DCBS: IME Survey - Claimant (Worker) Attorney Statements

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DCBS: IME Survey - Claimant (Worker) Attorney Statements

Postby Webmaster » March 4th, 2005, 2:50 pm

Claimant (Worker) Attorney Statements in DCBS IME Survey


Claimant Attorney IME Survey Question 5. What specific types of feedback have you received from your clients regarding IMEs? (selected survey answers listed)

1. Discourteous treatment of claimant.
2. Being forced (by physical means) to perform range of motions beyond their comfort level.
3. Having information in the report about testing done which was not actually done.

Rude and degrading treatment; cursory evaluation; rushed exam

Did not thoroughly examine claimant did not seem too interested or knowledgeable, told claimant one thing then wrote something else.

Rude, made to do movements that go beyond what they are able to do on their own (Doctor raising arm higher than could do by herself). Mischaracterization of facts and medical records.

Rushed, physicians asking "why are you here?" or missing file info or radiographic reports, demeaning attitude cut off when tried to list complaints, poor on professionalism

Outrage - based on being manipulated, misquoted and at times psychologically abused

Clients are treated like criminals, rudely , are hurried through exams and are not treated decently, like they should be

Doctors are rude, cause pain, don't listen, distort what clients say

When a lay person gets to a Dr the lay person expects some compassion at the very least. Sadly, most clients are looked at as malingerers and liars by IME practitioners

many feel abused by examiners

worsened symptoms; extremely brief time spent examining; no history taken; misrepresenting findings on exams when compared to later report

Reports contain inaccurate recitation of facts; Too little time spent on exam; rude/discourteous; Force Physical maneuvers to get desired or better finding; report findings but don't do exam (ie normal ROM, no Atrophy, strength normal, etc.) Examiner doesn't listen.

The physicians are rude or at best "cold" failed to perform tests which appear as having been performed in IME reports, etc

My clients often receive very positive feedback from CME's but then they are shocked at the written reports negative results

bullying by doctors, very short actual exams by IMEs, misrepresentation of what clients actually said by IMEs, IMEs say something different during exam than in their reports

They take 10 minutes. They are rude. They will not listen to answers.

Inaccurate info- minimal testing

One story regarding a female client with CTS. this buxom woman was told to sit bare chested in front of the panel of IME doctors. CTS is a wrist injury.

Rudeness, lack of respect, trickery, lying right to the claimants face.

They insult the claimants

feel disrespected - like cattle

Doctor not prepared, had not read chart, doctor unpleasant, doctor said I lied and that all was in my head, doctor examined wrong arm, doctor hurt me, doctor did not report what I said accurately.

The IME doctors are rough, push on them to increase range of motion, are discourteous, and things of that nature

The doctors are very rushed, they do not accurately report what occurred during the exam.


Claimant Attorney IME Survey Question 7. What do you consider the three greatest concerns regarding the IME process? (selected survey answers listed)

1. It is biased. You can't expect retired doctors who make 100% of their living from insurance paid medical examinations to write much that is contrary to what their paying client is going to be happy with.
2. Because these are either retired or non-practitioning physicians, they hold themselves out as being experts where they have no expertise. For example the orthopedic "surgeon" who has not done surgery since the mid-1980s, and is probably unaware of new diagnostic procedures or surgical methods, yet holds himself out as an expert.
3. Lack of fair information gathering process. The IMEs are, after all, given their instructions from the insurance company who is either looking for a reason to deny a claim or close a claim, or find that there is no permanent impairment. Therefore, the information taking is going to be slanted to achieve the insurer's ends.

Most of the Docs are no longer practicing
Most of the Docs have been "educated" by ins. co.

Bias of IME Docs
Insurers ability to outspend claimant to "shop" for opinion.
Inability of claimants to get treating Drs to respond

No back-up declaration under penalty of perjury required ( See Washington Labor Code #).
Opinions are cusory without back-up explanation.
Ime process is adversarial rather than neutral.

1.Impartiality
2. Doctor as advocate
3. Distance/travel from Central Oregon residents

Same physician w/boiler plate explanations
No attemps to schedule examinations at reasonable locations
weight attended by insurer to opinion

1. Doctors making 100% of their income form Insurance Companies doing IME's
2. ALJ and Board members not knowing that some IME doctors do not have credibility in the medical community.

