IME doctors in the firing line because of Diary of a Workcover Victim

dr-m-epstein

Thanks to “R”, it has come to or attention that Dr Michael Epstein recently wrote on his website that IME doctors are basically very much in the firing line (being complained about), because injured workers have ready access to a number of blogs , for example ‘aworkcovervictimsdiary‘ and the injured workers support network that feed into (injured) workers’ hostility towards the WorkCover system and those who work in it.”

michael-epsteinI have a certain sympathy for APHRA (Australian Health Practitioner Regulation Agency), it is a difficult task but those of us who do independent medical examinations are very much in the firing line. Especially because complainants have ready access to a number of blogs , for example ‘aworkcovervictimsdiary‘ and the injured workers support network that feed that feed into workers’ hostility towards the WorkCover system and those who work in it.”

Read article | Learn more about Dr Epstein (on his website) including the fact that he co-authored the GEPIC guidelines because he believed too many injured workers were rorting the system!

IME doctors in the firing line because of Diary of a Workcover Victim

Should we take Dr Micheal Epstein’s comment as an insult or a compliment? We say a big compliment indeed!

Let’s start by rephrasing Dr Epstein’s comment:

We would go as far as to allege that “those of us who are unfortunate to be injured or made ill at work are very much in the firing line by so called IMEs. Especially because the more notoriously grossly biased IMEs have ready access to a number of blogs , for example the ‘civil forensic psychiatry websitethat feed into those IME psychiatrists hostility towards the injured and ill workers and those who support them.”

Now, let’s get some Facts straight

Independent medical examinations

After a workplace injury or illness your whole future is essentially determined by reports filed by your treating doctor(s) and specialist(s)and any other professional treating you.  If your workcover insurer sends you to a doctor other that your personal treating doctor(s) and specialist(s), chances are good that this doctor (such as an independent medical examination doctor) receives the majority of his/ her business from workcover insurance companies.  Do you really think this IME or other assessor would give you a totally unbiased medical report regarding the status of your injury/ies fully knowing that other workcover referrals would stop if they did?

Many of those in the medical profession are extremely reluctant to admit that there are real mavericks amongst them – that is, that there are doctors in the profession who will give evidence, whether in the form of an ‘independent medical examination’ report, or by means of acting as an ‘expert witness’ in court, which is at odds (to say it nicely!) with mainstream medical practice.

When pressed, many doctors admit that there are such ‘maverick doctors’, however there are a relatively small number.When you ask them “Who?” they will decline to answer…. for obvious reasons!

We, injured workers who have been in the system for a prolonged time and have been ‘examined’ by many IMEs are very concerned that there are ‘lists’ of -let’s say- class A and B IMEs. Those IMEs on “the list” will be “A” class and those not will be “B” class, which frankly has a destructive potential and is not be in the best interests of the community or medicine. We don’t see the workcover and their insurers readily wanting to give up their “privilege” of choosing their favourite IME and medical witnesses! That workcover (insurers)  misuse such lists is plain obvious, why else would countless injured workers complain to aworkcovervictimsdiary about the same IMEs over and over again?

No matter how hard they – workcover and insurers – try to make the “lists” not discoverable, ultimately injured workers make the lists! And, of course, we urge all injured workers to file formal complaints, if they have been subjected to unprofessional and/or grossly biased IMEs. It’s the only way this callous behaviour and misconduct will stop.

Injured workers, like any other ordinary patients, want nothing but balanced medical opinions about their injuries. Injured workers, like any other patients,  would like to have a reasonable expectation that all and any “independent medical examination doctor” and “impairment assessor” are honest, accurate, professional and are ‘used’ to help injured workers rather than to impede their recovery, downgrade their injuries, or by telling porkies – all in the name of PROFIT (so as not to cut off the hand that feeds them!).

Injured workers’ rights

When you’re unfortunate enough to suffer a workplace injury or illness you (the injured/ill worker) need to observe your rights – But our injured/ill workers’ rights are never explained to us, are they?

When we were first (seriously) injured we freaking had to go on line to find out what our rights were only to find that our basic rights were breached over and over again by the workcover system and their insurer(s). Their websites are extremely cumbersome to navigate and when we asked for explanations by telephone it struck us that ‘they’ are  not properly trained, or worse, that ‘they’ simply don’t care! Or even both and hence our injured/ill rights are not readily considered. We believe that by not disclosing the injured worker’s rights, “they” have and keep “control”.

aworkcovervictimsdiary is basically a workcover (ordeal) survival guide, entirely dedicated to the truth about what you the injured or ill worker, will face in the workcover system.

