If the IME expresses bias in your assessment report, Complain Complain Complain

workcover-complaints

“This IME Psychiatrist saw me for the second time in 6 months in the wake of the severe bullying I incurred on a Return To Work. He stood up over me and shouted at me during the assessment, at a point where I was crying and having difficulty articulating my thoughts.  I can’t prove that can I? We were the only people in the room that day.   He then went on to write a very biased report about me, a report which led to my Workcover claim being denied….

…I wrote a complaint about him to the Medical Practitioners Board of Victoria in relation to what I believe are behaviours that breached professional standards and showed severe bias in a situation that demanded independence of opinion. The Board neglected to refer in its findings to this part of my complaint. Yeh, that’s right. Just another cloak of silence and invisibility thrown over just another little screamer on the scrapheap of the Workover.   That was six years ago, or more. I’m not the person I once was, I don’t have the same capacity and energy in life that I had before my workplace injury, but I’m still here, and because I still need regular psychological and medical support, I’m still in the Workover war. It’s a war I didn’t ask for, and it’s one they won’t let me leave. So here we go, I’m here, and I’m not leaving this war I didn’t ask for until it’s over, really, really over. I’ll know it’s over when I am confidant that my children’s and grandchildren’s welfare in the workplace is protected, respected and upheld, and that no worker suffers financial loss without proof of their own personal culpability in causing the workplace injury.   I’ve included below an edited copy of the complaint that I sent regarding his bias and breaches of professional standards.”  

If the IME expresses bias in your assessment report, Complain Complain Complain

By Survivor

 

 

Complaint re IME Psychiatrist, Dr  X

Breaches of Professional Standards and Bias by Dr X in Assessment and Reporting re Pauline Pope (July 4th 2003)

Bias in Dr X’s process of reporting and assessment.

 Assessment that is unbiased requires a careful weighing of all the information provided in a given situation. In this situation information was provided to Dr X in the form of:-

  • statements from my employers and co-workers;
  • medical reports and signed “Capacity for employment” declarations from my treating practitioners (Dr Y and Dr Z);
  • Dr X’s own report of his interview with me in November 2002;
  • an opinion from the Medical Panel comprised of  a Psychiatrist), an Occupational Physician, and an Orthopaedic Surgeon
  • his current 45 minute interview with myself.
  • A written statement from myself .

For a summary of the information supplied in the written submissions, see Appendix 1. These documents contain much information that is consistent with the view that I am a worker who has sustained a psychiatric injury as the result of work-related stress. Dr X says that he has read these documents, yet his analyses and opinions show little relationship to the information that was presented to him.   In Dr X’s report the bias is evidenced by these facts:-

  1. His report contains many inaccuracies and misrepresentations of the information that I provided to him during the interview. Since I have also provided him with an 11 page document which repeated many of my concerns in writing, it cannot be argued that this misrepresentation is the result of poor memory, or lack of time in the interview.
  2. He fails to present an evidence-based approach in evaluating symptoms and clinical findings.
  3. He makes assessments which are inconsistent with one another, and with the other information and evidence available to him. He expresses preferences by selectively filtering information and evidence relevant to the situation. This is apparent in his failure to pay credit to information from my health practitioners who clearly had more information about my illness, and “normal” character.

I will now illustrate the process of bias at work in each of the factors listed above by addressing specific points in Dr X’s report.

  1. 1.His report contains many inaccuracies and misrepresentations
  1. On page 2 of his report, Dr X states that:- “She expressed the opinion that she did not care at all what the employer’s rights were. All she said that she knew about were her alleged rights.”
  2. On page 4, he further states:- “She emphatically protests that her rights are important and that nobody else has any rights.”