That only doctors predisposed to opinion favorable to insurers are chosen
That the IME doctor does not demand more testing before rendering opinions
That Doctors rely on insurer referrals for a high % of their income

Unfair purchased opinion
Unprofessional handling documents or not having documents
Doctors attitudes/professionalism

Doctor bias
Doctor incompetence
Dishonesty

Rude doctor, exams not thorough enough, inaccurate reports

Biased
Biased
Biased

The physicians are grossly biased. They are paid by the insurance company and know if they want any continuing referrals from the insurers, they need to tell the insurer what will prove the insurers' position.
The IME companies have editors who make sure the reports are written in the language that the insure requires. Injured workers depend on the willingness of their overworked attending physician, who usually does not have time to write an extensive report
Injured workers rarely can afford to pay for expert opinions, while the insurance companies have an open budget for purchase of defense evidence. The process is economically unbalanced in favor of the insurer

IME's are a joke The whole Workers Compensation system is a joke. If you are an Injured Worker in Oregon you are screwed

not impartial
travel to portland is hardship
examiners do not act professionally

Integrity of examiners is lacking
No oversight of IME examiners
Inherent conflicts of interest w/ Insurere doctors and fees and opinions and repeat business

Examiners are Biased
Examiners are tired, retired, lazy and not up to date
Insurers are allowed to use doctors whose opinions and philosophies are known in advance (e.g., Dr. Radelki and Dr. Wathan on carpal tunnel syndrome).

IME docs work backwards to get the result the insurer wants
always always err on the side of the insurer
clearly not objective - usually have been prejudices by adjuster telling untruths

Bias
Unethical
Too Lucrative (leading to competitve dishonesty)

insurere bias of IMEs
undermine attending physician and jeopardize health and treatment of worker
slow down access to justice by injured workers due to delayed hearings, depositions etc

Bias
Bias
Greed

Biased doctors
Biased doctors
Incompetent doctors

Biased
Not treating Doctors
These guys go to conferences to learn how to screw workers

bias
bias
bias

Paid advocates with obvious bias.
Paid advocates with obvious bias.
Paid advocates with obvious bias.

Not independent
Too much and to be made by hack, retired, or suspended MD's

Lack of objective evaluation caused directly from the development of an Insurance defense cottage industry.
Use of IMEs to harness claimants ie pschological exams for shoulder injury.
Too many allowed without having to request them from the department
No witnesses or recordings allowed of examinations
out of town
inaccurate

Drs are bought by insurance companies
Drs are not practicing physicians

Doctors completely bought and paid for IME Doctors make 2---400,000.00 per year
No oversight
No liability for anything they do

Extreme bias and financial interest of
Misrepresentation of tests and findings on exam
Inability for third party observation

Dishonest "doctors"
Rude doctors
Doctors that hurt people: Radecki

The IME process is thoroughly corrupted. Doctors who perform these exams are in the business of telling insurers what they want to hear and they are highly paid for their service. The suggestion that these doctors are independent is a travesty of language, as are some of the firm names, ie. "Impartial Medical Opinions."

Fraud by IMEs
Bias by IMEs
Insurer are in essense buying back claims on the cheap by developing phony theories

Many/most IME Drs are "retired" earning big bucks by helping insurers get denials affirmed. (the insurers know which IME Drs have the "right" biases- these doctors have made up their minds about causation issues long before their examine / speak with claimants. Very, very frequently they do not even ask the claimant what their work involves.

It is totally unfair to the workers regarding selection
The reports are biased
It is almost impossible to get an attending physician to fully respond and the cost is huge.

Bias -Bias-Bias

Dishonest Doctors
Dishonest Doctors
Dishonest Doctors

doctors try not to see anything
doctors try not to see anything
doctors try not to see anything

Biased Doctors
Treating physician opinions should be given greater weight
Expense of combatting IME doctors

Doctors are chosen for expected opinions - particular biases
Workers usually end up seeing IME as tool to limit benefits

the doctors are prostitutes for the insurers
the doctors only rarely (5-10%) feel the condition is work related.
the doctors office is too far away

Not "independent" - hired guns for insurers

The assessment in not impartial
clients are sometimes insulted / not treated w/respect

its corrupt and unethical
insurer have the money, pay the doctors and win the cases
IME drs sell their souls

Fairness
Lack of independent judgement
Incorrect reporting of facts and reporting of findings

Impartiality
Competency
Incomplete Information
% prostitutes

1. Client unrepresented in process.
2. Most IME doctors are not balanced, telling insurer what it wants to hear.
3. Client is unfamiliar with the process.

