History incl. complaints of IME doctors lacks transparency

workcover-ime-no-transparency

We believe that one of the most difficult problems with the current workcover Independent Examination system is that there is usually no way for an injured worker to know the full history of the IME doctor who is performing the examination. For example, if a certain IME doctor has been the subject of multiple complaints, the injured worker has (generally) no way to know about these previous complaints. This is also the reason why we started our IME list.

History, including complaints, of the IME doctors lacks transparency

Fact is that workover insurance companies are relying on so-called independent medical examination (IME) doctors to perform “regular” examinations on injured workers; examinations which can greatly influence and even determine whether a workcover insurer will pay for the injured worker’s recommended treatment; whether they will pay weekly payments (and for how long); and even whether an injured worker will be compensated for their injuries.

The IME doctors who perform these examinations are supposed to be fair and definitely unbiased. Unfortunately, the reality is that too often these IME doctors are skewed and even biased against the injured worker in favour of the workcover insurer. This sadly often results is an already vulnerable injured/ill worker to be victimised again in their pursuit of (some) justice.

One of the most difficult problems with the current IME system is that there is usually no way for an injured worker to know the history of the IME doctor who is performing the examination. For example, if a particular IME doctor has been the subject of multiple complaints, the injured worker has generally no (or very little) way to know about these previous complaints. It appears that just about all complaints about IME doctors are kept secret by the body that regulates doctors in Australia, (and/or workcover authorities) unless and until there is a formal finding of (gross) misconduct by our state’s  Health Complaints Commissioners and/or health practitioner’s professional association (AMA), and/or by The Australian Health Practitioner Regulation Agency (AHPRA)  against that IME doctor.

Furthermore it is very difficult to sift through our legal case-law databases to find scathing and “adverse” remarks made by Judge(s) about certain notorious IMEs. Here is an example of a recent legal case where the defendant’s IME opinion was heavily discredited:Workcover Insurer & IMEs behaviour ‘disgraceful’ and ‘seriously alarming’ says Judge

It appears that an injured worker is only able to gather some information about the reputation of an IME by searching sites such as ratemds, and – of course – our site which has a list of frequently adversely reported IMEs.

Wouldn’t an increased transparency into the history, background (and complaints!) of IMEs result in greater fairness to all injured workers?

Wouldn’t it be fairer for injured workers (and their lawyers) to know how many formal complaints were made about a certain IME? How many of those IMEs have been scathed and their opinion(s) discredited in a Court of law? Wouldn’t it be fairer if workcover authorities would publicly publish – at the very least – the number and nature of complaints against IMEs?

It certainly appears that IME doctors are fighting to keep all investigations and complaints from examined injured workers as secret as possible from the public and injured workers.

It is also not the first time aworkcovervictimsdiary has been threatened with a defamation lawsuit by certain IMEs for allowing injured workers to voice their concerns and/or share their less than professional experiences! One such a misplaced threat came from a well-known not so independent (to say it nicely) IME psychiatrist. More recently aworkcovervictimsdiary received an email from yet another frequently adversely reported and (obviously) disgruntled IME psychiatrist demanding we apologise for “a defamatory mistake we have made” re an interpretation of this IME’s point of view in a public presentation. Apparently “it is upsetting people who are coming to see [this IME]”. Never-mind that this very same IME keeps being reported to aworkcovervictimsdiary for ‘not so independent’ medical examinations (LOL).