The slippage between these two different versions of what Dr X alleges I said is obvious, and it indicates of a lack of rigour in his reporting. I did not make any statement that could be interpreted in either of the two ways suggested by Dr X. I would never make such a statement as it runs contrary to my personal belief system. I am extremely cognisant of “rights” as a fundamental building block in the construction of a democratic and free society.  I have spent much of my working life in employment focussed on achieving social justice through the delivery of human rights. From 1978-1987, I worked in a program that assisted unemployed people, and that sought to establish reasonable social structures to support people who were without employment. During this time, I was involved both professionally and personally in activism and lobbying on the issues of people’s rights to employment, a liveable income, and housing. From 1998-2002, I worked in a community legal centre, where again great emphasis was placed on people’s “rights”. During this time, I was involved in working on issues such as domestic violence, the rights of refugees, and the right of all citizens to access free legal advice and information. I have always been a committed and active unionist, and have been fully involved in the ongoing struggle to protect the rights of workers. I have also worked at various times in other social movements seeking to establish rights for marginalised people, in particular the indigenous people of Australia.

  1. On p. 3, Dr X reports that:- “She had previously had an addiction to poker machines accompanied by the presence of dissociative episodes. These problems had been present before the events that she alleges had stressed her at work. However, she complained that these issues had been under control 12 months ago. She complains that because she felt isolated in the work place and frustrated by her WorkCover difficulties, she started gambling again and that she became dissociated again. On the 8th April this year, after attending a funeral she went gambling.”

 I do not recall saying that the “WorkCover difficulties” had anything to do with my gambling relapse. I doubt very much that I would have said this since I felt very strongly that my problems were attached to the kinds of harassment that I was being subjected to by my employers and my co-workers. In fact, what I reported to Dr X in my written statement to him (Appendix 2 p. 7) was:-

  • That I was traumatised by the staff “mediation” session (on March 7th) which I experienced as dumping session on myself and my friend who had complained of discriminatory treatment in the workplace.
  • That I later sought right of reply, which was rejected by my co-workers.
  • That I cried each day on the bus home from work.
  • That, after the “mediation” session, I began to have dreams about playing poker machines.
  • That, my gambling addiction had not been active for over 12 months prior to this.
  • That on 8th April, I attended a funeral, and subsequent to this, I experienced a dissociative episode and began gambling again.

The dissociative episode was preliminary to the act of gambling.  This is an important point for me, since Dr X’s reporting gives the impression that the gambling relapse caused the dissociative episode, when in fact, it was the dissociative episode which enabled the gambling relapse.  The dissociative episode was a result of the stress caused in me by the many personal and unremitting attacks that I was subjected to at work.  

  1. 2.      He fails to present an evidence-based approach in evaluating symptoms and clinical findings.

 

  1. “She alleged that all of her problems were due to these (work) factors, despite the fact that she had been depressed previously and in fact she had a history of dissociative episodes associated with compulsive gambling before her present psychiatric injury.” (p. 2)

The facts are that my previous depression was, as reported by the Medical Panel, significantly contributed to by my work situation. I do have a history of dissociative episodes which contributed to the development of a gambling addiction. I had been completely free of this addiction for a period of eight months prior to seeing Dr X for the first time. The Medical Panel actually interviewed me over two separate examinations which took approximately two hours, and involved three practitioners. This was a great deal longer than the 45 minute interview with Dr X. The doctors and psychiatrists on the Panel are his professional peers, yet he disputes the Medical Panel findings on the matter. As someone who works for Workcover, he should be fully aware that this opinion is also a legal opinion and is indisputable.

  1. Quite properly, her employer told her that she should await the results of a return to work plan.” (p. 2)

Again, Dr X should be aware of the laws governing the construction of a return to work plan. A return to work plan must be negotiated with the worker and their own doctor, and it must be done by the time the worker has been absent from work for 10 weeks. At the point when I requested to return to work, I had been absent from work for six months, and no negotiations regarding a return to work plan had been commenced by my “responsible” employers. After I flagged my intention to return to work with my employer, I was presented with the return to work plan as a “fait accompli” in that it was stated by my employers that I could only return to work if I agreed with the terms of the document and the accompanying letter. No consultation with myself or my treating doctor was ever entered into by my employers in regard to the construction of the return to work plan. In legal terms, there was nothing “proper” about the situation.

