Many IME Psychiatrists, even those who testify for workcover insurers avoid diagnosing psychological / psychiatric conditions related to injured workers’ trauma. They generally do this by deliberately avoiding any tests that were designed to assess the injured worker’s mental condition in question. Is it any wonder the IME finds no evidence of for example, PTSD or major depression when s/he doesn’t even test for it?
Ever wondered why so many independent medical examiners (IMEs) and so called ‘expert witnesses’ (who work for the defense: the workcover insurer) lie?
An IME (especially one that does ‘defense’ work in Court) can basically lie two times. After a third “contrary assessment” of a poor injured sod, the IME can generally forget those big-fee referrals, indeed! You get the gist as why so many IME psychiatrists LIE in their reports and opinions about YOU!
Continuing along the path of our articles: “Is your IME claiming that you exaggerate your pain?” and “Tips to defend an IME opinion or report”, we’ve had a thought or two on how to challenge a junk IME Psychiatrist’s medical report (or opinion) about [the lack] of any psychological injuries you suffer, or about what type of psych condition (if any) you suffer.
Defending IME Psychiatrists junk medical reports
To keep things fairly simple, we’ll pretend you (the injured worker) suffers from major depression, but the IME (independent medical examiner) psychiatrist diagnosed you with “anxiety”. We’ll also be referring to “me” as “the injured worker” for ease of reading.
The following amusing but very smart (indeed) questions assume you are depressed, however you can use the same type of questions or method of questioning to challenging biased IME psychiatrists for any psychiatric/psychological diagnosis (for example PTSD).
Dear IME Shrink, did you conduct any psych test on me to determine if I [the injured worker] had a depressed mood? Many IME psychiatrists never ever undertake any form of ‘test’ on an injured worker. I certainly have never been ‘tested’ by the numerous IME psychiatrists I have been sent to during the life of my claim.
Dear IME psychiatrist, did you actually weigh me? [A change in weight (loss or gain) of more around 5% of total body weight in 1 month can be a symptom of depression.] Did you ask me if I had recently lost or put on weight?
Dear IME psychiatrist, at the time of your assessment I felt very suicidal – Show me in your report and/or handwritten notes where you conducted a suicide assessment. (or ask: provide me with a copy of)
Dear IME shrink, surely you would know and agree that the narcotics used to treat my pain can also cause or increase depression, won’t you? And, IME shrink, where did you document that in your medical report?
[The following sample questions relate to specific symptoms of depression. If you have 5 or more of these symptoms then, (for example, according to the DSM-IV), you may suffer from major depression.] Feel free to change your questions to suit any specific condition, such as PTSD.
Doctor, if you were made aware of the fact that I was busy, active and engaged in hobbies prior to my accident, and now rarely go out, do not want to be with people, and often sit alone in a dark room, would you agree that is an indication of a serious and persistent lack of interest in the enjoyment of my life?
Dear shrink, was I having trouble concentrating when you ‘assessed’ me on behalf of workcover insurance X? Please show me where you documented that you undertook any tests of concentration along with scores.
Did you ask me if I was suicidal? [Note: even the most basic IME psych assessment should include this. Often, they do not bother to ask. The IME psychiatrists should ask about both active (plan to kill yourself) and passive (wish you would not wake up in morning.]
So, IME shrink, you basically concluded I am/was not suffering from depression by: a) not testing me for it; b) not asking questions about the diagnosis of major depression and; c) ignoring the tests conducted by other psychiatrists (and/or psychologists)
So, Doctor, as I understand it, your medical report reveals that you are not an expert in the administration and -especially-interpretation of these psych tests, such as those that were conducted by my treating psychiatrists, correct?
My treating psychiatrist(s) and/or psychologists’ undertook tests which reveal I suffer from (major) depression.
Would you agree that you do not understand these psych tests, given that you still concluded in your medical report that I do no suffer from (major) depression?
Dear IME, isn’t it true that the following symptoms I suffer from are, in fact, symptoms of major depression, as set forth in the Diagnostic and Statistical Manual? [Look up your condition for example in the DSM-IV. Go through the checklist. Give the IME specific examples of each, and then ask the following question.]
Phrase your questions in such a way that you do not ask “Did you ask…,” but “Where is it documented that you asked…” Why? This prevents the IME from taking a free pass by claiming s/he “remembers,” yeah right, 4 years and 4000 patients ago?! You want the facts. Where is it documented?
[Post dictated by WCV and manually transcribed on her behalf]
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