A World of Hurt: the independent medical examination
Unfortunately, for William Cassone, the road to workers’ compensation led through the office of Dr. Hershel Samuels, an Independent Medical Examiner with the New York state’s worker’s compensation system.
In New York State, many IME “brokers” actually write the report for the examining doctor and simply send the doctor the finished product for signature.
Some IME brokers (entities) have been caught red handed changing the findings and degree of disability of their own examining physicians. I know – I’ve seen the changed reports – as this was proved in the scathing NY Times series in 2009 exposing IME Dr. Hershel Samuels. (see video below).
As Dr. Samuels nonchalantly stated on the video:
If you did a truly pure report….you’d be out on your ears and the insurers wouldn’t pay for it. You have to give them what they want, or you’re in Florida. That’s the game, baby.
How’s that for honesty, ‘baby’!
We all know that this very same type of of IME FRAUD is happening here in Australia too, man, it’s even happened to me! I have been gobsmacked on numerous occasions just reading through some of the so called independent medical examination reports.
Examples include:
- that my so-called reflex sympathetic dystrophy (aka chronic regional pain syndrome), which was diagnosed by a very reputable and world-renowned pain specialist (and involves quite a few tests such as temperature testing of both limbs etc) is nothing more but a ‘bluish discoloration’ because I am keeping the “arm dependent”, obviously omitting that I have been wearing arm sling for the past 2 years (which keeps the arm/hand above heart level and therefore could not explain your arm/hand turning BLUE)
- that I have an old ring finger injury (correct) which resulted in a partial amputation (correct) but also an ulnar LACERATION (since when) and therefore my little finger is permanently bend (unable to straighten). That this little finger became bend is in FACT the result of a NERVE injury following surgery to the arm in 2009 and nothing more
- that I have “normal range of movement” in the elbow – where in FACT my elbow has been stuck at 30 degrees for over 2 years because I have been wearing a sling for so long (and workcover ceased my physiotherapy), and the elbow has thus become STIFF as a consequence
- that I have “normal neck movement”, whilst the fact is that I can’t even turn my neck to left because of extremely severe and constant muscle spams because my neck is trying to keep my shoulder in its socket
- one report stated that I can ‘freely do overhead movements’ (as for work) – whilst I have NO movement in the right arm at all
- oh and that my severe depression is CAUSED by the fact that I am upset that my (elderly) parents were unable to visit me when I had a cardiac arrest during surgery (for surgery to the arm)!
- etc etc.
What about your independent medical examinations?
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Another fraud accused injured worker entitled to workcover!
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Federal Court ruled AAT required to explain why it preferred the IME’s evidence
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Wake up call for medical report writers
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Hired Gun – a must watch video
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When work is not “a Significant Contributing Factor” to causing the work injury: a painful story
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Medical assessments and bosses – injured workers rights
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Injured worker jailed for compo fraud (Vic)
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Will you be charged a percentage of your compensation payouts? NO!!!
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Workcover case manager wish list for 2013
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When the workcover system lets you down…
Beware of workcover offers in relation to your impairment assessment as undertaken by the workcover IME of choice!!!
Some of you (injured work cover victims) will have your injuries assessed by a so called independent “specialist” workcover doctor and will then be offered a lumpsum according to your impairment rating. That impairment rating is often dishonest and thus that lumpsum is often up to 5 times less that what could be achieved. Also in some states, by accepting a lumpsum offer, an injured worker loses all rights to pursue a common law claim for damages – make sure you seek proper legal advice before you accept a) the impairment assessment from the workcover doctor (you can appeal the assessment at the Medical Panel!!!!), and b) before you accept a lumpsum payment!!!
I am disgusted! This is the kind of video clips they should show on TV instead of the 60-minute-type-oversensationalised “workers ripping off the system”.
It’s happening EVERYDAY in Australia as well. I just have to look at my own “impairment assessment report”….
Remember that you can appeal (and SHOULD) your impairment assessment at the Medical Panel – at least it consists of a Panel of at least 3 doctors, harder to cheat. I have personally been very impressed with the Panel in Victoria, they are very professional and very kind. My impairment rating miraculously jumped from 14% to 20%… hmmmm.
The workcover insurer, will CHOOSE the “impairment assessor” they will send you to, just like they choose the IMEs they send you to… if that doesn’t say it clear enough!
Don’t get ripped off! We are only “entitled” to so little considering our injuries.Many of us barely make 5 to 15% and are unable to pursue a common law damages claim for pain and suffering or for loss of earnings, even if we can never work again and suffer the most unimaginable pains for the rest of our lives. Contrary to the public’s opinion, most of injured workers will just get a little “lumpsum” of around 5 to 10,000 in “compensation” and that’s it for the rest of their lives. And for that they need an impairment assessment of at least 5% for arm/back or 10% for another body part! So that’s why it”s already so hard to even get 5%. It’s about mitigation! Make sure you have a lawyer and that you never agree with an impairment assessment without legal advice and never ever accept an offer (lumpsum) without legal advice!!!!!