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

ratemd

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 everyone, how do I start a new thread as I saw an IME yesterday and it was a pretty disgusting experience.

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    • put in a report straight away about his behaviour and the time he spent (or didn’t spend) and send to workcover asap, you need to so you don’t see him again and now there is a dispute and conflict of interest and his report will be rubbished . if agent uses a dodgy report and you have done all this take, report them to workcover also

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  2. Here is another one for you I had a conciliation meeting yesterday and the workcover agent used a phone recording of a conversation with my case manager to try and get out of approving my surgery request.They rejected my wages a few months ago from a report from an IME and they used the same rejection letter for my surgery as the one to reject my wages with the first one being about my current incapacity thats how lazy they are. I still didn’t get any where after all the times I have been to conciliation I find the process rather pointless they don’t seem to have enough power to over rule any wrong decisions.

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    • Cloud, when at conciliation ask the conciliator if its possible to be referred to the Medical panel to answer questions about your condition and weather you need surgery.

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      • @Jo my lawyer is not to keen to go up against a medical panel at moment. The agent was told by conciliator to ask the IME if surgery is required from my original injury from 2009 which in his first report said it was but agent still hasn’t done it yet but hopefully it will all backfire on agent because concilator stated they have no argument but he could not really do much with the limit of 5000 dollars I would have been out of pocket and would have had to pay for any costs over 5000 for surgery

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  3. These doctors are not independent because they all work for big companies.
    These doctors become Medical Examiners using their doctors credentials, abuse their codes of conduct and practice and their hippocratic oath, and abide by the Independent Medical Examiners guide lines for monetary gain, and after they’ve prevented an injured worker from receiving treatment from WorkCover, through foul means they go back to being a doctor treating the sick and injured. They are hypocrites!!

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  4. It is pointless going to any government department for help as they are all bound by red-tape, and because WorkCover is a government entity, you will get no-where. Also if you an elderly worker and have a workplace accident the compensation lawyers do not want to know, because it’s not viable. ? viable for who I haven’t found out yet. I was given the run around by the law firm that Erin Brockovich is associated with, and then was told that my case was not viable. Why shouldn’t an older injured worker get the same treatment as a younger injured worker. None of us go to work expecting to be injured.

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  5. So well said!
    exactly what I’m thinking but could not put into words… thanks

    I wonder how many of these unethical
    “doctors” are actually being reprimanded or their behaviour looked at by the medical board???

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    • @Kaye/Elise so sad but true.Corruption all the way to the top!
      Decided to contact WorkSafe Advisory service for some help.
      Might as well have called the bloody insurance company for all the help I got.
      Nice to know whose side they are on. All in bed together- must be pretty crowded!!!!!!!!!!!!!!!!!!!!!
      MadChef

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  6. The first oath of a doctor is “cause no harm”. IME’s do just the opposite of that – but I suppose every profession has it’s rat bags.

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  7. IME Dr. Richard Marks, Neurology. I had to have an IME with this whore, I have a stopwatch on my Iphone 5s, I had the stopwatch open and ready, the second he walked in I hit “Start”, the second he said, “Okay we are finished” I hit stop, it took Dr. Richard Marks a GRAND TOTAL of ONLY 2 minutes and 20 seconds to do a neurological IME exam! I sent out complaint letters to 5 different places, NONE of which cared, including my claim manager.

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    • My claim is out of Washington State, claim manager Mike Heaps.

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      • Looks like this is a world wide problem… But the neurological exam I had was done properly. I spent at least 30 mins in the Drs office, wish I could see him for treatment as he actually wrote me an honest report..

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  8. (A) Has anyone tried to contact the Ombudsman, Deborah Glass? Where has her “own motion” into Workcover, including IMEs gone? I have heard on the grape-vine that she is: (1) Not accepting submissions, but will still accept your individual complaints about Workcover; (2) Won’t investigate any complaint that is: (a) More than 12 months old; (b) Has gone before Conciliation; or (c) Is or is likely to be the subject of a legal dispute. (B) Also, has anyone heard before of an IME who was initially very supportive, being asked by the insurer 3 months after my after my last appointment with him for “a supplementary report” which he wrote without seeing me that effectively negates the main point of the report he wrote when he last saw me?