Our ongoing aim is to describe what you can expect from workcover (insurer), while – most importantly- simultaneously making you (the injured/ill worker) aware of your rights and how to exercise them.  That’s what this blog is all about, moving you in the right direction for information (and education).

We tell you what the system wants you to know. We also tell you in a painfully clear manner, devoid of most “legalese nonsense” what the system does not want you to know.

Knowledge gained from aworkcovervictimsdiary (and like-minded sites) will definitely help you survive, perhaps not thrive, but survive the workover system.

 

Further reading:

 

[Article by WCV and WCV3]



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25 Responses to “IME doctors in the firing line because of Diary of a Workcover Victim”

  1. It was almost amusing to read Dr Epstein’s website, especially the article entitled “AHPRA – What we don’t know”.

    The complaints he makes regarding the fact that Psychologist IME’s are unable to question the internal dealings or review process AHPRA imposes upon them bears a remarkable parallel to the inability of injured workers to get an open and transparent review of the actions taken by an insurer and/or dodgy IME.

    It honestly stank of double standards! Injured workers are all rorting the system, while the poor Psychologist IMEs are being hounded by the unfair AHPRA juggernaut!

    Just astounding, truely astounding. I for one am very greatful that resources like aworkcovervictimsdiary exist to allow injured workers Australia-wide to come together and compare notes. Just imagine how much more profit insurers could be making if some of us had meekly accepted the low-ball settlement offers or outright rejection of our claims?

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    • We All Know IME’S Hired And Payed By WorkCover Are As Dishonest As The Day Is Long !!! I Would Like To Know How Much They Are Payed For There Assessment And Report About Injured Victorian Workers

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      • Well in NSW they get between $800 -$2300 per hour for a non complex report- even though they don’t read any claim background and spend only 10 minutes with you. Can’t imagine VIC would be much different

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        • Agree. I know of one who boasted over 5000 assessments carried out and he was on appeal panels as well. Pretty good savings plan for a Occupational Physician.
          These assessors are all protected whether they carry out assessments according to guidelines or whether they misdiagnose injuries or even if they just plain lie, because it is “opinion evidence”. In the courts “expert witnesses” are a protected species as it is assumed they are acting in good faith and giving only an opinion. There seems no means of making them accountable when they lie because they say that was just their opinion. Unless you can dead set prove 100% that the IME has deliberately provided false and misleading evidence then they get away with whatever they want. They all sign their “expert witness” statements so technically, I would think those who deliberately lie are committing perjury. Would welcome legal opinion on that. This is what is undermining the WC system in all states- no proper accountability.

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          Bashed and bullied February 19, 2015 at 3:26 pm
  2. Oh the poor dears!

    It must be hard to be scrutinised whilst still earning tens of thousand from the insurers who have zero complaints about them and still want to throw money at them despite their IME breaches.

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  3. @Workcovervictim, you missed the best part of Dr Epstein’s post….that lodging complaints against these IME crooks and incompetents, even if the complaints go no where, actually works and causes grief to the IME.

    The IME psychiatrist friend Dr Epstein refers to had 3 complaints against him which were found to be unsubstantiated. He then gets a 4th complaint and without even investigating it AHPRA ‘performance manage’ him. Bloody hilarious!!!

    I choked on the hypocrisy of Dr Epstein comment that these complaints and being performance managed causes depression in IME doctors. Well I hope all these IME’s remember that the next time they are doing an IME psych exam on a worker with a psych injury from being bullied by being wrongly ‘performance managed’ and don’t write in their reports that the person has no injury or over reacting!! Or is it only IMEs that are caused psych injuries by being performance managed!

    So get those pens and paper out peoples and start lodging complaints…. it only takes 4 complaints to be lodged to get the IME performance managed. AHPRA have no time limit to make a complaint, so that rude prick of IME psychiatrist you saw 5 years ago…lodge a complaint against the bastard. In no time we could have them all being ‘performance managed’!!!

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    • That’s why we feel Epstein’s comment to be a huge compliment to us (and the IWSN!)
      We are mighty proud that – thanks to our site and the IWSN site – injured workers are finally learning AND standing up for their basic rights.

      I think Dr Epstein forgot that there are “IME Service Standards” as well as an IME Declaration. IMEs are supposedly to READ and ABIDE by them.

