Rude, hostile, biased & inhumane independent medical examination doctors & how to complain

rude-doctor-ime

It’s not the first time that we have received a most disturbing email from an injured worker who has experienced a most inhumane “independent medical examination” by a “doctor” who – frankly – bullied and humiliated the injured worker and who was described as hostile.

Rude, hostile, biased and inhumane independent medical examination doctors

On this occasion a severely psychologically injured worker was (again) sent to an psychiatric IME by his insurer.From the minute the injured worker stepped into the IME’s rooms, the IME’s attitude was hostile and he appeared to have formed his opinion and made his judgement. The IME’s behaviour was highly unethical and brutal. He did not appear to do his job as a doctor appointed to make an assessment, but rather behaved like a “BULLY”. He also had no right to order the poor and totally bewildered injured worker to refrain from taking his medication at the times he is required to do so.The injured worker sets his alarm to remind himself to take his medication at different times of the day so he does not forget to do so.Unfortunately his mobile phone alarm went off whilst he was in the room. When he attempted to take his medications which was due the rude IME , for example, literally snatched his bag of medication and “THREW” his medication on the floor which was in a bag and said “NO” medication until I finish my examination.

He also ordered him to do nothing, but listen to him (the IME) without interruption or explanation of what the injured worker may have had to say. This attitude & treatment towards the injured worker was nothing less than like treating a common criminal. The IME had also questioned the injured worker in a most humiliating manner regarding taking Marijuana or illicit drugs! And when the injured worker denied taking illicit/recreational drugs the IME kept on saying “Are you sure “about that”. The injured worker had told him that his father was a  Police Officer and that  he would do any such thing, as it would be a disgrace to do so.(the injured worker was brought up that way) . However, even so, the IME  replied and said “Oh that wouldn’t stop you from doing so-right!!The rude IME seemed to be the judge and jury without factual evidence and had already seemed to have made up his mind up even before the examination had finished and continued to “BULLY” the bewildered injured worker.

Note: this is just an extract of a series of disgusting events that took place.

Where is the IME’s ethics? The injured worker did not go to him for treatment, but presented himself as requested for an independent examination and not to be accused and treated like an animal or a criminal.

The injured worker wrote a complaint letter, which to date has been “hand-balled”

Another injured worker wrote thatThis 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…” This injured worker wrote a complaint letter.

Yet another injured worker wrote a complaint letter to my his/her case manager after an assessment with Dr Chris Baker:

I would also like to inform you of my disapproval of the following in regard to Dr Chris Baker’s appointment and capacity report:

  • Being consulted from behind a screen that could easily have been moved. I had to lie down for the majority of the appointment as I was in a great deal of pain. Dr Baker didn’t mind me resting obviously but didn’t feel the need to look at me while he asked his questions. I find this very unprofessional and incredibly demoralising and uncomfortable and have never come across such treatment with any practitioner. Dr Baker sat behind his desk and only saw me when he had to examine me and I had to stand up. [WTF!!!]
  • Questions that Dr Chris Baker chose to ask such as: How long have I been married, how successful was our (my other half and my) business, did we have regular clientele, did I have any other source of income and how did I see myself earning an income in the future? I don’t feel these questions were necessary nor relevant to assessing my ‘work history’ or my capacity. No other Occupational Physician has asked me these questions before.
  • Not being given enough time to answer questions and being rushed and cut off in mid sentence. I feel this clearly did not allow Dr Baker to get a full understanding of my issue. I feel it impossible that Dr Baker, no matter how much experience, can assess my condition of 25 months during such a short and abrupt appointment.

In an other case, a bewildered injured worker was told during an IME psychiatry that her mother must have committed suicide ! (whilst her poor mother died in a car accident through negligence of the other driver, and which remains a painful memory to the injured worker – besides the injured worker suffers from purely severe physical injuries and did not understand what this had to do with her physical injuries). At the beginning of the assessment the injured worker gently slid a folder across the “coffee table” (the injured worker had a freshly operated leg and arm, and at the time of the assessment has also a fully dislocated shoulder and used 1 crutch, so she could not easily stand up and walk across the coffee table) only to read in the report that the injured worker “had flung a folder at the IME’s head!”

In another case, an severely physical injured worker with a severe primary psychiatric injury (from the traumatic accident in the form of severe PTSD) was again asked to attend an IME psychiatry with a well know biased and rude IME. Her treating psychiatrist had provided her with a letter asking the IME to please refrain making the injured worker recall the traumatic event, as it would cause her a severe PTSD flare up and that ample information surrounding the traumatic event was available in multiple reports, incl a comprehensive medical panel assessment. The most inhuman shrink took obvious delight in making the injured worker recall the finest details of her trauma, to the point where the injured worker went cowering in a corner of the room with her hands over her head pleading to stop… still he continued. The injured worker suffered a major PTSD attack, necessitating immediate emergency hospitalisation. The IME’s only action was to drag this injured lady to the bathroom “to go an clean herself up” so that other patients and fellow doctors would not see in what terrible state this woman came out of that room. The injured worker and her psychiatrist successfully complained to the medical board and this creep received a final warning…

Case in point, there are (way too) many horrific stories of rude, inappropriate  independent medical examiners, who are engaging in unorthodox practices, designed to intimidate injured workers.

