The Earmarks of a biased IME report

IME-medical-whore

Unfortunately medical whores exist  and there are plenty of them. They are known as grossly biased IMEs and are the spawn of insurance companies. They are an embarrassment to the  medical profession and should be purged from it; yet, they are not.

In some of the more outrageous cases, the medical whore / IME is known throughout the local medical profession and the legal profession, and are even laughed out of Court(s).

If you are sent, by a workcover insurance company, to an “Independent Medical Evaluation/Eaxamination” (IME) – that’s what they call it – about 8 times out of 10 you will be sent to one of the workcover insurance company’s preferred medical whores.

If you don’t know it by now, the purpose of the alleged IME “examination(s)” is to provide the workcover insurance company with a good excuse to try to find every way, legal or illegal, but dishonest ∗not∗ to pay you certain (or all) workcover benefits. This can be denying your injury was related to work, denying treatment such as surgery, ceasing your weekly payments based on a “fit for work” assessement, alleging malingering or a “psychological overlay” when you clearly suffer from physical injuries etc.

Anyway, the purpose of this article is to outline the typical earmarks of a medical whore’s report and examination.

The Earmarks of a medical whore’s/grossly biased IME “Report”

  • A medical whore’s report will ∗almost∗ adhere or conform to the ‘truth’, but, overall, the IME report will often be inconsistent with itself and with known and measurable fact(s)
  • A (grossly) biased IME report will also not read like what you remember from the examination. The actual examination will be superficial, careless and short, and may include a few  ‘tests’ with pins and a hammer as to make it look official and to trick the injured worker (and the insurer) that a ‘thorough’ examination took place. The report will call this, for example, a “complete neurological examination”. If you bring x-rays, CT scans, MRIs along, then those images will be gone through quickly and casually (if at all). Reports  from radiologists will often  be criticised, their findings declared ‘ inconclusive’, and dismissed. Sometimes radiological reports may be criticised as ‘impressive’, and—of course—where possible (i.e. back injury) the IME will attribute your injury to “pre-existing degeneration”. If for some reason the IME states your medical imaging is “inconclusive”, rest assured that s/he will —of course— advise ∗against∗ any further conclusive tests. Medical whores love putting in their report(s) the injured workers suffers from a diagnosed “somatoform” disorder ( which is not even recognised as a disease!). Somatoform disorders are mental illnesses that cause bodily symptoms, including pain. They will write that the injured worker “claims to be suffering greatly”, and that way too much money is spent on seeking further physiologic causes of the injured worker’s problem, hence treatment is denied. The somatoform diagnosis is an attempted defense as it were, to prevent
    the injured worker from seeking further medical treatment, and, as such, to prevent the injured worker from obtaining just compensation for the damage done to him/her.
  • There will also be innuendos concerning your physical symptoms or even aspects or your personality. A lot of unimportant things will be declared “interesting” at the very least. The injured worker’s symptoms might even be subtly ridiculed, even being referred to as bizarre. The point of this is—of course—being to call you a liar, or a malingerer but without actually doing so. For example, in a recent Comcare case, … a Dr Gibberd (IME) who appears to be based in Sydney and who has little clinical practice at present, saw [the injured worker]  on 10 December 2010. He found no evidence of any underlying pathology and described the symptoms recounted by [the injured worker] as “bizarre” and not commensurate with the subsequent findings of the MRI. There was, he said, nothing in his examination which was consistent with “a synovitis on extensor carpi radialis longus or brevis”. The MRI findings, he considered, were “probably…just an imaging appearance, and not symptomatic” [WTF!!!] … Of course, the medical whore is the expert and knows better… until the matter goes to Court.
  • Innuendos can be conveyed simply by putting certain words in the report like “pain”or “stress” in quotes, implying, without saying, that that these symptoms are not real, or may / can not exist.. The word stress is also used in vague ways, that will confuse heavy duty stress (anxiety, major depression, PTSD) with minor annoyances so as to make your serious stress ∗appear∗to be a minor annoyance.
  • Quotes will be attributed to you, the injured worker; about half will be erroneous in one way or another, sometimes quoting you as saying the opposite of what you actually did say. Sometimes a slight change of word or phrase that by itself appears harmless. But remember, nothing that a medical whore does is harmless.
  • There will only be results reported that are subjective to the to the examiner, like reflexes and muscle strength. No objective evidence will be present. No objective tests will be made. The examiner simply makes up the numbers anyway s/he chooses.
  • Irrelevant remarks will appear such as “the worker didn’t elaborate” (of course, the grossly biased IME will not have asked for any elaboration.) while important statements by you will be completely ignored and absent from the report. You might see, “I found it interesting that, …” purporting to cast doubt on a particular result, or an importance where there is none. The report will consist mainly of what was “apparently” felt or said by you the injured worker (ignoring any existing documentation) and what was “interesting”, without any explanation of why a particular thing may have been interesting; more innuendo….
  • Any previous diagnosis will be denigrated indicating that your complaints are not due to the accident or that your problems may even have been caused by a treating doctor. The most perverse tactic is simply the declaration that there is nothing wrong with you.
  • There will usually  be a high density of “medical” assertions with few if any corroborative facts or explanations. Assertions and conclusions will also often exceed the actual area of the alleged competence of the “examiner”. A neurologist is NOT a psychiatrist. An orthopedic is NOT a rheumatologist, a general surgeon is not an orthopeadic etc.
  • There will be ∗no∗ suggestions for further tests ruling out other possibilities. The medical whore knows what the answers “are” before ever laying eyes on you; s/he does not want the truth known.
  • There will be an attempt to shift a physical cause to an ill defined psychiatric cause. The key words here are “psychosomatic” (rarely used) and “somatoform”, or “psychological overlay”; the implication being that there is nothing physically wrong with you.

Do you know of any other earmarks of a medical whore’s report? Add them to the list!

[Article dictated by WorkcoverVictim and manually transcribed on her behalf]



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3 Responses to “The Earmarks of a biased IME report”

  1. Here’s a simple one: Writing a report to such a quality that it barely makes sense to anyone sensible. I’ve recently been involved in just such a case where an IME report bore little resemblance to the English language, contained spelling mistakes, grammatical errors and appeared to be randomly strung together statements with little or no relevance to each other or to the compensable injury. These “statements” were then repeated a number of times throughout the report to try and reinforce whatever the insurer wanted to see. It wouldn’t have surprised me at all if the IME had actually outsourced the report writing to a third party and hadn’t even proof-read it before their scanned signature was copy-pasted to the bottom.

    Other hallmarks might include obvious template usage (Let’s try using malingerer template 5 today!), an attached supplementary report (IME didn’t say you were a malingerer enough and the insurer asked for more), or (as said previously) wide discrepancies between what was discussed in the appointment and what is recorded in the report.

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    • I found the supplementary report a joke .. It was specific questions from the insurer that I have never been shown but was even laid out in dot form including statements like I needed to return to my mothers city address?WTF? And the IME couldn’t even get my height correct , why because he never measured me ! There was also a mention of me wearing a back brace last year, not only was question never asked I have never worn one in my life ! If these people were tradesman for arguments sake they would be persecuted to the full extent by the law for there workmanship. Although in my case anyway there opinion which is in direct opposition to my surgeon, GP etc… Is taken as gospel to now cut my payments as I have not been seen to make a reasonable attempt to RTW even though I’ve only missed days due to pain levels etc.. When I tried to explain this to family no one can believe it , it’s almost when I go over this in my own head it all seems a bit far fetched

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