The following is a kind of generic letter to an IME psychiatrist in which I take up many real issues in reports written about me over the years, and challenge the IME about their role in this system.
Dear IME Psychiatrist,
Further to our pending assessment appointment, I wish to clarify and correct some of the information that has appeared in some of my previous IME reports. I have noted to my psychologist several times in the past that often within the context of these examinations, I give answers for the sake of providing an answer without being able to be clear as to the reality of the statements I make. I find the questioning process and the confusion I suffer in these stressful situations makes me feel compelled to give an answer even when I don’t have the clarity and access to my full memories to know the precise truth of what I am saying. This means that at best my answers provide only a small slice of information about the issue, and at worst my answer may actually be misleading. I have noted that this sometimes occurs when the IME uses a “rapid-fire” questioning technique that does not allow me to fully answer one question before presenting me with another. I would ask you always to give me plenty of time to answer any question you have before moving on to another.
I would also like to take the opportunity to counter some of the erroneous opinions regarding my character as a person and personal history “facts” presented by previous IME’s .
- I do indeed care about the rights of others. The IME who reported me as saying that, “I don’t care about any one else’s rights,” actually made that statement up. That same IME stood up over me and shouted at me when I was crying during the interview. That fact should tell you something about the nature of that particular IME. His whole report (July 2003) was tainted with bias against me. My personal history as a social justice activist and volunteer in my community should let you know that the IME’s statement was false and intended to demonise me and personally humiliate me at a very deep level.
- No, I don’t believe I have a “huge sense of entitlement”. I simply anticipated that Workcover existed to assist me to recover from workplace injury and to compensate me for any loss, and that workplace bullies would be called to account for their actions.
- Yes, I do feel “rage” and “resentment” about what happened to me at work. The bullying from colleagues and employers alike were in direct contravention of workplace policies and procedures, my contract of employment and the workplace bargaining agreement. My rage and resentment were predictable reactions to the bullying, but these emotions were not driving my behaviours when I returned to work. Nor were they fueling my Major Depression, as I was returning to work part part-time in order to deal with the issues.
- Yes, I had a somewhat impoverished and dysfunctional childhood. Is that something that should be used to punish me now and to argue that my childhood trauma was the cause of my injuries. I had forty years of studying and two marvelous careers in the interim.
- Yes, my father was a bully, an erratic unpredictable one, but he was also many other things. He was a person who tried his best for his many children, and was often kind to us as well. As an adult, I now understand that his violent outbursts were the result of post traumatic stress disorder from his war service on the Kokoda Track, which became severely exacerbated in the 1960’s when he lost his beloved farm and his livelihood to a bank foreclosure. You can well imagine what such traumas would do to the mental health of a worker with a wife and nine children to support.
- No, my father didn’t work on a “corn boat”, not that his employment forty years ago would have any impact on my current workplace injury. When coupled with information about our poverty as a family, the dysfunction caused by my father’s war service, and the sheer size of my family of origin (eleven members), I start to sound like I’m being tarred with the discriminatory brush that produces such terms of abuse as “trailer trash”. It is these subtle demonisations of the injured worker that I’m sure allow disreputable IME’s to victimise that injured worker even more.
- Yes, one of my brothers does have what appears to be a serious undiagnosed mental illness. He descended into this condition following an extreme trauma which he suffered in the late 1990’s. So extreme was this trauma that it could have had the same outcome for any human being. I do not intend to supply more information than this in relation to my brother as I am aware that everything eventually ends up in a Workcover file, and this would be a breach of his right to privacy. He is not the Workcover recipient here – I am, and in truth I have seen very little of my brother in the past 20 years as he lives in another State.
- Yes, I was raped twice when I was eighteen, and it did have a traumatic effect on me. However, I had two careers, loving relationships and worked successfully for many years before the first episode of workplace bullying diminished my mental health. Even after that I studied, raised my two children, and eleven years later, found permanent work again. Both events of workplace bullying I’ve experienced (1987, 2002/3) have triggered those long forgotten traumatic memories. I would suggest that common characteristics of these traumas – the over-powering strength of a mob at work, the complete disregard of my personal autonomy and human rights, the demonisation of the victim – are very akin to being raped.