  1. “Essentially, the worker appears to have a massive problem with rehabilitation. She has never accepted the terms of rehabilitation and she was disgruntled about the return to work programme.  In this setting, she continued to believe that she was a victim of other people at work, the insurer and the WorkCover system.” (p. 4)

   Doctor X does not indicate what the “terms of rehabilitation” that he refers to are. He did not request a copy of the Return To Work Plan. There was no psychiatric rehabilitation offered to me in the return to work document. There was no addressing of the many psychological stress factors which I had clearly outlined to my employers in a letter written to them five months prior. My employers continued to withhold 20% of my wages for long periods of time. As a part-time worker, my take home pay was approximately $310 per week. I salary sacrificed 20% which was meant to partially pay my mortgage. It was this money that was being constantly withheld from me, thus causing severe anxiety and aggravation about my capacity to continue to pay my mortgage. This financial abuse continued in the same form during this time when I was only working half my normal hours for half my normal pay.   The return to work plan contained clauses which disempowered and humiliated me as a worker. It proposed to send me to a psychiatrist to establish my fitness to return to work, whilst at the same time either ignoring or proposing to continue many of the psychological stressors that I had indicated were giving me problems.   It gave power to other workers to decide when I was “fit” to return to work. Any medical professional should be fully aware of the inappropriate nature of placing such a condition within a return to work plan. They might also be aware that it is illegal to do so. Community workers and lawyers are not psychiatrically or even medically trained. They cannot make such a judgement. Most professionals would also realise that such a condition would cause humiliation and disempowerment to the worker.   The return to work plan was clearly a hostile and ignorant document produced by a hostile workplace. For example, it proposed to withhold from me, for a period of several months, aspects of my job that I had previously indicated gave me great satisfaction as a worker. It also clearly indicated the nature of my illness, thus breaching my personal privacy by giving this information to my co-workers, who then used the information to humiliate me further.   Dr X attributes the problem to me without giving any indication of the facts which lead him to this conclusion. He alleges that I was “disgruntled” about the Return-to-Work Plan (RTW), and that this feeling lead me to believe I was a victim. This conclusion suggests that he has given no weight to the written document that I gave him (Appendix 2). He refers to this document in his report when he says:- “She insisted that I read some detailed document about her claim that she gave me. I have certainly read these documents.” (p.2)   The document in question is an eleven page litany of abusive conduct towards me by my employers, my co-workers and the WorkCover insurer – conduct which had been both escalated and sustained for well over a year. Dr X had no reason to doubt my honesty or my integrity as a person. Yet, his report demonstrates that he does indeed doubt my honesty, and that he allows those doubts great weight in informing his opinions.   The avoidance of bias requires keeping an open and enquiring mind, and seeking all relevant facts and evidence, with the aim of providing a balanced opinion. Dr X’s opinions obscure or deny all information supplied by the Medical Panel, my treating practitioners, my employers, my co-workers and myself. The information thus obscured is that which suggests that I am a committed and diligent worker, a normally calm, agreeable and rational person, and that my work is causing enormous stress for me and is affecting my cognitive abilities, my behaviour, and my enjoyment and management of my life.   In doing this, he must reject the evidence and opinions of my own two treating doctors, and the three experts on the Medical Panel.  

