Your Independent Medical Assessment – the truth

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As we have talked about hundreds of times, It is important to remember IME physicians are not concerned with your medical well being, and themselves have a clearly defined agenda and strategy to assist the insurance company with what appears to be, credible, objective medical opinion contrary to that of your primary care physician. This great guide to IME assessments, although American, is a must read for all injured workers, as it exposes the universal and real agenda behind those so called independent assessments.

Your Independent Medical Assessment – the truth

The IME physician often becomes the “devil’s advocate” who renders opinions and conclusions outside of his or her medical expertise. IME physicians may also assume the role of a disability claims investigator, paid by the insurance company, to provide documentation adverse to you and your claim.
Therefore, it is important to remember IME physicians are not concerned with your medical well being, and themselves have a clearly defined agenda and strategy to assist the insurance company with what appears to be, credible, objective medical opinion contrary to that of your primary care physician.

Their role is to attack the credibility of the insured by assuming every claim for benefits is a fraud that must be exposed.

Therefore, the claimant is dishonest. It is a great deal easier to attack your credibility, and the judgment of your physician than it is to ascertain medical restrictions and limitations preventing you from returning to work.

In doing so, the conclusion could be favorable to YOU and that would be adverse to the insurance company.

 

Alternatively view the guide in a separate window>>

Conclusion—Tips on how to deal with independent medical assessments

  1. Prepare for the evaluation in advance. Know your medical history and be consistent when telling your history to the IME physician
  2. Make an appointment to discuss your medical history with your lawyer. Let your physician know you have been asked to submit to an IME, and make an appointment to be examined by him/her on the same day
  3. Take someone with you to the exam who can speak for you and take accurate notes of the procedures. Take pictures of any swelling or obvious physical marks in the IME physician’s office
  4. Do not attempt to exaggerate symptoms or over react when touched or prodded
  5. Be cognizant of the fact the IME physician is neither your advocate or medical doctor
  6. Do not ask medical questions about your treatment, and answer only the questions you are asked. Do not contribute information beyond the scope of the examination. In other words, during the IME exam, don’t discuss the problems of your life
  7. Send the insurance company a request for credentials and other information about the IME physician. Also, request a copy of the report within a reasonable time after the examination
  8. Be mindful you may be surveilled by an insurance investigator. Wear braces, use canes, or other therapeutic devices as instructed by your physician. Limit your activities on the day before, the day of and the day after your IME examination. Look for strangers on your street, or neighborhood
  9. Ask for a copy of the in-house physician’s report on the IME. The insurance company may or may not give it to you, but ask anyway.
  10. Stay calm, and if the IME physician hurts you, say so. No physician likes to have a patient carried out of his office on a stretcher. If the IME physician manipulates you, or physically hurts you to the point of pain, ask for an ambulance to be called.
  11. After the exam, go home, relax, and be positive. These exams often have an emotional effect of making you feel guilty, or defeated. Never allow an insurance company to have that much power over you. You showed up for the exam, you did your best, you were honest, and that is the best anyone can do under these circumstances. Whatever conclusion the insurance draws from the IME report, has nothing to do with you, or how you presented yourself during the exam.

Best of luck with your quack assessments!

[Sourced and shared by our co-warrior and author Trinny with thanks! : http://www.badfaithinsurance.org] [Post entered on behalf of WCV who is emotionally drained after 2 such “medical assessments” yesterday 🙁 ]

 

 

 

5 Responses to “Your Independent Medical Assessment – the truth”

  1. Sorry I realise you already gave advice. If I can get lawyer to attend I will otherwise I’m thinking I’ll use my iPhone to record the whole exam (with his permission of course).

    I was thinking of telling him at the outset that I’m aware of his reputation so maybe I won’t do that?

    Just hit record on IPhone!?

    • Hi Dumbfounded, the sad reality is that there is very little an injured worker can do against dodgy IMEs and misleading reports, apart from requesting them to be corrected, which usually doesn’t work either.
      The power lies in that you can appeal a any decision made by your insurance company based on an IME report. For example Vic you go to conciliation and then, most often, are sent to a medical panel – where you are assessed by a bunch of much more decent and honest doctors.
      What this means is for example I had a very biased IME shrink report once, received a decision from my insurance company based on this terribly misleading report. The decision letter (i.e. deny a benefit, pay, etc) was then used to lodge a conciliation (where you can then submit as many medical reports as you want or need from your own treaters) and when it’s about medical stuff the conciliator ten usually sends you to a Medical Panel, the panel assesses you and the outcome is most often positive, and so you win….

      Many IMEs do not allow recording. They will say things like “it’s not a criminal matter, therefore you can’t record’). Most shrinks do not allow a support person, but most normal IME allow support person to be present (they can take notes and witness for you). If you secretly record then chances are that the recording will not be allowed as evidence in a court of law.

      Good luck!

  2. Thanks for this. I have an IMA this week for arthritis at a rheumatologist. Lawyer has advised this specific rheumatologist bats for the other side so we already know what the outcome will be. Is there any use. How can I debunk this?

  3. Great advice from aworkcovervictim. My problem with IME assessments is that they disturb and exacerabate my psych condition, often causing me to dissociate. In that state I am quite childlike and compliant, feeling like i have to provide answers to every question. I answer questions even when I can’t answer them with the full truth, and so little slivers of information are used to explain the “cause” of my illness. And of course the psychs want to plunder your whole past, just in case something that happened to you forty or fifty years ago can be used to “explain” your present psychiatric state! Aargh.
    Never see an IME psych without a support person with you, and without some way to record what happens in the interview. I find the dissociation causes me memory lapses so I often would leave an unaccompanied interview without being able to recall much of what has happened. I was always shocked when i saw their reports and the kinds of information they had dredged up from me, and even worse, they ways in which they interpreted that information.
    If people are up to it, maybe they could write a “response” to their offending IME report (good for your psychological health to stand up to this crap), or perhaps a description of the actual assessment for and report of physical injuries and post it on here. Don’t put up the actual report in case that causes legal problems for you.

    • I totally agree with you, Pauline, I have personally also experienced severe trauma from such psych IME “interrogations”. In fact one such an assessment caused me such a severe and acute PTSD that I had to receive emergency psych treatment after the exam. Some of those shrinks have no respect whatsoever for your mental health and do more harm. I often feel like a rape victim during IMEs, and it leaves me shattered, exhausted and sick for days if not weeks afterwards.

      I always get my own treating psych/psychologist to read the IME reports first and to discuss with me what transpired… and then read it myself with their support.