1. not independent.
2. inconvenient.
3. usually precursor to ending benefits.

1. stacked deck against claimants: yo male, truck driver all his life, had accident driving long haul, hit by farm truck. Invest. exonerated his yo male, very depressed by accident because other person killed; saw psychiatrist. SAIF sent claimant to Dr. Heck. Wanted to know why he had not gotten over it in a year. Dr. Heck not objective. Sent to Dr. Heck who said claimant not over it. Tx physician said not over it. Claimant now being sent back to Dr. Heck for third time. Insurance doctors. He knows ahead of time what they will write.

1. numbers of imes allowed.
2. scope of imes, subject matters gone into whether relevant or not;
3. fact that imes are not often practicing physicians.

1. Truly should be reasonable in terms of time and place. Asking people to travel long distances for their ime is very unreasonable, asking too much of the iw. The long travel skews the medical picture. It's a big inconvenience to travel out of town.

Docs seem unwilling to travel to see iws. Or docs are the ones they want because of their opinions, making iws travel out of town.

Short notice on schedule changes. Abuse of IME panels, stretching it out over time. IME physicians dabbline in psychiatry to explain conditions they have no experience in.

1. Relationship between attorney, insurance company and ime doctor is not out in the open.
2. The money interest of the doctor is not out in the open.
3. Predictability of the imes make them less credible.

1. Not impartial
2. Usually simply to give insurance company reason to deny claim.
3. Unfair

1. Old retired physicians who no longer practice medicine but need IME income. . Claimants have no input in the selection proces of IME doctors. . IME doctors offering opinions outside of their area of expertise (psych).

1. Financially driven by the carriers. . Predetermination of results.
2. Nonpracticing doctors earning more money writing insurance exams then they ever made in practice.

1. Bias of physicians who make their income on insurer exams . Physicians making legal opinions in their reports. . Claimant's inability to financially compete (insurer doesn't like outcome, they just get another IME scheduled)

1. The IME doctors know that if they write neutral reports, they won't be rehired

1. IME doctors are extremely biased
2. IME doctors do not understand the claimant's injury. . On more than one occasion, an IME doctor has been untruthful regarding what occurred during the exam.


Claimant Attorney IME Survey Question 8. In your opinion, how adequately do insurers prepare injured workers on what to expect in IMEs? (small selection of survey answers listed)

Only comments to workers regard travel and not process

They don't do much and they should do nothing

I know of no attempts to prepare the worker. Workers are lucky to paid for their travel time

My experience is that insurers compete to win and therefore preparing an IW for an IME is against the insurers self interest

The insurers do not tell the true story to the injured workers
Insurers demand and schedule IME's. They don't counsel injured workers.

Lead worker to believe they will be treated fairly so they co-operate without suspicion

Insurers always threaten workers, many ignorant and unrepresented, that if they don't attend and cooperate with IME something terrible will happen to them. They go to exam like sheep to a slaughter!

Frankly, I am certain that I do not want the insurer telling my clients what to expect because these exams are already so biased.

They don't prepare claimants for the biased nature of IME's

You must be joking!!! Insurers try to trick insurer workers about the process as much as possible, as do some of the doctors!!!
Insurers send a letter to claimants saying you must appear for an exam by x doctor at x date and time. There is no explanation that the doctor works for the insurer, and has no interest in treating the claimant.
They just tell them when and where to go!

All the worker gets is the appointment and the threat to cut off benefits

They are given date, time, location and threatened w/suspension of benefits if they don't show up

If anything they mislead claimant into believing it is a fair process.

This is the iw's attorney's job. First time unrepresented workers have not a clue about what the ime is about.

If not represented, then not at all adequately. Most injured workers believe the insurance is there to help them.


Claimant Attorney IME Survey Question 9a. Comments (Re: 9. In your opinion, how well do injured workers understand IMEs?) (small selection of survey answers listed)

Claimants do not understand that the treating doctor must concur with IME report re medically stationary data, etc.