      A psychiatric examination is also often traumatising, especially an IME on a traumatic issue, because the injured worker is forced to (repeatedly) relive the trauma. Having to repeatedly recount and relive the trauma for medico-legal purposes will very often add another psychological/psychiatric injury. If the psychiatrist IME is an abusive hired gun, and if the injured worker is forced by the system, as many are, to see a number of them, the additional injury can be very severe indeed.. ( see http://aworkcovervictimsdiary.com/2014/10/ime-frequent-vicious-psychiatrist-imes/).
      Also see the most reported problems with IME psych examinations

      Fact is that quite a few of those IME shrinks have probably caused more pain and suffering to injured/ill workers than any combined physical and psychiatric injury or trauma imaginable. These (few – always the same ones) hired gun shrinks are immoral, their job is immoral and they are ruthless…. and then they become ‘depressed’ when legitimately complained about, helllloooooo!

      It’s high time we purged those rogues from the system!

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      • Great news its about time we all stood up ,this dr epstein has do this site a big favour .I saw a psychiatrist in Canberra he is on the list a hard hitter for the insurance QBETMF I was not on this site at the time ,but I found out about him, this web site is awesome, I was going to commit suicide over all the crap they have put me through QBETMF I hate them. I must say when I saw this IME in Canberra he was asking about my grown children I got the shits with the whole bloody thing and let him have it I told him that he did not care about me he was in it for the money ,they are all only in it for money ,I would like to know why they get so much we need a Royal Commission in to work cover and why don’t IME’S receive a standard fee set by medi care of about $70 per injured worker, I wonder how many of these IME’S WOULD STILL SEE US!!!!!!!!!!!!! not many LOL.

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        • WorkCover should be taking this into account when they approve his contract! We too went to the HCCC and got the same response that the complaint did not reach the burden of proof required to prosecute which is “beyond reasonable doubt” and relates to the offense being criminal in nature. The issue is that the HCCC don’t seem to consider many of these complaints involve the IME providing false and misleading statements in their signed expert witness statements which are court documents- isn’t perjury a criminal act? I would also think providing information you know is not true to a court on a regular basis for a particular party is fraudulent. Why aren’t WorkCover having their fraud branch investigate these IMEs so they can be prosecuted?
          I urge all injured workers to ask for a copy of their claims file as well as demanding a copy of the referral sent by the insurer’s solicitor to the IME as solicitors are not allowed to influence an independent witness. I have the referral to the IME I was sent to, saying the solicitor thought my claim was no longer work-related- guess what the IME found? The whole thing was a sham and now I have my file that shows collusion between the insurer and their solicitors to ensure I saw this particular IME regardless of the guidelines. This is one of the IMEs regularly complained of. His day is coming!!

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          Bashed and bullied February 17, 2015 at 2:47 pm
  4. Maybe those ‘aggrieved’ IMEs can lodge a workcover claim (as they were allegedly made ill during the course of their job) and, in turn, undergo and experience many (rogue) IME assessments! Ha, imagine!

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  5. As your readers may be aware , I am all for publicizing the negative aspects of IME assessments ie the bias and lack of professionalism of some, but like Dr Epstein, I worry that the information on this website about IME assessors gives the impression that all IME assessors are unfair, creating an expectation of confrontation and unnecessarily pushing some injured workers into the legal system where further ‘damage’ can occur.
    I agree that often workers have great difficulty in obtaining objective and understandable advice about how the system works and that deficiency needs to be addressed.
    Some research is being done to help identify improvements to the system. I will attach a link to a recent presentation on this subject. A useful starting point for a balanced discussion about this problem area.

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    • @Peter Sharman – Thank you for your insightful comment. It is a tad troubling though that you feel that we portray ALL IMEs as ‘bad’. That is NOT the case. If you read our articles, including the above one, it clearly states: “When pressed, many doctors admit that there are such ‘maverick doctors’, however there are a relatively small number“[of maverick IMEs]. Our “IME List” also consists of a small number of repeatedly ‘flagged’ IMEs, in comparison to the entire list of known IMEs.
      What concerns us the most is that a small group (indeed) of IMEs are repeatedly reported to aworkcovervictimsdiary (and other like minded sites) for ‘less than professional assessments and/or reports’. When looking at the referrals to IMEs from insurance companies, one can easily see that ‘they’ tend to use only a relatively small number of IMEs, and – ironically – those are the same IMEs who have been complained about the most!

      It is not our goal to instigate hostility towards all IMEs, rather to inform injured workers who are unfortunate enough to be assessed by a maverick IME that they have rights – such as the right to make a complaint about that IME, IF the IME breached the standards of services or the IME declaration.