Complaining about rude, biased, unethical independent doctors

First of all record any IME assessment for evidence

Atlas Legal told us a while ago that if you are called into a meeting about your complaint, its investigation, or work performance as a result of you lodging a complaint about harassment and bullying you are entitled to electronically record any such conversation so long as the other side is AWARE that you will be recording the conversation.

The same goes with Doctors and or specialists.  Time and again, insurance company doctors and specialists treat injured workers with disdain and contempt. If you wish to do so you should be allowed to electronically record everything that is said in your consultation with that Doctor.  That is the most accurate way to keep a record of what was said during the consultation as well as a way to make sure that the Doctor remains professional and courteous during your consultation .

Minimum standards of conduct

Injured workers attending independent medical examinations will be interviewed and examined with care, consideration and courtesy.

According to the online claims manual victoria, The IME agreement sets a range of standards for s112 examinations which require the IME to:

  • make appointments (to undertake the s112 examination) as soon as practicable after receiving a request, usually within 3 weeks of a request
  • not keep injured workers waiting for an unreasonable period of time
  • interview and examine with care, consideration and courtesy
  • conduct examinations in accordance with recognised professional standards and applicable law
  • allow sufficient examination time for a fair and comprehensive examination that answers the questions asked
  • ask the agent to contact the injured worker’s treating practitioner where clarification is required
  • obtain written consent from the injured worker if they need to contact the injured worker’s THP (treating health practitioner) directly and
  • obtain approval from the agent before initiating additional tests.

Minimum standards for medical practitioner IME reports

The Medical Practitioner’s IME Agreement specifies minimum standards for preparing the report and for peer review of those reports for quality assurance purposes. The Agreement requires that the report must be:

  • timely ie within seven business days of the examination
  • accurate ie including accurate medical diagnosis, appropriate clinical examination, detailed history of the injury with supporting reasons for the diagnosis, an evidence based approach to evaluating symptoms and clinical findings, recommendations and indication where insufficient clinical information exists
  • unbiased ie independent, impartial, contain only relevant information and not disclose personal information
  • consistent ie internally consistent between opinion and findings
  • contain standard reference information including regarding purpose, timing, materials, relevant histories, findings and investigations and answers to the agent’s specific questions and
  • be signed personally by the IME.

Complain against an IME

According to the Online Claims Manual Victoria:

Section: Complaints against IMEs

If a worker is concerned about the conduct of a s112 examination, they may make a complaint.
Complaints may include allegations of any of the following:

  •     causing unnecessary pain in an examination
  •     complaints of an examiner’s manner
  •     incorrect reporting
  •     inappropriate behaviour.

WorkSafe’s role

All complaints about IMEs should be referred to the IME Services Branch of WorkSafe (contact 03 9641 1757).

The nature of the IME complaint determines how the complaint will be handled. WorkSafe will only investigate administrative complaints. Other complaints in relation to the professional and ethical conduct of IMEs may be referred to either the:

Types of complaints

Verbal complaint

If a verbal complaint is received, the agent must:

  • register a complaint
  • advise the complainant that WorkSafe assesses all complaints about IMEs and that the complaint will be referred to WorkSafe
  • Notify WorkSafe immediately about the complaint by contacting the Health Services Group on 03 9641 1757. The details to include are

complainants name (if not worker, please specify)

claim number

name of examiner

  •  outline of complaint.

Agents must not contact the medical examiner regarding the complaint or any matter related to the complaint.(!!!)

Written complaint

If a written complaint is received, the agent must:

  • date stamp the day of receipt
  • forward complaints within 24 hours of receipt to:

        IME Services Branch
WorkSafe Victoria
GPO Box 4306
MELBOURNE  VIC  3001

  •  or fax immediately to 03 9641 1767
  •  include any relevant additional information in regard to the complainant or medical examiner, for example medical reports, IME referral letter correspondence previously received etc
  •  place a copy of documentation on the worker’s claim file
  • notify the complainant that WorkSafe assesses all complaints about IMEs and that the complaint will be referred to WorkSafe.

Agents must not contact the medical examiner regarding the complaint or any matter related to the complaint.!!!!

Keep a register of complaints

Agents are encouraged to keep a central register to record the details of medical complaints against a s112 medical examiner, whether verbal or in writing. The details that may be recorded include:

  • date complaint received
  • medical examiner’s name and address
  • details of appointment
  •  name of worker
  • claim number
  •  name of employer
  •  name of person or organisation making complaint, if different from worker
  • details of complaint
  • type of complaint:
  •         verbal or written
  •         administrative or medical
  • date complaint referred to WorkSafe
  • details of any action taken.

