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, the medical panel, your rehab provider and even your own treating doctor.
Workcover insurers fail to disclose vital medical reports
Failure to disclose of vital psychiatric reports by Allianz to treating Doctors
A couple of days ago we received a copy of an email sent to AMS Consulting (a- ahum- leading provider of consultancy and occupational rehabilitation services) from the aggrieved father of an injured worker. The email was also cc’d to WorkSafe Vic and several people in the Vivtorian Parliament.
Mr [AMS] it has come to my son’s attention,and his treating Dr A that vital Psychiatric reports have not been disclosed from [my son] treating Dr and Lawyer for proper treatment and assessment .The numerous reports warranted by Allianz to be assessed by (IME) in particular his long term case manager [name] have not been shown to the above mentioned people.
A recent questionnaire was sent to his treating GP with out the IME reports being forwarded for his viewing and making a proper assessment and future treatment which the IME have clearly stated that he be reviewed in twelve Months time and further more my sons treatment to be closely monitored due to no improvement in he’s mental state of mind.
Mrs [Allianz Case Manager] was asked in a recent letter which was written by [my son] and helped by me [name] his mother on why the reports were not sent to his doctor for referral before the questionnaire was filled out.
She did not respond to why this had not been done only to write another letter stating that she believes that my son has a capacity to return to work on the return to work questionnaire.
Dr clearly stated on my sons recent visit on the [date] that my case manager did not phone or write to him as asked of her and explain why his reports were not sent to him by the case manager before making a decision on the questionnaire of which was answered without viewing the psychiatric report.
Dr [A] did in fact state my sons mental/Psychiatric state should be evaluated by a medical panel which is up coming which in turn will determine his current and future prognosis.Mrs [Alianz case manager] knows of this as well, but has clearly demonstrated to hold back valid psychiatric reports to my sons treating Doctor of treatment/valuations for the purpose of denying my sons rights of a fair and legal medical based assessment governed and passed through work cover legislation.We urge you to review this as other health care advocates within the Victorian state,and federal MP’s have also received this letter for investigation.
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Xchanging hides crucial evidence from IME
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!
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.
Has your workcover case manager deliberately withheld crucial medical evidence to your rebab service provider, IME, Home Help assessor, Medical Panel, etc… Please share your story and help us expose the real dirty tactics so commonly used by workcover insurers!
Shortlink: http://wp.me/p1MA9G-2Mm
Something similar is happening to me also. I have requested medical reports and circumstance investigation reports from the insurance company handling my claim (allianz) and have been sent only my original statement, not the full report, and have been told that they can’t send me my medical report, but that they can send it to my doctor. Of course then I had to request that they ACTUALLY send it to my doctor. It would be highly beneficial if the names of these parliamentarians were accessible to all, we as injured workers need to start lobbying those people to change this system, it absolutely STINKS!!!!
The email was sent to the following:
david.davis@paliment.vic.gov.au ;Complaints@health.vic.gov.au ;enquiries@health.vic.gov.au david.davis@parliment.vic.gov.au mary.wooldridge@parliment.vic.gov.au ;
You should also email the workcover Minsiter Gordon Rich Phillips (VIC)
Hi again the topic above which is about work cover agent from Allianz failing to disclose vital medical/psychiatric reports to treating doctors and lawyer is actually me.to up date on what has happen as far is the following.The recent IME which I was sent to was sent reports dated back as far as five years ago,YEP that’s right five years ago.The IME that reviewed me noted that the former reports were in fact out dated and had no relevance to the present review been conducted on that particular day.You see the case manager deliberately tried to in force a view to the IME that if I was reviewed in the past by another IME stating a return to work assessment would be a good idea for the sole purpose to see if my slight improvement would warrant some sort of rehabilitation but clearly stated that it did not mean that it would be probable to return to my normal work in a pre injury state.The IME also clearly stated that he believed I would not be able to cope simply because of the medication I’m taking and most importantly my psychical/mental state would not be looked upon as a valued nor suitable candidate for any sort of work.
Even with this said the IME clearly stated that it’s a questionable task that should be assessed but concluded it would be a waste of time.The Allianz case manager regarded this as a Great chance for a rehabilitation assessment be conducted simply because the IME thought it would be minutely possible to do so.The case manager then arranged me to see a rehab agent and we decided that a basic computer course that is equivalent to a grade six (introduction) to computers would be a good start.I attended the course,a three month duration.I asked the lecturer what prospects would I have in obtaining a job after the course was completed?,she replied by saying “this course is just a introduction it will not help you apply for a job”Mmm I then asked the lecturer what if I failed the course?,she replied no body in this class will fail even if you get a score below the required mark”. I then thought to myself what a waste of time and money.My score came in at 35 out of 100, and I received my certificate just for attending the course.
This is just a stepping stone as told by my case manager,” The world is your oyster with a shiny new pearl waiting to be seen touched and admired by all who endeavor to reach out and discover the endless possibilities that await you,if you seek you will succeed”.Now my case manager is poet further more a philosyfer
Dear Annie
It is quit clear under and accordance with section 107A of the Accident Compensation Act 1985 of the work cover laws and legislation that you have every right to obtain any IME reports.Allianz knows this and by law they have to submit any document,medical reports,independent medical reports.Basically what Allianz is trying to do is to make you stressed out and mis lead you,They have to submit anything that concerns your health reports available on written request.If they still refuse to do so then your options
are as follows.write a letter to to Merlin David release of information Co ordinator.phone number 03-92343601 or fax in written format to 03-86158610.This person is responsible for granting the release of any information,reports etc.