      As we highlighted in our article “Injured workers, like any other ordinary patients, want nothing but balanced medical opinions about their injuries. Injured workers, like any other patients, would like to have a reasonable expectation that all and any “independent medical examination doctor” and “impairment assessor” are honest, accurate, professional.

      Happy to continue a constructive debate.

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  7. I received a phone call tonight from a marketing firm rep. claiming he had been hired by VWA to conduct a survey on client satisfaction with the service. (I’m listening to him and thinking – “Oh really??? ….. Yeah, ……..like I really believe that!“) He wanted to know if the VWA had sent me a letter re. this. When I answered ‘No, I have received no such letter‘, he said that he would ensure that one is sent to me. Has anyone else heard about this? Surely, it’s bogus? It must be! He wanted to know if I would answer his questions then & there, but I felt it was all very sus and so said I’d wait until I received his letter – which I’ll check out with VWA. Also, my next IME appointment has been changed to my birthday. Do you think this is deliberate? Can’t think of a better way to celebrate the big day (she says, her tongue so high up in her cheek she could pierce her cheekbone!!!!) UUUUUUUghghghgh, N-O-T! I am trying to settle myself psychologically into some ZEN state of mind to just wait for the inevitable; ie. to have my hard won weekly entitlements and medical expenses terminated yet again because the IME thinks I’m more than ready to return to work, while it still takes me over 1/2 hour to get dressed ie. just out my clothes on (and I can still not put on or do up my bra, instead have to step into that wretched ARRRRRGH Bra pulling it up over my body only with my right hand, starting again and again if & when it rolls up like a malfunctioning roller blind). And I’ll tell the IME all this, how I have enormous difficulty bathing, dressing, cooking, cleaning, gardening, even sleeping, let alone working, AND how I am supposed to spend most of my time exercising after my treatment, but he won’t listen. He’s been hired to get me back to work, while my medical professionals want to ensure I’m physically healthy and fit to do so. So then I’ll start on the same slow ol’ merry-go-round of waiting: waiting around 6-8 weeks for conciliation, then waiting another 6-8 weeks to go before a Medical Panel, then you guessed it, waiting another 4 weeks for the outcome, then waiting a minimum of yet another 4 weeks before they process the reinstatement, etc. “Like the sands in the hour glass – so are the days of our lives….” I’ve become so cynical about this process, but at least I’m not alone. And now I read that IME’s like poor Dr. Michael Epstein it seems are doing it even tougher that workcover victims. Poor guys – my tongue is now so high in my cheek that its tip is sticking out of my eye socket and bouncing around merrily like one of the Muppets! Those poor IMEs! Bless their hypocritical little hearts and non-hippocratic minds and soul-less values. What a tough road they have to travel – they, like us, must also be insomniacs, but it won’t be physical pain that keeps the awake at night! Oh No! It must be sheer Hell laying awake all night wondering where they may most safely invest their money (especially in the current economic climate) or their next luxury international holiday travel destination. After all, WE HAVE SO MUCH IN COMMON!

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  8. I couldn’t get the link to post! Try again
    https://t.co/SoTOIF2ABE

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  9. Open Letter to Independent Medical Examiners.
    by Rowan | Injured Workers Support Network (NSW)

    Dear Independent Medical Examiner,

    This week one of your Victorian Colleagues Dr Epstine [Epstein] has made the accusation that our website and the Workcover Victims Diary “feed that feed [fear*] into workers’ hostility towards the WorkCover system and those who work in it.” With reference to the issues you as medical practitioners face when one or another of the patients sent to you for assessment complain to the Australian Health Practitioners Regulation Authority about your behaviour towards them.

    I will not take up arms against the particular statements- our sisters at the WorkCover Victims Diary have already made those arguments succinctly.

    I would address the general tone by Dr Epstine.[Should be Epstein]

    The Injured Workers Support Network is a “consumer group”, in the quasi-business language used by the health sector, for what in the welfare sector is called a peer-support group.

    Our focus is on providing advice and support to injured workers as they navigate this system. It is also to agitate our members to be empowered against a system that has been identified through a large number of academic studies to be dramatically disempowering (please see “Unexpected barriers in return to work: Lessons learned from injured worker peer support groups” E. MacEachen, A. Kosny and S. Ferrier, Work 29 (2007) 155–164).

    Part of this action is to identify the systemic relationships between different sections of the system, how these relationships are used by the system to add complexity and create their feelings of disempowerment and how to utilise the system to exert what power the system allows them to have. This trail is a well-recognised pathway to community growth and personal development.