  1. “She emphatically protests that her rights are important and that nobody else has any rights. Her allegations are of course unreasonable. I cannot determine whether or not some of her allegations about her problems in rehabilitation are reasonable or otherwise. What is apparent, however, is that it is her being in the WorkCover system that is the main cause of her current anxiety and depression.” (p. 4)

I deny the second half of this statement. I did talk about breaches to my own rights that occurred during the return to work process and about the impact that these breaches had on me. I did not say that “nobody else has any rights”.   Dr X admits that he cannot determine whether my allegations are reasonable or otherwise, yet he does not reflect on this further, or seek additional information to enable him to make a full assessment of the matters that I raised with him. The Medical Panel had already indicated that work was a significant contributor to my psychiatric problems. Again, Dr X ignores the views of his peers who have had a significantly greater opportunity to explore my health situation with regard to establishing the causative factors.    

  1. “She has a great sense of entitlement and this sense of entitlement and victimisation is driving her rage, her depression and her anxiety. “(p. 4)

Dr X gives no indication of the evidence that leads him to this opinion that I have a “sense of entitlement”, nor does he show how he measured the size of this “sense of entitlement” that he has attributed to me. I am doubtful that “sense of entitlement” would appear amongst the criteria and symptoms listed in any of the diagnostic measures used by psychiatrists.      

  1. “I believe that the worker has a capacity for employment but she is not returned to the workplace because of her sense of victimisation.” (p. 4)

  He does not give any indication of the facts which lead him to this conclusion. He did not, as I recall, have any discussion with me of my work capacity.  I was seriously ill when I saw him and, after seeing him, slipped into a suicidal depression. The list of symptoms that I described to him both orally and in writing would have made it obvious that I could not work. I was constantly crying, unable to do even simple daily activities like housework, or even cook for myself. I was unable to do anything other than try to get my claim accepted so that I would have access to psychiatric treatment to help alleviate my condition.   The “sense of victimisation” that he describes arose from the facts of victimisation. If Dr X had bothered to seek further information about my situation, and some enlightenment about the legal rights that workers do have, he may have realised this. If he had given any credence to my complaints then he would acknowledge that I was experiencing real victimisation which had traumatic effect and consequences for my mental health.    

  1. “I believe the worker would be capable of rehabilitation into an alternative job.” (p. 4)

Dr X, again, does not provide the facts which lead him to this conclusion. My self esteem had been shattered by the brutal attacks made on me by my co-workers in the “mediation” session. He himself admits that I was suffering depression and anxiety. How would I even apply for another job, let alone succeed in my application, given the daily crying, poor memory and concentration, and other cognitive difficulties that I described to him?      

  1. “Of course, the worker will continue to allege psychiatric incapacity because of her resentment and her belief that others should put things right.” (p.4)

Within this report, Dr X uses the word “alleged” or derivates thereof, a total of 14 times. A careful analysis shows that he uses it in relation to my own descriptions of my illness and symptoms, and its causation. He does not use it in relation to my statements about having a gambling addiction, my history of dissociative episodes, or my statements about my life history.   The use of this word is such that it creates in the reader the impression that Dr X considers me to be a liar. I am not such, and some further exploration of the matter by Dr X would have made this clear to him. Unless of course he believes that it is appropriate and of no consequence for workers to be denied their income for long periods of time, to have their private health information given to all and sundry, and to be subjected to humiliation by the public exposure of their health issues.        

  1. “I believe that the worker would be capable of returning to suitable employment if she gave up her belief that she is a victim. “ (p.5)

Dr X attributes my problems with work to my belief that I am a victim. He pays no credence to the facts of what I had experienced. I was subjected to victimisation through the processes of exclusion, isolation, denial of natural justice, financial deprivation, discrimination, humiliation and breaches of privacy which had continued for a period of over a year at this point.     4. Dr X’s makes assessments which are inconsistent with each other and with the other information and evidence available to him.     

  1. “What is apparent, however, is that it is her being in the WorkCover system that is the main cause of her current anxiety and depression.” (p.4)
  2. “She has a very great sense of entitlement and this sense of entitlement and victimisation is driving her rage, her depression and her anxiety.” (p.4)
  3. “She obviously had pre-existing psychiatric problems and these problems, I believe are the main cause of her current difficulties and her inability to accept rehabilitation.” (p.4)
  4. “I believe that her current psychiatric condition is primarily the result of her resentment and presentation of herself as a victim.”(p.4)

In the above four statements, Dr X variously suggests that the main cause of my injury is:-

  • Being in the Workcover system;
  • My ”great sense of entitlement”;
  • My “pre-existing” psychiatric problems;
  • My resentment and presentation of myself as a victim.

