WorkCover Victoria caught out doctor shopping!

judge-slams-VWA

In a recent case, a Judge slammed the Victorian WorkCover Authority’s conduct about doctor shopping -that is using public monies to obtain unnecessary multiple medical reports from independent medical examiners in the hope to find one that will say what they’re after.

WorkCover (Victoria) appeared to have gone “doctor shopping” in the case of a worker claiming compensation for a spinal injury, a judge says.

In a recent judgment, County Court Judge John Bowman said the Victorian WorkCover Authority had had three neurosurgeons examine a man who suffered a back injury at work.

The state of Victoria and its agencies are required to behave in legal proceedings as “model litigants”.

Judge Bowman said: “It is not the role of a model litigant to continue to expend public monies pursuing medical reports from additional experts in the face of opinions adverse to it from experts already consulted, in the hope that, sooner or later, someone will say something which gives it some comfort.

 

“If the ‘neurosurgeon’ shopping reflected a win-at-all-costs approach, that would be disappointing.

“It may be that there is some other explanation for what occurred, but it has an unfortunate appearance.”

Judge Bowman granted Steven Bates, 44, leave to sue for damages.

The judge said that despite accepting liability, and the overwhelming weight of medical evidence, the VWA had contested the cause of Mr Bates’ condition.

Maurice Blackburn’s Kim Shaw said Mr Bates had been subjected to unnecessary examinations so the VWA could get the medical opinion it wanted.

“The VWA had no support . . . for opposing Steven’s case and wasted public money,” Ms Shaw said.

WorkSafe’s Michael Birt said the authority was examining the judgment.

The court heard Mr Bates, who was wearing a safety harness, fell backward on to a pallet while standing on the pallet platform of a stock picker at Crosby Tiles. He was manually moving boxes from a pallet resting on the stock picker’s tines.

In the months after the May 10, 2006 accident, he developed numbness and weakness in both legs and increasing unsteadiness.

After the removal of a cyst compressing his spinal cord, damage to the cord was discovered, the court heard.

One neurologist opined that a cyst could be acquired as a result of spinal trauma, and believed it was a result of his back injury.

Other neurosurgeons and an orthopaedic surgeon believed the injury had aggravated an existing cyst.

Judge Bowman said it was probable the cyst had existed before the accident.

“What is clear is that such a traumatic event led to the exacerbation and deterioration of the condition, if it was pre-existing, with resultant development of spinal cord compression and damage.”

Thanks God, the Judge slams Victorian WorkCover Authority’s conduct!

[Source: Herald Sun]

What if we, the workcover victims went doctor shopping like that? GP after GP, specialist after specialist until WE got the ANSWER we WANTED? Until we got all the benefits and treatment we wanted and much more? What would workcover think about that. Huh?!

 

As I mentioned in a previous post or two, my case manager has sent me to no less than six (6) IME’s over a period of 14 months!!! It was so obvious that she was extremely desperate to ‘find a way out’ and to obtain the answer she wanted. Unfortunately for her, she got herself burnt even more, for some of the IME reports revealed an even worse injury and suggested I may NEVER be able to return to the workforce all together. So how can you justify the spending of what, around $5000 on medical reports in the hope to save perhaps $200 on something like physio or psychology or a taxi fare here and there!

The other thing that I have noticed is that if and when the workcover agent sends you to for example two (2) different IME, let’s say for assessment for taxi transport, and those IME reports both strongly support taxi travel, but then, a few weeks later they receive a letter from one of your own treaters, like a physio or chiro whom you haven’t seen for yonks cos they cut that ‘benefit’ off ages ago, and he/she says that you don’t really need taxi travel, they will revert to your treater’s letter as “evidence”!!! This is just unbelievable and is, indeed, nothing else but doctor shopping.

 



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7 Responses to “WorkCover Victoria caught out doctor shopping!”

  1. How on earth can they justify this kind of expenditure? I mean they do this kind of doctor shopping all the time, it begs the question on how they get a return on their investment…They must be doing some really really dirty scams (as in find many ways not to pay out entitled compensation to many victims) to just break even… In your case alone they have had a loss f about $5000 as they have not been able to cut off any “benefit” – so, where will they recuperate that money do you think? It’s just such a disgusting, unethical practice and most particularly because the prey like vultures on the injured, weak and vulnerable…It makes me sick just to read about it, let alone to undergo it myself.

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  2. In my case they wouldn’t fund a detailed report for twelve months and then I had to ask the neurosurgeon to reduce the price by $400.
    They kept saying there is nothing in the report we don’t already know, and then substituted a different report to mislead me the conciliator and the Medical Panel.
    Now even though they don’t want anymore reports they sent me to an IME recently to get him terminate my claim.
    They are the lowest scum on earth!!!

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  3. Hey
    I hear that a “wall street” type demonstration is planned for next weekend in Melbourne

    We should all go and show how Workcover treats us …….

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    • I tell you what will happen — you’ll be photographed doing something that will then be twisted out of reality — your payments will be stopped.

      WorkSafe doesn’t care.

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  4. It’s called “Occupy Melbourne” and it’s all about protesting corporate greed
    Its on at the City Square on 15 October.

    It’s being organized through facebook and apparently 3000 have signed up so far.

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  5. Hehe
    My payments stopped 8 years ago and my treatment was last week so I have nothing to loose….

    That’s what they want you to think so why let them win?
    This is a chance to show them we are not scared!

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  6. Found a good ‘article’ about IME’s A Bressington -Legislative Council (SA) June 2010 – http://www.bressington.net/Files/SpeechesPrivMemMotns/Independent_Medical_Examiners.pdf

    😉

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