    As Dr Epstine highlighted. Part of this pathway is to utilise a capacity to have a perceived or real problem reviewed by someone outside that system. The HCCC and AHPRA are appropriate bodies to do this. It is not appropriate for the IWSN to play a role in judging whether a particular individual should or should not go to these bodies, just to ensure our members are aware of and have access to these pathways.

    The Injured Workers Support Network’s daily articles present information from the injured workers viewpoint. Information is gain through conversations with members, emails and texts about what members want to know about.

    We up-date our information when new information comes to hand and are always looking for the contribution of other professionals.

    Anyone can comment on our stories (as long as those contributions match our comments policy) but we do not allow for people to be named who are not already public or political figures. This is why we talk about Independent Medial Examiners as a whole.

    We are aware, as no doubt are you, that there are a range of (to use the terms ineloquently) “good and bad” medico-legal professionals working within the workers compensation system. We are aware of concerns for one medico legal professional who was so entrenched within the insurers camp that they have had a lease free office within that particular insurance company and at several stages was on their payroll. We have had other stories of a practitioner whom was derided by some of our members for being too harsh but who was overheard by at least three of our members on different occasions having a raging row with the member’s insurance clerk in defence of that member’s claim.

    We know of a medico-legal practitioner, who despite being told by all parties that their report was about another patient- refused to change that report.

    We are aware of another medico-legal practitioner who refused to see a member referred by an insure because “their Nominated Treating Doctors report is as good if not better than the one I could provide.”

    We’ve heard of breaches, we’ve heard of outstanding work, we’ve heard of abuse, we’ve heard of compassion.

    What we’ve heard though is all individualistic. The personal experiences of our members and the actions of medico-legal practitioners as individuals.

    What we know is that the Independent Medical Examiner system is enshrined in legislation. The insurers enact it on a monotonous basis. The industry as it exists is dependent on the insurers.

    The outcome of this is the system drives medico-legal practitioners as a body to be reliant on the insurers whose aims are to reduce costs by denying claims and cutting payouts. Medico-legal practitioners are the largest tools the insurers use to do this. Your advice is not free. The injured worker is not your client.

    I would hope that this forced relationship with the insurers would not influence your professional decision but, as the examples I provided previously show, that response is one of individual choice.

    The issue is systemic, not individualistic and needs a systemic solution.

    *Parenthesise added

    Note: I have asked Dr Epstine [Epstein] to contribute more on the issue of IMES to our website. It is important that the dialogue is opened up

    Link to original article: http://www.injuredworkerssupport.org.au/open-letter-to-independent-medical-examiners/

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  10. Hi all
    Could someone please explain to me the difference with APHRA, HCCC and the Medical Council?
    I had a very bad experience with an IME, I reported him to the HCCC. They told me that they could not do anything because his actions did not meet their required threshold but they put my complain through to the Medical Council. They found that his actions required further investigation and he was called to a meeting of his peers to explain. I don’t know what the outcome of that was because I was too upset to follow it up. I was told by the Medical Council that having this dr in one of their meetings is a big deal for them. They have to represent themselves with lawyers. In a small way, I take satisfaction that I did something.
    Workcover were not able to do anything. Is there a point in taking this up with APHRA as well? I would be happy if this person who calls himself a doctor was removed from the system.

    your thoughts

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  11. Rowan’s letter is excellent! I have also received TWO (very late letters from Worksafe [VWA]) saying that they HAVE hired a marketing firm to invetigate the quality of its service delivery to its client’s base. Apparently, I am going to be interviewed! Has anyone else received such a letter?

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  12. So the loaded deck is upset because some of the cards aren’t in their pack. Give me a break. I have had IMEs lie, ignore medical evidence, recommend treatment which they are not supposed to do, write humiliating reports that have no relevance to my injury and generally treat me like dirt. I am also aware of injured friends and relatives who have had medical reports written with statements about their support person in the report (no permission asked for) and an IME psychiatrist who yelled and screamed at a injured worker and told them to get out. Yep, very professional NOT. Many of the doctors who work as IMEs are retired, have had some professional conduct issues which means they cannot work in general practice or have such poor interpersonal skills they cannot sustain a medical practice, others are purely motivated by greed. Ask yourself why any caring doctor would do this kind of work, those who can do, those who can’t become IMEs.

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  1. Open Letter to Independent Medical Examiners. » The Injured Workers Support Network - February 13, 2015

    […] will not take up arms against the particular statements- our sisters at the WorkCover Victims Diary have already made those arguments […]

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