Referrals to s112 medical examiner who was the subject of a complaint

If the worker has lodged a complaint and specifically requested not to be referred to the IME again, agents should seek an alternative IME for future examinations.

Note: Only WorkSafe can remove a medical examiner from the approved list but agents can determine which medical examiners from the list are to be used.

So: Complain to WorkSafe, complain to the Medical Board and the Health Services Commissioner
as to minimise your chances at being hand-balled and at maximinising the chances that someone will look into the creep.

Also please rate the creep(s) on rateanMD website and help protect your fellow injured workers !

 

[posted on behalf of workcovervictim]

3 Responses to “Rude, hostile, biased & inhumane independent medical examination doctors & how to complain”

  1. Did you know that there are “impaired doctors programs”. But would a doctor report a colleague who is impaired? Most say that they have an ethical obligation to do so. However and dishearteningly, most doctors feel that they would approach their colleague privately rather than make a formal complaint to the board.

    The  type of impairments are commonly seen include (but are not limited to):
    a. doctors with mental (including addictive disorders),
    b. doctors with severe personality pathology whose behavior impedes appropriate care/ assessment etc, and
    c. doctors who are incompetent and lack the fundamental knowledge, behaviour and skills to practice.
    Obviously, there is a degree of overlap among these categories, and by far, the area with which we are most familiar is the doctors who is abusing controlled substance.

    Perhaps the most problematic is the doctors with characterological (i.e. personality) disorder. The doctor may be sarcastic, hostile, and demeaning. He may cling to the belief that no one dare pass judgment upon him, and for the most part, he is correct. Colleagues will try to keep their distance. Office staff will turn over. And, once again, patients (incl injured workers) are inordinately acceptant of even this form of abuse.

    As a rule, if you suspect that the doctors incl an IME with whom you are consulting is impaired, always realise that there are reporting options! And please report him/her! The more we, injured workers complain and report rude, hostile and inappropriate, incompetent IMEs the more chances we have of having that / those creeps taken on the street!

     

  2. Complaints from your treaters will carry more weight.  The Medical Board may not take one injured worker’s complaint seriously, but will have to if several complaints are lodged against the same IME by different people.  That’s why it’s important to lodge your complaint in writing yourself if you can, even if your treater does not.  It is also therapeutic.  Suffering is silence will not help you or anyone else.  Wouldn’t bother wasting time complaining to WorkSafe, the body who appoints the insurers and receives a yearly dividend from them.

    In the USA, IME sessions are video taped as evidence.  There is far too much riding on these assessments to attend without protection.  There have recent cases of IMEs fabricating responses, which is quite disturbing but not surprising.  Let’s face it, the fact that these “doctors” are even working for the insurers says a lot about their ethics or lack of.  Successful practitioners do not need to supplement or derive their incomes this way.   Many are nothing more than an insurer’s hoar.  They are aware, like Pavlov’s dogs (analogy intended), if they behave (report) as expected they’ll get rewarded, and it’s a lucrative reward!  Here are the rates for Vic as of 1/12/12, http://www.worksafe.vic.gov.au/__data/assets/pdf_file/0005/50639/IME-Medical-fee-schedules-1st-Dec-2012.pdf

    Psychs get $872 for first report and $520 for supplementary reports, within 12 month of assessment.  These are schedule fees, but “loadings” can get approved also, i.e.. regulars can get more (and do). The manipulation of not only the IME Reports is a sham, but if you get a hold of the insurer’s referral you’ll see how the insurer “prepares” the IME even before your assessment!  Of course there is the odd ethical IME around but unfortunately they are rare, so you need to arm yourself.  That’s the sad reality.    Recordings can be admitted as evidence in Australia as long as the person being recorded is aware and agrees.  Next time the insurer tells you that you have to attend another medical appointment, kindly inform them that they will need to choose someone who does not mind being taped.   There is nothing in Australian legislation I could find that prevents you from taping or bringing someone along to tape it.  Correct me if I’m wrong?

  3. Great article Workcovervictim. Yes always complain, even when you doubt you’ll get a result. Things that happen in the assessment session are impossible to prove without witnesses, so don’t go see them without a support person with you in the room. Remember that abuse is more likely to happen behind closed doors where there are no witnesses, and these guys have so much power over you in this situation that they can cause you even more severe damage.

    It took me three years to get to a point with my injuries where I could have the sense of self and my right to justice to complain about the IME who bullied me. But I am so glad I did, even though the Medical Board failed to address my complaint in relation to the obvious “bias” and “professional misconduct” of this particular IME, and the IME continued to deny his bad behaviour. My complaint made for a rather entertaining clash of opinion and belief between myself and the IME who actually expressed the belief that “some victims cherish their victimhood”. Mmmm

    Could we take a straw poll on that everyone? Any of you yet arrived at the Nirvana of “Cherishing your Victimhood”?