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    • Sarah-Jane happens all the team…my original treating surgeon and an insurance IME who both wrote reports in my favour…where both hassled by the insurer to write supplementary reports as the insurer was not happy with their outcomes…My treating surgeon was swayed by the insurer and wrote a contradictory report….where in one breath he states incapacity and in another denies it exists and tried to say my injury in the supp report was pre-existing whereas all his other reports state they are related to work injury…..The only thing in my favour was the insurance IME who was my treating surgeons mentor during his training days refused to budge on his findings and stated he was not a man for hire!…Hence my then treating surgeon could not go against the IME’s report other than stating what the insurer wanted which was my injury was not work related or it was pre-existing…This showed me he WAS a man for hire and I dropped him like a hotcake….Whereas the insurers IME was dropped like a hotcake by them as he refused to write the reports they wanted…..That IME Dr has since written me a new report which has not changed from his original reports other than the injury will never get better….This lovely truthful IME is now my treating Dr as he refuses to do reports for insurance Co’s now….so challenge the reports….I did read somewhere either on here or on the injured persons site about insurance Co’s forcing Dr’s to write reports in their favour otherwise they wont get anymore work…and they hassle the Dr’s to death where the Dr eventually caves in and writes want the insurer wants…..

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  9. australia post has and does use IM whores to avoid, deny responsibility towards injured employees and victim blame at any cost.
    Also be interested to hear comments on Doctor Frederick Phillips, flash new rooms ( someone is making the dollars) milcoa wa and any thoughts on Dr Michael Alexeef also wa.

    disgusted March 2016

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    Briarne Isabella Langton March 29, 2016 at 1:35 pm
    • Well I guess he needs to fund his expensive habit somehow….West Perth doctor Michael Alexeeff’s hopes of erasing a past Melbourne Cup nightmare are still alive, with his mare Allez Wonder almost certain to be part of another imposing Bart Cummings assault on the big race. probably one of the main reasons why he chose to be a hired gun….His reviews on ratean MD are varied…i wouldnt trust him

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  10. have been doing a little research on a company called Mlcoa, very slick, but what is it about beauty being only skin deep, very true Granny. Mlcoa state their aim is to provide optimal outcomes for all clients, including the delivery of IME’s and resolution of long term cases. How can they possibly provide optimal outcomes for their client and at the same time provide an independent IME on the injured party who is not their client. Do these people actually believe this crap.Also worth a read is enticements they offer to encourage doctors to consult for them

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  11. yes you’ve nailed it HONEST REPORT they are the key words, that is what I wanted, whatever that was. I doubt that the doctor I saw will ever be held accountable for his dishonesty, however I will on principal alone make a formal complaint to the Australian Medical Board.

    regards

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  12. I’m dealing with a hired gun at the moment. I’m on Comcare with a self-insured company with a long-running orthopaedic issue. After four orthopaedic surgeons have agreed my case is permanent and degenerative (including an orthopaedic specialist from mlcoa), they sent me to a “geriatric octogenarian ‘occupational physician'”. His prognosis: mild degenerative arthritis, and claim my pain is “contrived and exaggerated”. His physical examination only took 5 minutes, and involved jerking the joint to the side and using his shoulder and whole bodyweight to test range of motion. The history section took 2 hours, during which I had to get up twice to ease discomfort, yet he noted that I “sat comfortably for 2 1/2 hours”. Despite being a cartilage injury, he sent me for an x-ray, non-weight bearing, which shows none of the cartilage. He used this as “definitive proof” that pathology is absent, resulting in a “fair opportunity” letter stating that they are ceasing all liability. During that period I’ve had an MRI and an appointment with an orthopaedic specialist, revealing that the knee has a radial tear, full-thickness wear to the medial and patellofemoral compartments, a joint effusion and chronic synovitis. Don’t let these wise-guys tell you any different, they’ll use subtle underhanded techniques to create doubt in your own mind. I know I’ve still got a fight ahead, they’ll probably still try to cease liability despite hard evidence. But stick to your guns!

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  13. write to the medical board and complain about this “specialists”
    this is their bread and butter, being paid by insurance and lawyers…
    however they do not want to loose their licence. I know it’s another hassle to have to deal with but it can be very effective especially since you have the proof of many other professionals contravening his “verdict”.

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  14. Hello,

    I just signed the petition, “NSW Upper House Members: It’s time for an Inquiry into the real impact on Injured Workers..”

    I think this is important. Will you sign it too?

    Here’s the link:

    https://www.change.org/p/nsw-upper-house-members-it-s-time-for-an-inquiry-into-the-real-impact-on-injured-workers

    Thanks,

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  15. I will be glad to! I think we need one in Victoria too!

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