What’s more, the lack of transparency is not limited to complaints made against these IME doctors to for example the AMA or Health Commissioner or AHPRA etc. It certainly appears that our own legal system  also protects IME doctors and other so-called “experts” from past judicial findings (legal cases) or commentary that a particular IME doctor or expert was an advocate for one side, provided misleading evidence or was acting as an independent expert. For example, there is one particular IME who has had the following written about him by a judge in a recent, past legal case (see: Workcover Insurer & IMEs behaviour ‘disgraceful’ and ‘seriously alarming’ says Judge)

  • There are a number of troubling features about this case.
  • First, notwithstanding that every specialist in the case took a history that Mr Fogarty injured his back when the straddle crane he was driving hit a pothole, Dr Casikar (see profile on rateanmd) did not take that history. Instead, he seemed to have a history that Mr Fogarty’s symptoms started spontaneously at work with no provocation at all. Such a history was not consistent with Mr Fogarty’s evidence and was surprising, to say the least.
  • Moreover, Dr Casikar’s assertion that Mr Fogarty’s symptoms could have developed at about the same time or the same stage of his life, irrespective of his employment, was unsupported by any reasoning and stretched credulity to breaking, bearing in mind Mr Fogarty’s age and the lack of degenerative changes in his spine, something that Dr Casikar expressly noted. The basis for Dr Casikar’s assertion is not clear. Moreover, Dr Casikar’s suggestion that the proposed surgery was for degenerative changes in Mr Fogarty’s back was inconsistent with the objective evidence and further undermined the doctor’s credibility as an independent medical examiner.
  • These matters raise serious issues about Dr Casikar’s objectivity that warrant investigation into his status as a WorkCover approved impairment assessor.
  • Second, the general conduct of this matter has been seriously alarming. Notwithstanding Dr Casikar’s opinion, his report provided no proper basis for Allianz, viewing the matter objectively and fairly, to deny the claim. A fair reading of the history of the claim demonstrates a perfectly consistent story corroborated by complaints to first aid and strongly supported by all the treating doctors and by several objective investigations, namely, a CT scan, MRI scan and a positive discogram. Allianz had no proper reason for denying liability and should not have done so.

All of the above commentary are about one expert retained by workcover insurance companies (in the above case: Allianz) in a legal action involving a genuinely injured person. Notwithstanding that these judicial findings are public, rumour has it that in any subsequent case, the IME doctor cannot be confronted with these past judicial findings. These past findings are kept secret from the jury/judge/arbitrator hearing the new case and we believe that it is most unfair.

We believe that in order to better protect injured workers, the laws should allow a so-called IME expert (for the Defendant = workcover insurer) to be seriously questioned about his/her past complaints, any investigations and definitely, past judicial findings. After all the injured worker’s entire life is usually scrutinised and exposed, which includes anything the defense can find in an attempt to discredit the injured worker; i.e. a decade old speeding fine!

In essence there should be more transparency. Injured workers should know the full history of the IME doctors who are examining them.

For now, keep rating your experiences with IMEs! And send us any legal cases or articles you may have found regarding the IME, so that we can maintain a sliver of transparency!


 

Injured worker shares info about another “rogue” IME

Recently an injured worker was kind enough to share some information about another rogue IME T Entwisle. In doing so, the injured worker stated s/he hopes it may be of some use.

I’m sure you are aware of what his victims are saying here:
https://www.ratemds.com/doctor-ratings/3494747/Dr-Tim-Entwisle-Melbourne-VIC.html

I searched the Australian Legal Information Institute and found Entwisle has been before the courts for factual errors in his report.
http://www.austlii.edu.au/cgi-bin/sinodisp/au/cases/vic/VCAT/2010/327.html?stem=0&synonyms=0&query=timothy%20entwisle
The applicant won.

Another hearing in the supreme court is also listed for Entwisle against his long-term buddy from medical school
in the 60’s. Ian McGoldrick, yet another rogue doctor.
http://www.bmartin.cc/dissent/documents/health/mcgoldrick.html
http://www.theage.com.au/news/National/McGoldrick-treated-hundreds-tribunal-told/2004/12/06/1102182227380.html
http://www.smh.com.au/business/mccabe-scores-a-deal-on-way-out-20091005-gjch.html

They have both left families devastated with their medical incompetence and each made a handsome profit doing so.