There can be only one main or primary cause, so these statements demonstrate the internal inconsistency in Dr X’s opinions. Once again he obscures other contributing information by simply filtering it out. He absolutely refuses to consider the possibility that I was indeed subjected to the treatment that I complained of.   All of the above statements are challenged by the facts. To have arrived at these opinions, Dr X must reject my own oral and written statements to him, my employers’ statements, the opinions and evidence of my treating practitioners who have known me for years, and the opinions of the Medical Panel.   He does not explain the “pre-existing psychiatric problems” nor does he provide any evidence to support his opinion that it was these problems which caused my “inability to accept rehabilitation”. The only pre-existing psychiatric problems that are evidenced in his report are my gambling addiction and the adjustment disorder which was the subject of my earlier Workcover claim. In relation to the development of the latter, the medical panel determined that my work was a significant contributing factor.   His enquiries in relation to the addiction were brief and pointless. He wanted to know where I got the money to gamble with. He did not enquire as to the length of the addiction, nor as to the intensity of it.   I had been addicted for six years. During the last 3 years of my addiction I was employed at a Community Legal Centre for 20 hours per week. I chose to work part-time and accept a lower income so that I would have time and energy to devote to ridding myself of the addiction and its underlying causes. I attended personal counselling for some years, and then joined a group. At the end of March 2002, I ceased the addiction. I did not have an active addiction when I returned to work in January 2003, so I fail to see how the addiction could have contributed to “an inability to accept rehabilitation.”

  1. “I am aware that the (medical) panel considered that the worker was suffering from a mild adjustment disorder with anxious and depressed mood that had arisen in response to stresses in the work place. However, the panel considered that despite this, she was capable of performing her pre-injury duties.”

I returned to work the day prior to my interviews with the Medical Panel, so the Medical Panel was in fact correct. I was well enough to return to work.  Doctor X had seen me first in November 2001. He himself states in that report:- “I believe that the worker has been incapacitated for employment because of her major depressive disorder. I believe that within two or three months she will be fit to return to normal pre-injury duties. She may need to be referred to a psychiatrist, but I have some doubts that you (CGU Insurance) are liable for this expense. She may also be helped by psychological treatment. Hopefully, with adequate treatment there will be no permanent impairment.”  He refers to the need for me to have psychiatric help, and expresses the possibility of “permanent impairment” occurring in the absence of adequate treatment. Yet, here I was again, seven months later, in a much worse state than when I first saw him in November.  He does ascertain from the current interview that I have received no psychiatric treatment in the interim, and that the stresses from work have escalated. Would not a reasonable person be somewhat concerned as to the seriousness of my condition at this point?   Instead, Dr X doubts my integrity and in doing so he commits an act of bias against me. The terrible things that are happening to me through work are white-washed as “allegations”, and are given no weight within his opinion.

  1. “When she went back to work on rehabilitation she was extremely resentful and not surprisingly, she developed an aggravation of her psychiatric condition.” (p.4)

Dr X alleges that it is my resentment that is driving the development of my psychiatric condition. Yet he does not provide evidence to support this opinion. In his report, Dr X emphasises two emotions that I was experiencing – anger and resentment. He does this, by referring to them both several times. He does not mention either of those feelings in his earlier report on me. Presumably I was not experiencing those feelings then. So, did he stop to ask himself why I should be expressing such feelings now?   Through the stress that he gives to my “anger” and “resentment”, he effectively  discards and obscures the many other feelings and emotional experiences that I described to him including shock, anxiety, humiliation, fear of poverty, rejection, abuse, alienation, trauma, feeling persecuted, crying, emotional pain, loss of self esteem. He also discards and obscures the physical symptoms that I complained of. These include loss of appetite, and physical pain. And, finally he discards and obscures the cognitive malfunctions that I described to him, including poor judgement and thought processes, paranoia, and intensification of feelings of depression and anxiety.  These are all serious symptoms of burgeoning mental illness.   Only serious bias on his part can account for the weight given by Dr X to “anger” and “resentment” as causative factors in relation to my problems.