We do a video here at office

Many think they were sent to an impartial doctor who is there to help them - some think they were sent by their doctor

Most expect impartiality

The phrase "Independent medical exam" is misleading, and workers often expect that they will get a legitimate and neutral second opinion, rather than a biased report

Think Doctors will believe them. Think it is to make sure they get proper medical Diagnosis

again, depends on the client

Many actually believe IME Doctors are their friends and are there to help!

They don't understand typically that a IME (or DME as it should properly be called) is nothing more than another step on the way to a benefit denial

I tell tem what to expect

They don't understand that most IME's are performed solely to defeat the claim.

Few workers understand process. Some with prior experience are negative - prior bad results, failure to be listened to

only after talking to us do injured workers "get it"

Often they think the IME doctor is there to help them! Then they are crushed when they find out IME doctors are not real doctors.

Generally claimants understand IMEs very well after they've been through one and they see what has been written about them. They realize that this doctor has been hired to find a reason to disallow their claim.

They actually expect to be treated politely and to have an honest, unbiased, independent evaluation.

It is hard to get a worker to understand they must attend an examination and cooperate with a lying hack

It depends on injured workers level of experience with the system

Claimants are trusting and unsophisticated. They do not understand that they are in a hostile arena.

Depends on who their attorney is.

Most don't have a clue what they are about.

If they have an attorney they understand it better. If they have no attorney, slightly.

Those who have been in the system know the ime system pretty well. Those who are new to the system don't know what the ime is about.


Claimant Attorney IME Survey Question 11. What are your suggestions for improving the IME process? (all survey answers listed)

Increase the number of practicing/treating physicians who do IME work and require those who do not to provide financial disclosures with their reports.

If insurance companies truly want to have meaningful examinations which are fair and unbiased, they need to employ practicing physicians instead of those who are in the "IME mill" business. In other words, doctors who do IMEs as an occasional supplement to their income, not as their sole income. Thus, the IME doctor would be in tune with patient concerns, up to date (hopefully) on diagnostic and treatment procedures, and more interested in being fair because his income would not be dependant on insurance company funding. I would recommend that an IME doctor's income must be at least 65% derived from a practice.

get rid of the poor Docs; make them qualify to do IME's one qualification should be that they still practice

Take away the economic advantage of insurers. Provide economic incentive for treating Drs to express complete and detailed opinions

1. Require a back-up declaration under penalty of perjury be required for IME doctors.
2. That the Workers' Compensation Division establish administrative rules setting forth guidelines for IME doctors and reports to assure impartiality.

Make the IME doctors objective

Send evaluations to claimants. Impose travel limits (i.e. 50 miles or less)

None after denial is issued. If carrier thinks there is sufficient evidence to deny claim then IME serves no "Independent " purpose

Return language of "reasonable location" to schedule. Limit # of IME's any one physician can perform.

Get rid of non practicing doctors who are essentially "?" doctors who lost privileges or retires from practice. Use active, practicing doctors not the panels or mills

IME physicians must be of the same specialty as the doctor treating the patient. No physician should be allowed to perform an IME unless at least 85% of his practice is from active patients - not from IME work.

Get credible doctors who really are trying to figure out what is going on with the worker instead of just making its client ( the insurance company) happy and getting a quick $2000.00.

follow California system : Make IME's certify They give same opinions if they were treating doctors.

Make it simple for client to get their own IME and do not allow insurer to use the check the box process when selecting the treating doctors concurrence

Get rid of professional IME doctor
Most injured workers have no money for medical experts. Insurers will naturally keep sending IME business to doctors who are "right thinker". All IME' should be paid for from a WCD fund assessed from insurers, and the IME doctor for a given IME should be drawn at random from a list prepared by WCD from doctors who sign up with WCD to do IME's. The only way to bring about truly independent opinions from doctors is to set things up to where the future business does not depend on what a doctor puts in a report that will be read by the person who pays for the report

Insurers make an effort to use fair evaluators and there are fair defense medical exams/examiners

Get rid of the IME mills - they're a disgrace to the system.
Encourage a process akin to the medical arbiter process

get rid of it

Implement fair standards and an evaluation process accessible to claimants to hold IME doctors accountable for their actions

Appoint panel of IME Drs AKA recon procedure and appointed by WCD/WCB

I don't know it is an adversarial process. Most doctors are more objective in medical arbiter exams than in IME's. Its just a fact.