Now these two par*sites have a failed property business venture worth millions leaving hundreds of investors out-of-pocket.
http://www.austlii.edu.au/cgi-bin/sinodisp/au/cases/vic/VSC/2014/14.html?stem=0&synonyms=0&query=timothy%20entwisle
http://www.austlii.edu.au/cgi-bin/sinodisp/au/cases/vic/VSC/2013/709.html?stem=0&synonyms=0&query=timothy%20entwisle#fnB1

I find it hard to believe this is the first time Entwisle has been involved in business dealings with McGoldrick.

I am waiting for the day this rogue is struck of the medical register like his buddy Ian McGoldrick and in the media spotlight publicly named and shamed for the par*site he is, writes the anonymous injured worker.

 

[Post dictated by WCV and manually transcribed on her behalf]



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10 Responses to “History incl. complaints of IME doctors lacks transparency”

  1. Good to be back online! I’ve really missed being able to discuss issues with others in my boat! Hope you’re feeling a little better WCV3! I’ve been puzzling about the following: I’ve reached the point where the insurer is requesting me to see a psychologist ostensibly (according to my verbal conversation with CM) to assess whether there is a psychological element to my injury. When I read the CM’s letter, the reasons given are again to: “Reason for the independent medical examination
    I have arranged this independent medical examination
    1. to assist me to review your medical or other health services.
    2. to assist me to consider your weekly payments entitlements. ”
    Now, I have no problem with this. However I am attending this IME a month after attending an Orthopedic Specialist who clearly states I am unable to work and therefore am entitled to ongoing entitlements, etc. (He even suggested an alternative more serious cause of my symptoms which has not thusfar been considered by medical support “team”). But what really concerns me, is that I have also been advised further on in the CM’s letter that the psychologist IME will/may also do the following: “You may also be asked to demonstrate certain movements to enable the examiner to assess your injury” ???????? I question whether a PSYCHOLOGIST should be doing this straight after the insurer’s ORTHOPEDIC specialist IME has clearly done this with surely far greater validity than the pyschologist. How is a specialist psychologist able to observe with an acceptable degree of authority my demonstration of certain movements to assess the extent of my physical injury? It’s like asking a vegetarian to assess the quality of a slab of meat, or asking an Eskimo to assess the validity of Malcolm Turnbull’s recent seizure of the position of Australian PM. The specialization of Psychology provides no authority as an expert in assessing my physical disability. I am curious to know if the CM is seeking some sort of opinion to the effect that the pain is really for the greater part in my head, so he can reduce the amount of entitlements paid to me? Isn’t there some Workcover rule that if it’s a secondary – psychological issue, resulting from the physical injury, the entitlements may be reduced? Also the psychologist I am being directed to see is not listed on the IME list. I don’t want to mention his name, as I am a little paranoid about being identified on this website.I would welcome some input from you WCV3!.