- Yes, I once had a partner who was violent with me. I left him quite quickly, and though it was a shock to be a single parent, I am pleased with how I responded to his violence and managed the situation. That was thirty years ago, and I continued as a worker for another five years until the first experience of workplace bullying broke my mental health.
- Yes, like so many women of my own age, I am menopausal. I have noticed that many IME’s seem to diagnose this as the cause of my mental problems. They also make the same diagnoses for other female injured workers or a similar age who I’ve met. In the fact the paragraph used by one IME I saw, was exactly the same, word for word, as the paragraph he applied to another injured worker who showed me their assessment report. I don’t think menopause is why I had a breakdown. My periods were on a very regular 28 day cycle, and they ceased immediately when I had the breakdown from the bullying. No gentle tapering off, no hot flushes prior, no mood changes (I was fortunate to never suffer from PMT). I menstruated once more two and a half years later when I was finally under care and treatment from a psychiatrist and feeling a little better. Two weeks after this, I was bullied again by the Employer and my claims agent in tandem. I never menstruated again. Could I say the Workover frightened me bloodless? I do think it’s a long stretch for for any IME to say that it is menopause that is causing my problems, particularly since the only information they elicited from me in interview was the very bald statement that I was menopausal.
- IME’s have reported on my involvement in de facto relationships. I found this question confusing as “de facto” is a legal term and meaningful relationships can occur for long periods without the parties ever living together. Consequently I gave quite a misleading answer. From the age of 20, I was in a total of 4 relationships that I would call meaningful, and these relationships lasted for a total of 10 years. Since my serious injury in 2003, I have not had a meaningful, couple relationship as this possibility has been precluded by the injury. Apart from that pertinent effect, I do not understand what my relationship status, or my fifty year old, deeply personal family history could possibly tell you about my workplace injury or my capacity to return to work.
- My study has been commented on by IME’s as me trying to establish and alternative career for myself. It was, but more than that, it was also an attempt to give me a sense of future, a counter to the hopelessness and helplessness inspired by workplace bullying and the Workover. I actually studied a total of seven semester length subjects from 2004 to 2008. I ceased study after this as my capacity was being severely affected by the post traumatic stress disorder. The course I had chosen relied heavily on “group work” and I was becoming less and less able to deal with being in groups. I had a number of “episodes” on campus whilst studying and completely lost faith in my ability to continue studying in this way. My inability to work in groups arises directly from the circumstances and nature of my workplace injury. At work I was subjected to a specific form of bullying known as “workplace mobbing”, and this has sensitised me to the point where my symptoms begin to manifest whenever I am in groups of more than 3 or 4 people. I have tried to counter this symptom over these many years by joining groups in the company of a friend. For example, from 2005 to 2010, at my own cost, I regularly attended a twice weekly Aquarobics group at the local pool and a weekly Tai Chi and Qui Gong classes. I could only do this because I had a good friend who was willing to participate in the groups with me, and enough financial resources to pay for the sessions. I also belong to a community singing group, again accompanied by a friend. I have been unable to attend this group for the last four weeks due to the increase in symptoms brought about by the approaching “psychiatric examination”. I am also no longer in a position to pay for my gym membership, or to maintain regular attendance in groups so this therapy is now denied to me.
- Yes, I do use marihuana. I am not a continuous daily smoker. Lack of money, the desire to do things that are not compatible with being stoned (e.g. driving, visiting friends, looking after my granddaughter), all serve to mitigate my use. I find it useful in general for reducing the jumpiness and hypervigilance which I experience when my symptoms are stirred up, and for dream free sleep. I have had many long breaks from smoking throughout my life, some of several years duration when I was bearing and caring for my children. Most recently, for example, I did not smoke from April to July last year as I was homeless and travelling day by day in my car, and I did not want my driving to be affected. I am also not smoking it at the moment as I need my money for other more pressing necessities. I stop using pot easily, and apart from poor sleeping, and somewhat heightened hypervigilance, I do so without any noticeable distress physical or mental. I do not believe this is an addiction, but, like a glass or two of wine, it is a comfort seeking behaviour.