To balance the playing filed, allow an injured worker his or her choice of expert exam paid for by the insurer, for each exam that the carrier arranges.

Payment should come from (impartial) WCD funds or other impartial source
Dr should not be chosen by insurer employer like
No. of IME should be sharply limited
more restricted their current "?"

Take it out of the hands of Insurers and put it in hands of Workers Comp Department

Videotape the exams. Prohibit IME's from asking question about privileged matters, or irrelevant ( non-medical)"?", Provide copy of adjusters question with the notice to attend

This process needs to be conducted impartially - By Doctors who do not get paid by the insurer for their opinions - Some (many) IME Drs receive over 100K per year from insurers. How can one ever expect an impartial report????

Public -accessible website listing the Docs their clients their CVS Their IME incomes, their relationship with the IME agency E.G> who owns Ortho Consultants PC

Select Doctors the same way they are selected for reconsideration exams. No IME after claim is denied

I'd do away with it completely. If a carrier wants to hire an expert fine. But don't require claimants to go in mandatory expensive exams thats not necessary

Stop making IW's travel >50 miles when perfectly good docs are locally available

Require IME doctors to have active clinical practices
Oversight panel to review reports - some doctors never find in favor of workers
Require Board exams, continuing education credits
(e.g. XXX is licensed in Oregon by reciprocity only & is blatantly biased in reports & depos - hasn't practiced in many years - never practiced in Oregon - multiple malpractice actions in Maryland, loss of hospital privileges - Then moves to Oregon and makes great $ from "?" no integrity credibility etc.

To include practicing doctors in the process - especially a balance between fair - minded Drs. Many Drs, however do not want to get involved w/WC cases. They are to much of a hassle.

none

require they maintain an active patient practice of at least 50%. Require that they disclose with their report the amount of money they receive from IME. Require that insurers/employers use Dept. based rotating list of examiners.

Get honest, unbiased doctors and instruct them to give honest, unbiased opinions. Advise workers in simple terms that the exam results are important to the outcome of their claims.

Have them performed by physicians hired by WCD at modest rates

I would have all doctors that take W/C patients - put them all in a pool, by specialty and have insurer blindly assign one

Make a pool of CME's available to Insurers (like arbiters examinations)
Make CME physicians accountable to MRU

limit IME's to doctors who actually practice medicine
Insurer pays for claimants medical reports
limit IME's to one per event(new claim, NMC/OMC, agg. etc)
Give "?' to treating doctors
Allow claimants to object to specific IME docs.

Pay them less ($250 max)
Involve more attending physicians
Require that all IME/CME doctors have established active private practices

call IMEs insurance medical exams instead if independent medical exam as most of these doctors are not "independent" per se

Including income discourse for IME's

Use medical arbiter system
Let workers actually get a WRME

Write a rule that requires the ALJ to give an IME less weight than the opinion of a treating doc

use real bonafide doctors, not paid for preordained biased prostitutes

let attending physicians pick the IME's or the injured workers attorneys

Completely dismantle present system which is unworkable.

Make them Independent
Place a cap on the amount that can be charges so profit motive goes away; let claimant pick which doc will go to.

All IME doctors must treat patients as 65% of their practice

Select examiners from a panel of active physicians who actually treat patients in a clinical practice.

at least make the doctor come to the claimant

at least make the doctor come to the claimant

Don't use Drs that are retired and only in the IME business

Require all Doctors who rx injured workers to participate and limit carriers to 1 IME per claim

Make Insurance call in an Insurance med exam - make them be more honest about process. Make insurers provide an accurate report to worker on IME - Why they must go to them, what they are used for as an effort to quash claim

Drs should be practicing physicians
Shut down the cottage industry of doctors bought by insurers

Require that any doctor who performs IMEs must get at least 65% of his income from direct patient care!!

Require Drs to have significant private practice

stop making it a growth industry for the retired medical specialists community

Get rid of them altogether and go to an arbiter like program

Stop it or at least make them be real doctors who treat people for a living not hired liars.

