover “happy”….
- Bring a friend who can attest to the time spent in examination, and what actually happened and what was said. No matter what, is said or done, this person is *not* to leave your side. Be as insistent as necessary. Take notes with times, or have your witness do it. Use an audio tape recorder. If they refuse the recording, just ask them why (i.e. have they got something to hide?). I have noticed over the years and over the very many IME’s that some of them may not necessarily lie as such in their reports but will OMIT crucial facts (such as extremely important symptoms, even wounds, fractures etc). Many IMEs will just MAKE UP entire fictitious stories and make you wonder where on earth they got this or that [story] from.
- The very best thing to do, if possible, would bring someone with you to actually video record the entire procedure. If the videotaping is refused, make sure you get the the refusal on tape! This is particularly useful if you know that they are sending to an extremely bad whore (saying that, I think I might just start publishing a list of them!).
- Consider using a hidden voice or video recorder such as your cell phone. Keep this for your records and compare the recording with the actual report prepared by the IME physician. If you have identified inconsistencies, consult with your solicitor, show them the recording, and the report and point out the errors. This is particularly useful for very important IMEs such as those of permanent impaired assessment ratings.
- Do not be afraid of of offending the IME “doctor”! They’re out to crucify you in any event (at least 99% of them). Ask questions, especially if you are taping (video or dictaphone) the event. These are not Gods but human filth and should be treated accordingly, however stay polite.
- When asked a question, answer only the question, no more. The whore will make up answers for you anyhow. Give as little information as possible. Whatever you do or say will be twisted and perverted to be used against you. Volunteer nothing. You may have read in one of my posts about a Psychiatrist Whore who was asking some ridiculous questions about my parents etc. She asked me whether my mum or dad had come out to Australia t visit me when I had a near fatal complication after one of my surgeries and I said ‘no’. Note that my parents are quite old (well into their seventies) and a flight from Europe to Australia is not an easy undertaking at that age and when they’re not in the best of health. Now that you know how old my parents are, you can estimate my age (not a young chicken either)… Guess what, beside the fact that the whore has no business in asking me about my parents or any other NON-WORK-INJURY-RELATED stuff, the whore decided to write in her typical whore report that “I was very upset that mum and dad did not visit 3 years ago and this is severely compounding my depression/recovery”… OM(fuc**ng)G! So as you can imagine, workcover then tried to make it look as if the cause of my depression was that mum and dad did not visit instead of the other way round: that is had I not suffered the work accident in the first instance I would have not suffered any of its “after effects” either, right. Jeezus Christ.
- Answer frugally: This independent medical exam Doctor is going to ask you many questions in great detail. Keep in mind to answer his or her questions as simply as possible. Yes or no answers are the best you can give. Try not to elaborate on any subject. Never guess! If you are unsure or do not know the answer to a question, simply state “I do not know”. If the physician is asking questions about your doctor, or your doctor’s opinion, tell the exam doctor to look in the file that was provided to him or her, all that information should be in it. It is also ok, if you are uncomfortable, to tell the exam doctor that all of your injury information is also in the file. You can keep repeating this as much as needed. Independent medical examination physicians will try to get you to sing like a canary in hopes to get you to say something different.
- Make your pain known: verbally speak about your constant or daily pain. While you are at the exam, if you are having any pain, complain about it. If you have a back injury and sitting aggravates it, say “My back is hurting, I can not sit down”. You have the right to be comfortable at the exam. Make sure that the exam doctor is well aware of all aches, pains, or discomforts that you are having while you are in the exam room. Talk about your pain over and over making sure that he or she has heard you complain about it several times. This way there will be no mistake on how you are feeling during the exam.
Anytime this doctor makes you do something that hurts tell him or her loudly! If you do not make it known that what is happening is causing you pain, the doctor will write in his or her report that the injured worker did not have any pain. Make your pain known!
- If you have had enough torture (especially with a psychiatric examination), or most especially if the examiner is actually hurting you (mentally or physically), announce that the examination is over and leave. When it comes to this, make sure that the announcement is being taped and your reason is stated. It also helps – for psychiatric IMEs- to have a letter from your treating GP, psychologist or psychiatrist asking NOT to make you RELIVE the trauma(s) as they are very upsetting to you (which is true) and exacerbate your PTSD and/or depression. It is also useful to have a letter from them detailing a summary of the events, diagnose(s) and treatment.
- Spend the time and effort to get (your own -independent – examinations by truly competent , reputable and conscientious physicians/ specialists. They are becoming scarcer and harder to find. Rule of thumb: genius recommends genius. Remember that you are entitled to a second opinion under workcover – so use it to your advantage!!!!
- Thanks God perhaps, for some medical whores have, by their consistent outrageousness and stupidity become known throughout the medical and legal profession, and even become known by judges who will dismiss them, or laugh them out of a courtroom. In this case, your defense has already been made for you. if you browse through some case files (court hearings) you’ll rapidly be able to pick some up. There are a few examples,one of which stands out in my mind (because I also have been sent to this whore recently, known as one of the nastiest and harshest IMEs); well he has been repeatedly laughed at in court (and his whore reports dismissed) because (maybe of his very old age -he is at least 86 years old) he can’t even tell left from right in his report(s), i.e. he will describe the injuries allegedly suffered by the victim to the left arm, namely a right broken wrist and a left crushed finger… etc… Terrible, terrible, terrible indeed. With regards to my own assessment with this same whore, and although overall the report was in my favour (had to be because I am so fu***d there is really no way out), this IME wrote for example (and I kid you not) that he examined me on 6 September 2012. How is this going to look in a court of law,especially considering that the report is dated 15 September 2011.
