IME: hired guns

 

Also know as Medical Whores

hired-guns-medical-whores

What is an IME?

It is an examination scheduled by your employer, its insurance carrier or third party administrator. The purpose of the IME is to obtain information about your injury from another source in order to evaluate or contest your injury.

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How is it independent?

It isn’t. We prefer that you think of the examination as a “defense medical examination.” The insurance company selects the doctor who is going to perform the examination from its list of (preferred) ‘approved’ doctors. Who do you think is on the list? That’s right, doctors who have told the insurance company what it wants to hear.

Who performs these examinations?

Doctors of all variety of skill and training do these examinations. Typically, we see doctors who are just starting out in practice and doctors who are winding down their practices (yep, that’s right, there are many octogenarians!). Both of these groups of doctors are looking for another way to add to their income by doing these exams. A smal group consists of doctors who actually enjoy the work, which frequently involves testifying in legal matters. It is important to understand that money, and the promise of future income can often will influence opinions. Medicine is not an exact science. There is often room for reasonable doctors to come to different conclusions about the same case. That is why people seek second opinions. If an examining doctor could go either way on an opinion, do you think that he is going to go your way or go where the money is?

Is the examining doctor required to follow the rules of the medical profession?

Yes and no. Because the doctor will not treat you, no doctor-patient relationship arises as a result of the examination. What you tell the doctor is not privileged. The doctor has no legal duty to you. So, if his opinion is wrong, he cannot be sued. The doctor will not tell you what the doctor thinks and will not answer your questions. But, the doctor needs to be able to show that the examination was done according to normal protocols and that he reached his conclusions in a medically reasonable manner, otherwise the doctor’s opinion can be rejected by the court as inadmissible or as unbelievable. There is a lot of room for manipulation of the outcome.

IMEs or Medical Whores

Hired gun-IMEFor those who are not familiar, workcover claims/case managers are able to require an injured worker to attend an appointment with a medical specialist for a so-called independent medical examination. The claims manager may or may not provide the medical specialist with the injured worker’s claim file or other (relevant) medical reports that have been undertaken. The ‘independent’ medical specialist will be asked to answer one or more questions relating to the existence and management of the injured worker’s medical condition.

The subsequent report of the medical practitioner, provided it complies with the relevant guidelines, can then be used to determine the injured worker’s entitlements and in any relevant legal proceedings. An injured worker must attend the independent medical examination, for failure to do so would be considered a breach of the obligation of mutuality and could result potentially in the discontinuance of weekly payments.

There is no specific provision in the Workers Rehabilitation and Compensation Act dealing with IMEs and, as such, there is no limitation on the justification for the number of independent medical examinations that a case manager can require an injured worker to attend.

It is very well known that some IMEs (some whom are even flown in interstate) have a reputation for being pro WorkCover; that is, they are more likely to provide a report that is favourable to the claims manager’s interests and hence detrimental to the injured workers.

These include independent medical examiners engaging in unorthodox practices designed to intimidate injured workers and are also known as HIRED GUNS or Medical Whores (prostitutes).

We found an interesting but older (2004) parliamentary “Questions on notice”  where Senator Harradine asked in writing: How many specialists does Comcare employ to assist it in making determinations as to whether to continue liability or otherwise? How does Comcare determine which specialists it employs (as consultants or in any other role)? How does Comcare determine whether to discontinue using a particular specialist? Please provide a list of all specialists employed rude-doctor-imeby Comcare, their names, positions and company, and the dollar amounts paid to each for each of the last five years?  From this paper you can see how much certain IMEs have been paid by Comcare, reflecting the (over) use of some well known not so independent IMEs. For example, DR JOHN MICHAEL SABOISKY received $61,530  between the years 98/99 to 03/04.DR NEIL WILLIAM MCGILL was paid $60,863… Worth having a look at. See Answers to estimates questions on notice – additional estimates 2003-04.

Wouldn’t it be very interesting if all workcover authorities and their agents published their lists of IMEs and the dollar amounts paid to each one? Undoubtedly we would see the ‘preferred’ IMEs.

Did you know that a small group of IMEs are paid up to $500,000 to deny claims and surgery!? Also see original media article (NZ) “Minister to examine latest ACC claims“; “High-paid ACC doctors in Otago“; “Questions and Answers – September 13“; “Questions are being asked about ACC’s specialist assessors

The 4 doctors named are Martin Robb, Vic du Plessis, Bill Turner and David Beaumont

Dr Beaumont and Dr Robb are registered as consultants by the Australasian Faculty of Occupational and Environmental Medicine.

Whils these IMEs were identified in New Zealand, We have been made aware that at least one of the doctors has already visited Australia, used by a certain workcover insurance company, to, ah well, deal with long(er) term injured sods! Beware!

How to prepare yourself for an IME

You may want to start by reading our popular but factual article entitled Disillusion yourself of any idea that the independent medical examiner is independent to get a good idea of what we are talking about (and dealing with) here!

There are quite a few things you can do to protect yourself during and independent medical examination (a must read) however here we expose a number of known hired guns which you must avoid at all cost! (Many more useful articles can be found under the Tag ‘Medical Exam (IME)‘.)

Some, most of those so called IME’s will kill your case in less than 5 minutes.

Refusing to attend an IME / complaining about an IME

If your case manager/workcover insurance has requested you attend a well-known hired gun for an “independent assessment”, you may be able to refuse to see this IME, it is your right to refuse to be examined by a totally biased IME and your lawyer can help you to be send for examination to another more ethical independent doctor, on the argument that ‘all IMEs are supposed to be independent, so what’s the problem?’. However, generally speaking you would need to have ample hard evidence that this IME is biased. This can be in the form of a publication (news article, journal article, etc) showing a clear bias (and as such ‘conflict of interest), but you can also make a case in the event this IME has a ‘fishy’ past (eg. prior convictions etc).

