Defending IME Psychiatrists junk medical reports

IME-Psychiatrists-lie1

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?

I recently heard that at some medical experts’ conference the attendants were asked “How many times can you reach a conclusion contrary to workcover insurance interests and still be hired by the insurers?” Just about everybody’s response was “Twice.”

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) :mrgreen: 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).

question-workcoverDear 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.

question-workcoverDear IME shrink, can you be kind enough to show me -or provide me with a copy of- where exactly [in your report] you specifically tested me for depression and anxiety.

question-workcoverDid you actually go through the particular symptoms of (major) depression and anxiety with me?

question-workcoverDear 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?

question-workcoverDid you actually ask me if I was depressed?

question-workcoverIME shrink, did you actually ask me if I cry/cried a lot?

question-workcover IME shrink, show me where exactly you documented that you asked me how often I cry?

question-workcoverCan you please show me in your medical report where you discuss my family members’ (i.e. my husband) statements about how I have changed since my accident?

question-workcover Can you show me in your (biased) so called independent report where you asked me how the accident affects/affected me emotionally or mentally?

question-workcover 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)

question-workcoverDid you ask if I was taking any medication? Did you ask how much narcotics (pain killers) I was taking?

question-workcoverDear 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?

question-workcoverWhere did you document in your medical report or handwritten notes that you asked me whether or not I was having any side effects from the medication I was taking?

[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.

question-workcoverDid you ask my me about my hobbies, etc., before my workplace accident?

question-workcoverWere you aware of the fact that I was a [highly competitive horse rider], and [sailed] every single weekend?

question-workcoverWere you aware that my orthopedic surgeon told me I would never ever again be able to undertake these activities?

question-workcoverDear IME, surely you would agree that it can be extremely depressing to give up a hobby that one loves? [Never mind a career/job I so much loved]

question-workcoverCan you please show me where in your notes and/or medical report you documented that you asked me how it felt or affected me to give up those beloved hobbies?

question-workcoverDear IME,  isn’t it true that exercise can help reduce depression?

question-workcoverCan you show me where in your report you discussed the fact that I am no longer able to exercise because of my injury?

question-workcoverWould you agree that going from being able to exercise frequently to being unable to exercise to any significant degree or at all can increase or even cause depression?

question-workcoverDoctor, 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?

question-workcoverIME Doctor, isn’t it true that persistent lack of interest in the enjoyment of  life is a symptom of major depression?

question-workcoverDear IME Shrink, where did you document that you asked me about my sleep patterns? Am/was I sleeping too much or too little everyday?

question-workcoverPlease provide me with a copy where you documented that you asked me if I am/was  experiencing fatigue.

question-workcoverPlease show me where exactly you documented in your notes or medical report that you asked me about my feelings of worthlessness.

question-workcoverDear 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.

question-workcoverDear IME, did I have recurrent thoughts of death/dying?

question-workcover Please provide me with a copy of what you documented about my recurrent thoughts of death, or that you even asked this question.

question-workcoverDid 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.]

question-workcover Please show me where in your assessment you documented whether (or not) I was suffering from any agitation.

question-workcoverDid you ask me, specifically, if I had any of the above symptoms?

question-workcoverSo, 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)

question-workcoverDoctor, would you agree that as a psychiatrist you are an expert in the administrations and, especially, the interpretation of psychiatric/psychological tests?

question-workcoverSo, 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?
question-workcoverMy 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?

question-workcoverPlease show me in your code of ethics where it instructs you to ignore objective psych test data prior to reaching conclusions?

question-workcoverDear 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.]

question-workcover Doctor, if my symptoms are legitimate, then wouldn’t you agree that according to those symptoms I meet the definition of (major) depression?

smiley-tear

 

Always ask where it is documented!!!

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]



This post has been seen 1625 times.