  1.  “Although employment appears to have been a significant contributing factor to the injury, the aggravation of her condition since her return to work may be related to reasonable action taken on behalf of her employer.” (p.4)

Dr X here agrees that my condition has been aggravated since my return to work. However, he claims that the aggravation of my condition may be related to “reasonable action taken on behalf of her employer”.  I was complaining of serious breaches of my contract as an employee. Pay was systematically being withheld from me.  I was being subjected (in the form of “meetings” and “mediation”) to regular humiliation in regard to my health issues. I was denied my normal rights as a worker to a safe and healthy workplace.  None of this can be called “reasonable”.   These stresses do impact on the mental health and wellbeing of those who are subjected to them. There is nothing “reasonable” about the conduct of my employer and my co-workers. They were scapegoating me for debriefing my friend and for assisting her to document her complaint. The actions that I took in debriefing her and in acting for a short period as her advocate are supported by the policies and procedures of my workplace.  I followed the law of protocol; my employers and co-workers followed the law of the jungle.

Dr X  failed to act in a professional manner and he failed his of duty of care to me

 

  1. He failed to produce an independent report
  2. His behaviour during the interview exacerbated my condition.
  3. He did not pay careful attention to the reports of professionals who are more informed re my “normal” personality, health issues and employment situation.
  4. He did not seek further information to fill the gaps.
  5. He made many unsubstantiated personal judgements of me and of my condition and its causes.

As an Independent Medical Examiner (IME), Dr X is required to abide by the Service Standards contained in Schedule D of the Victorian Workcover Authority IME Agreement. These Service Standards provide the governing criteria for measuring his behaviour as a professional.   The Service Standards require that interviews and examinations be conducted “with care, consideration and courtesy.” Dr X breached these requirements by the nature of his first question of me (“Are you in a relationship, yet?”), and by shouting at me when I was crying. He also breached them by failing to give weight to my complaints, and to the reports of my doctors.   The Service Standard require that “the length of the independent medical examination will be sufficient to make a fair and comprehensive examination of the injured worker with a view to answering the questions asked by the Report Requestor.”  My case was a very complex one, and was difficult to deal with in the 45-minute interview allocated to me. Dr X admits that he was unable to make a sound judgement about the very central issue of whether the employer was taking “reasonable action” in this matter.  Yet, he did not seek a further interview with me. Nor did he seek clarifying information from any of the sources available to him.   The Service Standards do provide him with the opportunity to take more time with his investigations, and to contact my treating practitioners for further clarification. Not only has he not done this, he has apparently placed little weight on a statement made in my doctor’s report, where she says that during a consultation with her, my affect “was tearful, extremely anxious, agitated and almost confused – I found it a little hard to grasp the story and sequence of events from this normally most rational and calm patient.”   The author of this statement, also noted in her report that I had been her patient since 1996, a period of six years. Here was another professional who clearly had long term knowledge of my character and my health issues, including my gambling addiction and my personal efforts to free myself from it. The professional process of determination outlined in the Service Standards does call for some contact with her to obtain clarification of the points over which he himself admits to having some confusion. Dr X failed to make this contact.          

Consequences for me of his failure of duty of care and lack of professionalism

  I realise that the Board does not deal in matters of compensation or the making of amends. However, I have listed below some of the consequences that I and my family have endured as a direct result of Dr X’s failure to perform professionally, and with due diligence in accordance with his duty of care for me. It is important that he realises the extent of the damage that can be caused by such failures on his part.