If you believe the IME has ill-treated you, please make a formal complaint. You must do this in writing to the workcover authority, and also to the medical board in your state.

If a worker is concerned about the conduct of a [s112 (VIC)] IME examination, they may make a complaint (best in writing) to the workcover authority.

Complaints may include allegations of any of the following:

  • causing unnecessary pain in an examination
  • complaints of an examiner’s manner
  • incorrect reporting
  • inappropriate behaviour

Also make a written complaint to your insurer (case manager/cc Team Leader) and request the IME makes corrections to his/her report.

For more info on how to make a complaint see FAQ WorkSafe Vic → Workcover Vic Complaints

Similar processes apply in all states.

If the worker has lodged a complaint and specifically requested not to be referred to the IME again, agents should seek an alternative IME for future examinations.

And remember that you can appeal any decision your insurer has made based on for example a dodgy IME report!

Before you collapse from a nervous breakdown at the imminent prospect of having been requested to see a hired gun, please take a deep breath and take some comfort in the fact that many of those hired guns are laughed out in Courts! That’s right! Their reputation(s) are so bad, they simply have no ‘leg’ to stand on when it comes to their biased and twisted ‘opinions’ or even ‘testimonies’ in a court of law. Many are not even trained in the field of our injuries (i.e you suffer from a complex orthopedic injury yet are sent to a geriatric octogenarian ‘occupational’ physician or worse, a ‘general surgeon’) and their opinions do not compare to those of our own experts in the field!

aworkcovervictimsdiary.com believes that our government can and should do a far better job within workcover system to at least ensure that all workcover victims are treated fairly so that they have the best possible chance of reaching optimal recovery after a work injury.

Getting rid of biased IMEs

One way to ensure a fairer system would be to purge all poor quality -and frankly- biased insurer-chosen IME doctors, which are a massive ongoing problem for injured victims.

In order to attempt an ending to the practice of substandard, biased IMEs injured workers should all add links to interesting stories and legal cases with quotes from the judges (where applicable) of fact that speak volumes about the inferior quality of these IMEs.

Injured workers should also make a formal complaint about any biased, unethical, inappropriate IME they have been sent to.

Read more on how YOU can take action, and help us purge the system of all rogue IMEs>>

Know of any disgraceful, biased IME?

Know of any biased, bad IME? Please share this doctor with your fellow injured workers.
However, please be aware that the administrators of aworkcovervictimsdiary.com have received lawsuit threats for alleged DEFAMATION. (see case 1, and case 2). It is therefore extremely important that, if you wish to name and shame an IME, you provide the hard evidence of alleged wrongdoing and that you are fully prepared to stand up in a court of law to defend a defamation lawsuit!

If you cannot provide written evidence of wrongdoing, aworkcovervictimsdiary simply cannot publicly publish your allegation(s), as they are not prepared to cop the blame for unfounded slander, and be dragged into a court of law and deal with the additional cost and stress of litigation for something you wrote without substance.

You can however rate any doctor on “rate an MD website” and use the link (and not the IMEs name) in a comment. Yoy can also rate and review our list of known IMEs on our IME List page. You can also use anonymous sites such as PasteBin.

Example of RateMD

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Good luck with your IME’s…. make sure your read the articles under ‘IME’  for some good tips and insights and how to prepare and protect yourself during those dreaded examinations.

 

tipA Useful resource: List of IMEs and ratingsrate

 

updated 24 Sept 2014

313 Responses to “IME: hired guns”

  1. Hi guys thanks for sharing your experience with your cases iv been on workers comp since mid 2013 and its been one hell of an awful ride! The insurance company’s have caused me more pain than my injury I didn’t believe they could be this bad! I feel for you guys I really do! I have a question guys iv been asked to attend an ime examination for the 3rd time this time with a rheumatologist they have selected 3 and want me to choose one they are: dr Christopher Browne,dr loretta reiter & dr Peter youssef. I was wondering if anyone can give me any info regarding these doctors like if anyone has been to them anything will help I don’t know which one to choose. Thanks guys all the best 🙂

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    Rondell Sally May 31, 2016 at 4:00 pm
    • Hi. I don’t know the other 2 drs but I did see dr Christopher Browne a few years ago. He actually reported to the insurer in my favor. Not sure what he’s like now though.

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  2. Hi thanks for your reply he reported in my favour aswell! My original doctor gave me 55 wpi but dr brown stuffed up my results whoever does see him my advice is check your results! Dr browne first gave me 4% wpi then after seeing my doctors report gave me 20% wpi then after i saw a doctor from the WCC dr loretta reiter she gave me 31% wpi and stated shes not sure how dr browne got 20%wpi according to the same charts should of been more like 34%wpi because their results were similar. This is for regional pain syndrome right arm! Now we are proceeding to a damages case and the insurance want me to see dr browne again for a work capacity assessment. Hope this goes well! Thanks again for your reply i appreciate it 😀

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  3. Be aware that in NSW the guidelines for IME’s have been changed, the insured now MUST give you a choice of 3 IME’s so you can pick one. they must start with 3 within 30km’s, if none, 50km’s and gradually expanding outwards.

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    Sharon Hughes June 23, 2017 at 6:49 pm
read-before-u-commentThis is a statement pointing you to our seriously injured but esteemed and honourable Social Networking Sites Warning and our comment policy. A must read in the context of a very adversarial workcover system! Remember to mention in which state you reside if you seek advice.

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