Let’s just imagine that we are a doctor or specialist and that we’ve accepted to treat an injured worker.Who is really making the medical/surgical decisions about our injured workers? Shouldn’t the workcover insurers at least share the liability or at least bear the responsibility of their own actions or lack thereof?
Many workcover victims ask us whether IMEs can prevent an injured worker (you) from getting recommended surgery. Unfortunately the answer is “yes” but the following tips may ensure you win the “battle of the medical opinions” and have your surgery approved by workcover.
The following “Guest Post” submitted by “Mad Chef” highlights that Independent medical exams (IMEs) are among the most disputed components of our troubled workcover system, and offers some tips on how to challenge an IME/insurer’s decision (in VIC).
When surveillance material (e.g video) is sent —by the workcover insurer— to an Independent Medical Examination doctor (IME) or a Medical Panel for commentary/opinion/assessment, basically the surveilled injured worker is entitled, by law, to explain (alleged) “inconsistencies” between the surveillance video and the injured worker’s medical history/restriction.
This article is dedicated to injured worker “Kevin”, who has (had) the courage to confront a(n alleged) grossly biased IME in court. Never forget that the IME (for example an orthopedic surgeon) who has been hired by your workcover insurer to do an “independent” medical examination of you is not your friend. Most are only hired to do a specific job and that is to minimise the damage aspects of your workcover case. Some IMEs are pretty honest and their assessments, reports and even Court testimony is straightforward. BUT there are some IME doctors who have absolutely no moral. They will say whatever they need to in order to advance their client’s (the workcover insurer) cause and goal.
Back to the topic of workcover insurer-chosen IME doctors, which remain an ongoing problem for many injured victims. Many of these so called independent medical examination (IME) doctors are in the IME business because they are looking for another way to add to their income by doing these exams. It is important to understand that money, and the promise of future income
can often will influence those IME opinions.
The following story, about a ‘bad’ and/or ‘questionable’ experience with an IME Orthopedic Surgeon in Castle Hill (NSW) was submitted back in December 2014 as a “Guest Post“. We weren’t quite sure whether to publish it or not. In the context of the current “IME” theme, we have decided to publish this story, however we have censored the IME’s name, which was put into the title (heading) of the originally submitted “Guest Post”.
Better guidelines and quality control are really needed for independent medical examiners (IMEs) and impairment assessors, along with rigid ethics requirements and recordings of examinations/assessments of all injured workers.
The following article was submitted by “Bullied” as a Guest Post. The article focuses on a shocking, disgraceful, totally unconscionable recent legal case (NSW) that basically highlights everything that is wrong with the workers compensation system, including the insurer and the IME. The Judge in this case directed that the independent medical examiner (IME Dr Casikar) AND the workcover insurer (Allianz) both be investigated for their disgraceful and seriously alarming [mis]conduct!
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.”