  1. Dr X’s report was used by the insurance company to deny my claim for Workcover.
  2. As a consequence, I spent another 10 months without my usual work income, and without access to psychiatric treatment, which I was personally unable to afford. The government pension of $200 per week barely covered the costs of my mortgage repayments, food and power.
  3. My illness deepened during this period, as a direct result of both Dr X’s abusive interview style and the denial of my claim for Workcover income and support for treatment.
  4. As a result of the loss of income, I lost my equity in my home of 7 years, and was forced onto the rental market. Where I previously paid $100 a week off my mortgage, I am now paying $260 a week out of my small capital to rent. The value of my investment was previously increasing each week through repayments and the ongoing rising market value of the property. Now, my capital decays week by week because my costs outweigh my income. The Workcover income is only 75% of my previous income and is inadequate to meet my costs of living. Added to this are the additional financial burdens added by illness and the need for treatment.
  5. My addiction to gambling continued during this period with extreme consequences for my financial wellbeing.
  6. As a result of the lack of access to treatment, I believe that my illness was seriously exacerbated to the point where I may now have permanent damage which is evidenced by my ongoing experience of episodes of significant loss of mental stability and function. These episodes are stimulated by any experience of bullying, manipulation, bureaucratic obstruction and violations of my rights.  It does seem to me that earlier access to treatment would have curtailed both the length of the illness, and the seriousness of it.  In fact, I have already shown that Dr X himself considered the possibility of such a consequence in his first report.
  7. The financial losses consequent to being on Workcover for 3 years are huge.  At the age of 54, I now face the prospect of a very impoverished early retirement. I have no superannuation of any consequence. I cannot return to the work for which I am qualified. My ability to obtain work at a reasonable level of income, now demands both that I recover from this illness, and that I spend time and money on retraining. The costs of retraining to a reasonable level are prohibitive in my situation.
  8. I am a mother.  My son at the time was 11 years old about to turn 12. Can you imagine the emotional difficulty for him of observing the effects of mental illness in his mother?  My daughter was 19 years old, and not living at home. She also felt a lot of pain through seeing her mother decay in this way.
  9. Both my children were very proud of me when I gave up gambling successfully at the end of March 2001. As a family we saw this as the beginning of a new and better epoch for us. They saw me sustain my abstinence from addiction for twelve months through a very stressful and difficult time. After my return to work, they saw me become so victimised and ill, that I once again became a slave to addiction. The psychological consequences for them of these experiences will take many years to ameliorate.

From April 2002 to January 2003, I endured the following fairly extreme life stresses without breaching my abstinence:-

  • Because of the discriminatory treatment of my friend and the ongoing problems with my pay, I lost faith in my workplace;
  • I was very anxious and depressed about the situation with my work;
  • I was in constant pain from my back, neck and shoulder injuries;
  • I was hounded during this time by a group of threatening men known as the Blackshirts. I had encountered the Blackshirts through my work as a Domestic Violence worker at the legal centre. They harassed and threatened me and made unsavoury references to my son outside my home, hacked into my computer; and regularly leafleted the neighbourhood with smut sheets about me.
  • My best friend was dying of breast cancer, and I was committed to spending some regular time with her each week. During this period, she moved permanently into the hospital as her disease progressed.

The evidence points clearly to what happened to me after I returned to work as the trigger for dissociation and addiction.

tipAlso see our article “All rogue IME doctors ought to be purged from the workcover system” which includes the complaints procedure.