If you have a legal representative this can be down by them,but remember they will charge you for any written request that involves such confidential reports.Just remember Allianz will try to hide anything that they do not want you or your treating doctors from seeing,especially if it is in your favor.further more phone WorkSafe Victoria and explain your situation and demand these reports be released at the earliest time.Also state the reports are needed for assessment for treatment by your doctor.This will actually shock Allianz because you know your rights and will pissed of you know what they don’t want you to know.Make sure your claim number is included in your letter to.
Mr Terry Towell who is the managing director of Allianz Australia Limited can also be contacted who will see into why your case manager has refused to disclose vital IME reports from you as well do state your knowledge of your rights to him as well (mentioned above). You can find his contact details on the home page of Allianz’s web site.The postal address is GPO Box 9863 Bribane QLD 4001.
Don’t let the dogs(Allianz) intimidate you because that’s their intention and are trained by lawyers,and independent
specialists in these areas.
Best of luck and don’t forget YELL AND SCREAM like Erin B says after all your human not a dog like these insurance monsters who get paid by your employers to do the dirty on there behalf. Remember knowledge is power.
Kind regards
Al a Workcover Victim.
Thanks Al for the excellent tid bits. Just as a precaution, it is best to always refer to the state of the legislation you are referring to as the workers comp law varies from state to state.We don’t want to confuse our readers as we are covering all of Australia now, although we still mainly focus on VIC and NSW at this stage.
For example there have been recent changes made for example to the GIPA in NSW (obtaining information under FOI basically)there are restrictions in place now as well as a fee in some cases.
Also with re to obtaining copies of IME psych reports, it is still usual practice for insurers not to disclose those directly to injured workers, however you can request a copy to be sent to your doctor.
For more info on Freedom of info stuff, simply click on the colourful tags “FOI” on the right handed side bar to view the related articles we have + sample letters.
Your absolutely right mate,I did forget the recent changes within the states,and one must comply with the new restrictions that are in place.I guess I’ve been lucky because my case manager is being pressured by my doctors,lawyers and other health care advocates which have found her merits in managing my case misleading in so many arrears.
So yes it does not apply to every person,further more it also depends on the situation the injured worker is in and the relevance of the injuries sustained.the rights to obtain your medical reports under section 107A is for the Victorian Accident Compensation act 1985 and is different like you mentioned to other states,A very valered point.But you did fail to mention that Insurance companies don’t make up the rules and have to comply with the AMA guidelines,the same applies to injured workers.we to have to comply with the protocols to obtain any sort of document,reports so on.Thanks for out lining the difference.Cheers Al
Kind regards
Al Workcover victim
When you have to attend an independent medical examination or the medical panel, always make sure you ask them to see the Schedule 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. Always take all your own medical reports (Xrays etc) with you and make copies of the most important ones so you can give them to the IME, Panel, rehab who-ever and there is NO excuse!
You have a right to see the schedule of attachments and you have a right to submit additional information!
Note with the Medical Panel, additional information should be submitted prior to the appointment (can be done via email).
Also WorkCover/WorkSafe guidelines clearly state 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.
Allianz (Xchanging etc) 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.
for NSW for example, 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.”
[note from Admin: comment taken from a previous comment from “the question is…” posted under comment from here http://aworkcovervictimsdiary.com/2011/09/workcover-only-provides-very-selective-material-to-independent-medical-doctors-and-medical-panels/}
Make sure you not only complain to WorkCover Authority (i.e. workcover NSW/ WorkSafe etc) but also to the MINISTER of WorkCover.
These are very serious matters and are unfortunately an etremely common dirty tactic used by all workcover insurance companies.
In Vic this is Minister Gordon Rich Phillips.
I had the same happen to me 3 months ago.
I asked this so called independent Dr if he was provided with this information he said yes i asked again he said yes and kept telling me that he had everything; I asked how would you know if you had everything unless we compare what I have with me and what you have not been provided with, he kept going on that he had everything. So the so called examination commenced not 1 minute into the so called independent interrogation and examination I pointed out that he was missing vital information regarding my injury, he then had to admit he wasn’t provided with that information. I again stopped and suggested we compare information to see what else the insurer had intentionally left out, again he declined. Further into the Interrogation / Examination I pointed out that he was missing this Particular piece of information he acknowledged he didn’t know about it and again refused to compare my material against his material.
So I made a comment with words to the effect : If You are independent, then why are you not interested in the truth, I understand that the insurer is paying you, don’t you feel deceived that you were not armed with all the information?
He ended the so called examination and told me that he had enough to go on, I said whatever and left.
Guess what I was lucky, he shafted them in his report and they had to pay for it. perhaps my words got to him as well.
We the injured should be able to record these so called Independent Dr’s etc…..After all we are recorded by Private Investigators against our will.
Congratulations on the way you handled that. Very good indeed!
Fantastic “injured 123″ that was a brilliant and inspiring way to deal with that situation! Thanks also “workcovervictim” for all of that contact information.
I wish I had the balls Injured 123 has!
When discussing the issue of ‘missing’ medical reports for IME’s it should be noted that if you have legal representation, that you discuss the issue with them. I was made aware of an injured worker who has been told that if their legal team want the IME to have a report or reports, they will give them to the IME.
My understanding of this is that in a case before the courts or medical panel, the fact that the IME has not been supplied all available reports works in the favor of the injured worker.