- Be well prepared for the examination, rehears if necessary.
What are the earmarks of a Medical Whore’s “report” and “examination”?
- the IME ‘s “creative” assessment’s report will *almost* conform to the truth but, overall, it will be inconsistent with itself and with known and measurable fact(s). As I mentioned, there will be crucial OMISSIONS
- It will not read like what you remember from the examination. The actual examination will be perfunctory and short, including a few attacks with pins and hammers (if you are lucky) to make it look official.
The report will call this a “complete neurological examination”!
X-rays and other images (if you have them) will be gone through quickly and casually.Radiologists’ reports will be criticised, their findings declared unimpressive or inconclusive, and often dismissed. No conclusive tests
will be either recommended, suggested or ordered. Often they will even be advised *against*. This is of course nothing more than an attempted to prevent you from seeking further medical treatment, and to prevent you
from obtaining either the treatment you need (i.e surgery, physiotherapy) or fair compensation for the damage done you! For example, two years ago I went to a real IME whore for an initial impairment assessment. This whore was an “occupational physician” and has never ever operated on a shoulder, has never treated CRPS (aka RSD) etc. Well to keep workcover happy and to heavily reduce the permanent impairment rating, the whore did not even test for the CRPS/RSD. No pin prick test, no temperature of the limbs were compared, no nothing! But because my entire hand, fingers and forearm were dusky, mottled, ice cold and blue (as in no blood supply) and because my partner was present – thus he could not completely get away with his lies, he dared to write in his report that the “discolouration of my hand/fingers/arm etc is because I keep the arm dependent and is not because of the so-called CRPS or RSD”. Now that I am permanently in a sling (with the hand and fingers above heart level) was obviously omitted, that he did not do any test for RSD was omitted and he also dared to write that “there is no need for further expert opinion”. Consider that I had been and still am in treatment for severe CRPS/RSD with a very reknowed (internationally known) professor specialised in pain and anesthesia…who diagnosed me with severe CRPS/RSD… well… see what I am saying? It’s just DISGUSTING.
- There will be innuendos concerning your physical symptoms or aspects or your personality/psychological state. Unimportant things will be declared “interesting”. Your genuine symptoms might even be subtly ridiculed, even being referred to as “surprisingly”, “bizarre”, “unheard of” or “very rare”, etc. The point of this is, of course, being to call you a liar, without actually doing so. Implications will be made that you are either stupid or delusional, by comparing what you may have said about a particular test, and what the whore states actually happened; what he states happened will, of course, be a total fabrication. Of course, the whore is the expert and knows better. Another frequently used phrase is “there appears to be a psychological overlay….”
- Innuendos can be conveyed simply by putting certain words like “pain”or “stress” in quotes, implying, without saying, that that these symptoms are not real, or don’t really exist. A distinction will be made, said outright or implied by innuendo, between pain and pseudo (as in fake) pain, stress or pseudo stress, as if the two were objectively distinguishable; they are not. Pain is pain. The word stress is used in vague ways, that will confuse heavy duty stress with minor annoyances so as to make your serious stress *appear* to be a minor annoyance. There is no way of distinguishing between pain and “pseudo-pain” (quotes meaning to imply that there is no such thing).
- Quotes will be attributed to you; about half will be erroneous in one way or another, sometimes quoting you as saying the opposite of what you actually did say. Sometimes a slight change of word or phrase that by itself appears harmless. Nothing that a medical whore does is harmless.
- There will only be results reported that are subjective to the to the examiner, like reflexes and muscle strength. No objective evidence will be present, even though some numbers may be present.
No objective tests will be made. The examiner simply makes up the numbers anyway he chooses.
- Irrelevant remarks will appear such as “the patient didn’t elaborate” (of course, the whore will not have asked for elaboration) while important statements by you will be completely ignored and absent from the report. You might see, “I found it interesting that, …” purporting to cast doubt on a particular result, or an importance where there is none. The report will consist mainly of what was “apparently” felt or said by you the patient (ignoring any existing documentation) and what was “interesting”, without any explanation of why a particular thing may have been interesting; more innuendo.
- Any previous diagnosis will be denigrated or dismissed, basically indicating that your complaints are not due to the accident or that your problems may even have been caused by a treating doctor. The key word here is “iatrogenic”. The most perverse tactic is simply the declaration that there is nothing wrong with you.
- There will be a high density of “medical” assertions with few if any corroborative facts or explanations. Assertions and conclusions may often exceed the actual area of alleged competence of the “examiner”. A neurologist is NOT a psychiatrist. An orthopedist is NOT a rheumatologist, etc.
- There will NEVER be suggestions for further tests ruling out other possibilities. The whore knows what the answers “are” before ever laying eyes on you; he does not want the truth known.
- And there will or may be attempts to shift your genuine physical injury onto a psychological problem! This is often seen in injured people with back pain or neck pain.
- More often then not, should surgery be unavoidable, they will suggest the cheapest type of surgery, which is often the most inappropriate one! On one occasion an IME (who by the was was not even a qualified shoulder surgeon) stated that I needed to have my entire arm FUSED! Right! Not only is this a very outdated procedure with many complications, but in a young person, this irreversible procedure would take away any chances for me to have a little bit of function with a reverse shoulder prosthesis, which my renowned shoulder specialist (as well as two other second opinion specialist) recommend – but hey, this prosthesis is VERY expensive….