8 Responses to “Defending IME Psychiatrists junk medical reports”

  1. I had a recent IME report (requested from defence lawyer) which was filled with contradictions. He failed to look through my medical reports and didn’t ask the right question. He accused me of being hostile and not being forthcoming with information in the report, when he realised his mistake. IME said he could not determine what was pre-existing and what was caused by the actions of my employer then in the next sentence suggests it was 80% pre-existing and 20% work! He gave me a brand new diagnosis of having passive aggressive disorder amongst other things yet didn’t discuss a single symptom of what I have experienced. This whole report was a sham and completely the opposite to every treating doctor, psychologist and psychiatrist or other IME. Instead of trying to point out his contradictions, you may use the information useful to your case such as prognosis is not good, will not be able to return to work etc. I have to laugh though… Apparently my condition is due to my whole “misfortunate life”! IME just ignored the fact it was poor workplace practices and bullying that lead to psychological and physical injuries, two surgeries after being hurt at work and repeated hospitalisation don’t really matter. Neither did the fact I was in good psychological health previous. The thing that annoyed me about all the lies is how he made me out to be someone I wasn’t when interviewed, and claimed to have had conversations with me that never happened. He literally made up things I had supposedly said to him. Lies! It shouldn’t have surprised me how unethically he reported. But he is paid by the defence lawyers to try undermine my case. They aren’t independent – they are interrogating medical exaggerates.

    Thumb up 0 Thumb down 0

    • Yes Al, they are ALL in bed together.

      Thumb up 0 Thumb down 0

    • OH how true Pauline Pope, I hope QBETMF, are reading this post ,we know you sneak in on here and read the posts. Well from what I have been put through they are unethical, corrupt and have a conflict of interest .What you do and say does and will affect injured workers who suffer 24/7 how many of us have tried too or committed suicide ? does any one keep a record of this may be we could start a list. For me everyday I find or try to find a reason to be here, and its hard when a insurance company owns you. I should write on Facebook every night at 2 or 3am I hate QBETMF they are unethical and corrupt pack of bastards , I don’t sleep much , I still wonder how much of a bonus they get when one of us tops our selves ,I wounder what am I worth ?????????????????

      Thumb up 0 Thumb down 0

  2. The term “independent specialist” made by the Workcover authority is per se misleading, deceptive and discriminatory because it implies that those paid (read hired guns) by the insurance companies are honest while all the rest is deceptive and dishonest!

    Thumb up 0 Thumb down 0

    Xchangingvictim June 3, 2015 at 5:11 pm
  3. Can anyone better this for dishonesty…………

    Last year I had a serious injury hearing for my psych injury from workplace bullying. Workcover pulled out a psych report from one of their well know hired gun IMEs who had assessed and diagnosed me as having no psych injury….the IME has never even met me!! Workcover had me assessed and diagnosed in secret!!

    How the fuck do you diagnose a person you have never even seen???

    Thumb up 0 Thumb down 0

    • @ninja I thought I had heard nearly everything until I read your comment, I am totally gob smacked!! Is there no limit to the unethical behaviours from these insurers? I’m sure if we did something like that we would face fraud charges in Court?

      Thumb up 0 Thumb down 0

  4. That IME sounds just like the one I complained about whose report prevented me from accessing workcover income and health support for a very long ten months. I never attend IME’s now without taking a friend/witness into the examination with me. They just get greasier, but less blatant in their misdiagnoses. And they won’t bully you in front of a witness.
    The whole IME thing is a very blatant example of the Conflict of Interest that the workcover system is riddled with, and of the ways that these conflicts of interest work against the best interests of the injured worker. Conflict of Interest is a huge legal No No, as it is fundamental to the development of a load of corrupt practices of the kind we injured workers see in the Workcover systems. The question has to be asked – how come a system that involves the livelihoods and daily work of so many lawyers manages to get away with these conflicts of interest and associated corrupt behaviours for so long?

    Thumb up 0 Thumb down 0

  5. They are all in bed together, and don’t care a toss about any of us, To them we are a pack or lazy sods!!,well to all insurance and IME’S you are all a pack of evil, uncaring bastards and I hate you all ,we all answer to someone in life and death and you will all meet your maker with what you have done to hard working Australians . I believe that what goes around comes around. Evil breeds evil, So when something happens to you!! don’t say why me ? we on this site know why, everyone deserves a life to be happy and live the life we have been given, but you make our time on this earth hard ,sad, and while God may forgive you ,We will not.

    Thumb up 0 Thumb down 0