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    • @Sarah-Jane – with re to the letter you receive to attend (yet another IME), note that you received the typical ‘standard’ letter – this is a pre-made letter template which gets sent to all injured workers who need to see an IME. As you can gather from the letter, your CM is obviously not very ‘educated’ (to say it nicely) as s/he simply copied and pasted the letter without making personal amendments. Again this is so typical of just about all CM’s and it truly reflects their level of education (none, or little) ad care factor (zero). So don’t fret about it, a psych will not make you move your injured limb/body area to assess function. The other thing is that it is very common to be sent to a psychologist or psychiatrist even if you only suffer from a physical injury and even if that injury is severe. The letter that will be sent to the psych will have questions on it, including whether you suffer from a psychological overlay. ((ie. in my case “…it has been suggested that she suffers from a psychological overlay…” (nobody ever ever suggested that in any way shape or form!!!)) So basically there will or may be attempts to shift your genuine physical injury (or some part of it) onto a psychological problem, and worse, blame it on “malingering”.
      It is important that When asked a question by an IME (incl psychologist), you answer only the question, no more. The IME will make up answers for you anyhow. Give as little information as possible. Whatever you do or say will be twisted and perverted to be used against you. Volunteer nothing. You may have read in one of my posts about a Psychiatrist Whore who was asking some ridiculous questions about my parents etc. She asked me whether my mum or dad had come out to Australia t visit me when I had a near fatal complication after one of my surgeries and I said ‘no’. Note that my parents are quite old (well into their seventies) and a flight from Europe to Australia is not an easy undertaking at that age and when they’re not in the best of health. Now that you know how old my parents are, you can estimate my age (not a young chicken either)… Guess what, beside the fact that the whore has no business in asking me about my parents or any other NON-WORK-INJURY-RELATED stuff, the whore decided to write in her typical whore report that “I was very upset that mum and dad did not visit 3 years ago and this is severely compounding my depression/recovery”… OM(fuc**ng)G! So as you can imagine, workcover then tried to make it look as if the cause of my depression was that mum and dad did not visit instead of the other way round: that is had I not suffered the work accident in the first instance I would have not suffered any of its “after effects” either, right. In addition this IME (whore) wrote that I should “undertake volunteer work” – she had NO regards whatsoever for my very serious physical injury, at the time my last (number 7 of 10 I think) surgery had just broken down and my arm was literally hanging out of its socket, the arm blue because of lack of blood supply. I was also on 1 crutch as I had sustained a bad permanent nerve injury to my leg during that surgery when they harvested my hamstrings to transplant into my shoulder. Days following the IME assessment I was in emergency surgery. However because of what the IME stated I was harassed (almost to death) by my CM at the time to return to work (volunteer work) and threatened with all sorts if I did not comply. I did not seek volunteer or other work and simply told the CM that nobody in their right mind would make me work and that she needed to clarify my work capacity (none) with my surgeon and not with a shrink.In the end I won.

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      • Thank you so much WCV3! I had reached the conclusion that it was a generic letter after I emailed my CM (x 2) to query it. His email today admitted the letter is automatically generated with the statement (which supports your statement that he did not bother to check it): “You may also be asked to demonstrate certain movements to enable the examiner to assess your injury.” His first email assured me the Psychologist IME was going to only assess me psychologically. In his 2nd emailafter I’d asked for further clarification (ie. of his official letter re. appointment made and reason for attending Psych IME) then meant that the IME may assess me psychologically on the basis of my demonstrated physical movement – which I suggested as politely as possible was nonsensical). He then replied in an email that I “had a point”; that the letter was automatically generated “as it (always) is (for anyone) whether attending a psychologist or an orthopedic surgeon”, and I would not be asked to demonstrate my physical injury to the psychologist. It seems to me, they should clear up this misuse of language. I can imagine some real psychologist whore of an IME really taking liberties and actually insisting on a demonstration, then claiming the victim was faking, etc.

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  2. HI Sarah -Jane I am still trying to get the petition done ,but I need help please if anyone can add something . We also need stat’s on suicide loss of homes marriage also those who tried to commit suicide I am happy to put my name up at the top of our list but I need help I cannot get this done if no one will help so lets STAND UP AND BE COUNTED PLEASE it can not hurt lets face facts we have been given nothing ,for me they sent me to HELL I found out HELL is WORKCOVER thanks guys and gals xo

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  3. Funny thing how they harass you while you are still in hospital or while you’re basically at point of medical crisis. My CM and her supervisor harassed me while I was suicidal in a mental health ward giving me two days approval and threatening to send me to one of their “independent” medical assessors to see it I needed to be in hospital!!!! Of course, all that did was make me worse!! Then they gave me a week to get out after my psych had a go at the supervisor and CM’s supervisor got onto their solicitor who got onto my solicitor, telling me I had a week to get out because they were making me an offer. So the fact they wanted to settle my claim was the basis of their approval of my treatment!!! In the end they got one of their “independents” to ring my psych but he was quickly set straight so they wasted their money because that made me worse as well so I had to stay in longer! It is pretty tough out there!!
    Any Royal Commission should investigate the fraud being perpetrated by the insurers and their “independents” who have a financial benefit in providing reports that are just plain fraudulent so claims can be disputed. Same old issue of when a claim is disputed, regardless of evidence, the solicitors and the person who wrote the fraudulent report benefit, win or lose because the more dispute the more they get paid!! Even the insurers haven’t realised they could save money by just sticking with the factual treatment evidence in the first place and by just supporting injured workers to get better!!