 

4 Responses to “If the IME expresses bias in your assessment report, Complain Complain Complain”

  1. If still working on modified or pre-injury duties and the employer demands you see a psychologist, complain to fair work australia who can order that you select your own psyc as you have a right to informed consent. My employer allowed me modified day shift duties and were very resentful that I made a workcover claim, they had one staff member assault me three times, the third time I yelled at him that I would thump him back if he touched me again. Employer then falsely claimed I was violent even though video showed me being assaulted. they brought in a very dodgy psychologist Manson Ignace (yes I do want to name him I made complaints to Aust Psyc Society about him no reply) who pushed me twice while a guard stood in the open doorway hoping I would hit him back. I complained to Fair Work who allowed me to choose my own psyc, I selected Ian McKinnon who sees though this set-up and writes report not a violent bone in my body. Highly recommended forensic psychologist Ian McKinnon http://ianmackinnon.com.au/

    • Tim, thank you so much for sharing this invaluable tip. I was not aware that you could go to FairWork.
      I once refused to see a highly biased IME shrink for the 2nd time and my lawyer (Shine) managed to have me sent to a really good IME – he is listed under our “great doctors”.

  2. I feel so sorry that we are all constantly subjected to this form of abuse. These psychiatrists bring shame upon their profession by prostituting it in this way.
    An IME who abused me was eventually “retired” because of complaints against him, but he’s back practising as an IME again. Go figure.
    I do think it’s worth complaining, if only to document our resistance (hampered as it is by our injuries) to this dreadful system. Also if enough people make formal complaints about the same IME’s, even unproven, the evidence mounts up. I think of all this documentation as building a tsunami of resistance that will one day help sweep this ugly system away.

  3. Thanks for sharing this most disturbing letter and wacko psychiatrist. Reading the letter certainly shows a high degree of bias from the part of the IME. This is however, and sadly, a TYPICAL example of how (many) IMEs write up their “reports” [you don’t cut off the hand that feeds you – in other words, IMEs are paid by the insurer and rely on many requests for “independent repoorts” from the insurer – the only way you can get a lot of referrals/requests is,of course, by providing highly manipulated reports in favour of the insurance company.]

    I believe this kind of “examination” and subsequent highly misrepresented (even fabricated) reports is rampant and that all (or 99%) of injured workers have, at one stage, read such a report about themselves.

    That includes me. Whilst I suffer from severe physical injuries, and a primary psych injury (PTSD from my violent assault) I developed (like many) secondary psych injury such as depression.

    One such an “examination” by a well known hired gun, that was used to “assess whether I could take part in rehab and RTW, notwithstanding that my arm was literally hanging out of its socket and that a 6th urgent surgery was requested) really disturbed me terribly.

    The IME stated in her report that I “threw /flung files at her” (whilst I gently slid them across her desk!) and was “extremely angry” and that “this behaviour was not normal and would be in line with bipolar disease” (WTF!!!).

    That I needed to “undertake volunteer work straight away with a view of RTW”, whilst, as I said, my arm was hanging out of its socket, the last surgery had just broken down and a request was made for further major surgery. The IME had NOT even looked at the medical evidence provided about the status of my physical injury!
    This, as you can well imagine, caused my CM to subsequently harass me and my psych treaters to “facilitate work” for me!

    Anyway, I could go on an on… I was SHOCKED beyond belief when I read this report – it was my first wake up call to the real dirty business of “IMEs”.

    In the end, I was made to attend numerous other shrinks, incl a medical panel and they ALL stated that I suffer from depression and severe PTSD (in addition to the severe physical injury) and that I am unfit for all work, both from a mental and a physical point of view.

    When I wrote a complaint to this IME (and the board) and pointed out the FACTS – no response was ever provided to me.

    However, I have come to know that this IME is routinely laughed out of a court of law… which helps appease my distress and shock about this evil ‘report”.

    So, about complaining, complaining… it is my opinion and experience that it leads to nothing. On would be lucky to receive an acknowledgement of the complaint.

    I do however believe it is always worth writing a complaint, and stating the facts, even to the insurer, so you have it on record and can, if need be, later on point out how biased the report was and that you (and your treaters) did not agree with the report/opinion provided (bought!)