I am desperately trying to make sense of the reason(s) why my case manager from hell has send me yet again to an independent medical examination (IME). Anyone able to make sense of this?
According to the Claims manual, If the information is sufficient to resolve the medical or treatment issues then a s112 report is not required.
My case manager requests I attend a physical IME
22 May 2011
My case manager you wrote to me that “I note you have made several comments about your physical condition but I am only interested in assessing you psychiatrically“. WTF 😉
This after a) I underwent an MRI in March showing serious deterioration (ruptured ligaments) b) my treating orthopedic specialist knee surgeon requests approval for major surgery (which I eventually did not undergo because after numerous failed surgeries and many serious complications I am too scared). However, when my case manager requested I attend a psychiatric IME I asked her why on earth she was not sending me to a (more appropriate) physical IME.
I attend a psychiatric IME and the report states that I am totally unfit for any work for the foreseeable future. The report also stated that I must have taxi transport as I am unable to drive or take public transport without the risk of serious further injury.
“We are arranging a further physical assessment because it has been 12 months since your last assessment.” WTF 😉
“We will make a decision about your eligibility for taxi transport to and from medical appointments once we have reviewed both the physical and psychiatric independent assessments” A shrink assessment for taxi??? WTF 😉
“The physical assessment will be with Dr X – X Orthopedic Surgeon on the [date] @ [time]”.
“Mr X has called to advise he cannot consult on the [date] and due to the fact he was not available for some time we have arranged an appointment with Dr XX on [date] @ [time].”
“You will be sent a letter with all Dr XX details. He is an Orthopedic surgeon and based on all the information you have been providing regarding your injury we believe it is necessary to have the injury assessed based on my conversation with your specialist orthopedic knee surgeon.” WTF 😉
“Mr XX is a general Orthopaedic Surgeon whom I have requested to provide an objective clinical opinion, taking into account all the information we have available from your claim file and the information you and your treating doctors have been providing us regarding your injury and my conversation with your treating specialist knee surgeon.”
I replied as follows: ” you must provide me with a written request to attend an IME, and provide me with the reasons for the IME (with a surgeon who does not have expertise in knee injuries. You also need to give me (written) sufficient notice for the IME appointment with date, location, explanation for the IME. As explained earlier I will undergo numerous scans and tests the day before which have many side effects such as vomiting and dizziness and there is a high possibility that I will not be fit to attend the IME the next morning. Can you please reschedule the IME.”
Please find attached a copy of the letter for the appointment with Dr XX on [4 days later] @ [time]. The appointment details are as advised in an email on 26.7.2011.
You have an obligation under WorkCover to attend IME appointments in relation to your work related condition. If you are unable to attend the IME due to prior a medical appointment, you will need to provide information from your doctor confirming this. WTF 😉 I told her!
When I looked at the “formal letter of IME appointment” …
The “reasons for the IME” were (WTF???)
In addition the letter states that Dr XX is an orthopedic surgeon (specialised in KNEES). However, Dr XX is NOT REGISTERED as a “knee” specialist, nor “shoulder & elbow”, nor “hand” specialist. He is not even registered as a “trauma” surgeon, but is registered as a GENERAL orthopedic surgeon.
Also, I had been scheduled to be reviewed/examined physically by the Medical Panel, on 16 August, just a week after the IME.
- Why did my case manager send me to a physical IME? Considering that I was in any case certified unfit by the recent psychiatry IME for the foreseeable future.
- The IME of 1 year ago, with no less than a BOWEL surgeon (I kid you not) detailed in his report that I had a catastrophic injury, a useless limb (this before the further deterioration) and had ‘no current work capacity” and – most importantly stated that “the worker needs to be sent to specialised knee surgeons for surgical opinions”
- Why change the reasons for the IME like underwear? Why can’t they just be honest?
- Why the need for an “objective assessment” of my knee after having personally spoken to my top knee specialist surgeon (who told me that this case manager had dared to challenge his opinion that a) I am totally unfit for work, b) I really need taxi transport and c) recent MRI’s objectively show the catastrophic damage/deterioration of my injury. How can they ask a general orthopedic surgeon- who is NOT specialised in knees- for an”objective assessment” of a highly specialised and advanced, very rare and devastating knee injury, in a young person, that already required 9 operations and is deemed ‘at end stage’ (requiring prosthetic implant)
- Why the need for an IME a week before a Medical Panel Examination (which overrules anything anyway).
When I receive a copy of the IME report, I will share the real reasons for the IME (questions they asked) with you. I am curious!