- I do smoke tobacco quite intensely during and following up any exacerbation of my workplace injury. It’s unhealthy and expensive and I wish I didn’t. I keep trying to give up. I ceased, after many many attempts, through my own efforts in early 2009. I remained tobacco free for the next two years, until I experienced a severe retriggering of the ptsd symptoms during my first camping experience after I became homeless. I have smoked heavily since that time. It is an addiction, and one that I have seriously struggled with whenever I am in a better state of mind.
- I’m not addicted to alcohol. I realised in my 20’s that I’m allergic to spirits and avoid them like the plague. I do occasionally have a glass of wine with my meal. I probably get through about 12 bottles of wine a year, all of which are shared with friends.
- My claims manager doesn’t want to know about my desire to return to work. Despite my many contacts with the insurers in regard to the issue of return to work, IME’s never ask me about my desire for retraining and my desire and need for paying work and the efforts I made to obtain these. FYI I have included two of the many letters that I wrote to CGU – the company that was then my case manager. My compensation claim was settled in October 2008, and I made many attempts over the next 18 months to get some retraining and return to work assistance, all to no avail. My attempts were met with silence at first, then insults in the form of very humiliating and frustrating communications from the insurer – as you will understand from the enclosed letters. Lack of work, with the daily personal feedback and the financial support it provides is contributing to my ongoing psychiatric injury.
- I do have a very serious addiction to poker machine gambling. With regard to that, I am unable to access my bank statements at this point, but believe that I began gambling again sometime in 2010, possibly in September, but I am not sure as it occurred once again in conjunction with a dissociative episode. I had been in remission from this dreadful condition for over 5 years. I believe the gambling recurred in this way because I had reached the end of hope and had an exacerbation of the Major Depression as a result of my fruitless attempts to secure my future through retraining and return to work.
- I am not litigous. I do not have any other current compensation claims. This one, which now only provides me with weekly counselling sessions, and my psychiatric medication is the only one. I must say that I consider the use of the term “compensation” in relation to Workcover claims to be an abuse of the word.
I understand that in the context of the examination, you will simply be asking the questions that the insurance company provides you with. My question is why? What does any of this information, particularly the deeply personal information about family and relationships, have to do with helping me to recover and move on? There is no longer any legal question in relation to the source of my workplace injury. Or is it what I think is happening – the insurer is simply making use of IME’s such as yourself, to extract information that they can use in the event of a legal case, and to further incapacitate me with an upsurge of symptoms. Since the legal case has reached settlement long ago, this also doesn’t make sense, but perhaps it’s a case of the machine continues on its’ blundering course regardless of what is happening in reality, and with complete neglect of the impacts upon my personal health and well-being.
I note that I have not been assessed since the end of the legal case in 2008, and that this current assessment was organised only after I had contact with the insurer to again seek employment counselling and retraining. Apart from making this appointment, they have left me sinking behind the wall of silence in relation to that request. I note too, that you were not provided with any brief in relation to assessing me for retraining or return to work. I further note that the reports supplied to you by the Workcover insurer were extremely selective, over three years old, and included no recent reports from my treating practitioners. They did not even send you my Serious Injury Certificate and accompanying report.
I apologize for taking more of your time in regard to this matter, but feel that since you are supping from the Workcover trough, and inadvertently being used as a carrier of the cruelty of this system, then you deserve to know just how polluted the water is. I thank you for allowing me to bring a friend into the examination with me. I also thank you for allowing me to supplement my dysfunctional memory by allowing me to record the assessment interview. Without a support person with me, without the sense of safety and protection that provides me with, I would normally experience months of surging ptsd and depression symptoms following on such an assessment. Indeed, instead of being in “fight” mode with the ptsd, as I currently am, I would be in “freeze” mode struggling with continuous suicidal ideation, as has happened in the past.
An Injured Worker.