    The main game is dispute for the benefit of those who create them!!

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    Bashed and bullied September 25, 2015 at 8:50 am
    • Hi bashed and bullied,

      I too suffer from mental health issues which have been aggravated due to a workplace injury, yet work cover do NOT want to even know about them.

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      • It is a long and difficult process to prove you were injured at work or that your existing mental health issues were aggravated and the issue is because you are not well you can’t even begin to fight it all on some days when you can’t think straight or even get out of bed. I only survived because my partner fought for me as did my psychiatrist and psychologist. I had everything documented of what happened in my workplace and I made complaints as it happened. I had times when I have self harmed in my effort to get away from it all and I was bullied further by the insurer after I was medically retired by my employer. It took many years to settle my claim and I am better without the continual bullying and harassment from the insurer. I am still guarded about my mental health and still attend my treatment because I have to be careful as I can go down so quickly. The trouble with the workers comp systems in regard to mental health is that they lack understanding and knowledge of how people can be effected by workplace events as well as what a person with a mental health illness has to endure just to live let alone live in peace. There is no peace with mental health illnesses and it is a disgrace the manner employers and insurers bullying those who have such issues.
        I would only suggest you get some legal assistance. The state you are in will have its own means of legal support. In NSW you can find a solicitor and have them apply for assistance for you through ILIARS at WIRO. You can call WorkCover direct on 131050 for advice. I assume when you say WorkCover you mean your insurer.
        Has your employer submitted your claim? Were you subject to an IME who reported you had a pre-existing psychological injury and then deducted this from your percentage of injury?
        There are a lot of hurdles to jump over but if you don’t have much luck with Workers Comp you may have been discriminated against by your employer if they knew you had a pre-existing mental health problem and bullied you because of it. if this is what happened then ring the Anti-Discrimnation mob in your state for advice. If it was the case you were sacked due to your mental health issues you can ring Fairwork Australia for advice.
        Without knowing what happened or your state I can only give you the general advice above.
        Just make sure you keep up treatment and see a psychiatrist and psychologist under a Medicare Mental Health Plan and find time to nurture yourself. I was lucky to have support from my family who still look after me and make sure I am safe.

        You are a person and you have the birthright to live in some peace and you deserve it. You are worthwhile regardless of what other people think or do to you or how they judge you. Be yourself and accept that you may be unwell but that doesn’t mean you are less value than any other person on the planet. As I say, we are all on the spectrum of something!!
        Look after yourself. Hope this helps.

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        Bashed and bullied September 26, 2015 at 11:26 am
  4. Thank you so much for your reply. I am covered for up to 85% of my wage on Work Cover here in QLD. I have only been assessed via my GP and had an MRI, and am still awaiting an appointment with an orthopedic specialist of my choice.
    I have not seen an IME as yet, but as I had so much trouble with my prior injury, and am not 100% strong emotionally, I have spoken with my previous case lawyers, however am hesitant to proceed for fear of being fired from my job.
    Your reply has given me some courage and I really want to say thank you,

    Doug

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  5. Thanks, Doug.
    Just put one foot in front of the other and get through your treatment as one can only deal with one thing at a time. The most important thing is to survive and until you have your appointment with the orthopaedic surgeon you won’t know which path you might take so don’t panic about anything yet.
    I am in NSW so it may be different but in any case you need to reach maximum medical improvement before anything like lump sums come into play. Hopefully you will get good recovery and get back to work.

    People who run this website are really good people and everyone on here is very supportive so if you are down, have a say and someone will help you stand up again. It is my pleasure to be able to help someone else and it makes me feel better as well.

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    Bashed and bullied September 26, 2015 at 7:37 pm