Regulate who may perform IMEs e.g. doctor must be licensed to treat patients before allowed to do IMEs. Doctor must derive less than 100% of income from insurance exams. Doctors with major restrictions on license should not be allowed to do IMEs

Prohibit doctors who don't have active treating practices from doing these exams. Prohibit doctors who exclusively do exams for one side or the other from participating. In the alternative require that examining doctors be required to make full disclosure of their income from doing IME's, what percentage of their work IME's comprise, what percentage of their work is done for insurers and employers.

Insurer must pay a matching fee to claimant so worker can buy their own opinion

Stop sending workers to IME doctors who do not believe particular conditions can be work related. For example XXX MD believes CTS can only be due to : (1) sex, (2) age, (3) genetics and (4) weight


To be truly independent or impartial, the IME should be composed of a panel that looks at the claimant and insurer agree to - more, new, actually "independent" doctors would help, rather than the same old predictable doctors that are simply "hired guns" for insurance companies. There should be an "oversight" panel to make sure that reports are balanced.

The Director should certify them. There should be a process to challenge examiners for bias; the IME reports should be sworn and notarized subject to penalty for perjury.

The Director should certify them. There should be a process to challenge examiners for bias; the IME reports should be sworn and notarized subject to penalty for perjury.

What "process"? The insurer demands it, claimants must attend. Now that we acknowledge them as "Insurer arranged" exams -- not Independent exams as we once did -- we can also acknowledge that the "process" is insurer arranged - Guess I am not clear about what you mean by "IME process"

use doctors who treat patients

The IMEs should be handled like medical arbiters exams. If the insurer wants an IME, then the claimant and Insurer (or their attorneys) would have to mutually choose the IME doctor, the WC Division would assign the IME Doctor.

require the insurers use the widest variety of IMEs or let the Dept pick the IME instead of the insurer.

Allow carrier paid IMEs for claimants on a one for one basis with claimants having the right to chose the examiner just like the IMEs are chosen

Eliminate it or require insurers to pay for a meaningful response. Give greater weight to the opinions of treating physicians

1 IME /claim (initial , NMIC, etc); and 2 IMEs ever

Have a neutral examining board not funded by the insurance carriers. Select a "?" by claimants and defense lawyers concerned

have the department operate a list of several names from which the claimant can strike one or two and insurer must choose or require IMEs to be drawn from a pool agreeable in general to both sides

Eliminate it. restrict participating doctors to do no more than 10% of their practice/ income in IMEs. Require insurers to use doctors assigned randomly from state approved list

Make it completely independent. The insurer has no choice of the doctor to use They should be signed up by the Board w/ the understanding they will be taken off the list w/too many complaints of abuses.

as long as it exists, it will be viewed negatively

Select them similar to the "reconsideration" process

Have a truly independent board of medical and legal professionals review the IME. Of all doctors annually to ferret out the truly biased. Require all IME Drs to sign an "?" of honesty. Require them to undergo pain education courses.

Rules like Washington that IME doctors be actively practicing medicine 70% of income "?" specialty)

Worker should be able to have interview with Doctor recorded; someone who could be present with claimant at IME if claimant wanted. Not necessarily a trained medical person. Could be a lay person claimant felt comfortable with.

Be sure doctors are independent and their practice not largely dependent on insurance company business. Money concerns overcome objectivity.

Get rid of it. Believe treating physicians. Or allow video taping of IME.

1. Fire most of the strictly IME doctors.
2. Draw up a list of doctors in active clinical practice.
3. Have an IME agreed to by both sides and allow video-taping.

1. larger pool of doctors
2. panel of doctors may be more appropriate
3. more independent process, objective
4. fewer imes

1. Does Calif comp claims. Calif has an agreed medical evaluator who parties believe is objective. Cl and defense attorneys agree on a specific doctor. In 90% of cases parties agree, and parties are bound by the doctor. May question the examination findings. Insurance company pays for the exam.

If insurance co does not want an agreed med examiner, then it can send cl to an independent exam, but the cl also gets one of his/her own.

In Oregon the insurance companies can overwhelm the claimant's attorney with multiple doctor reports.

Defense can overwhelm claimants because they have more resources. In Calif they have tried to take the economic advantage out of the system. Every case with an AME in Calif has settled for him. Much better system and should be looked at for Oregon.

Cl attorneys feel deck is stacked against them in arbiter examinations. AME process is much preferable to what we have in Oregon.

Reduce the number of allowed imes. Reduce scope of imes. Make the ime doctors be doctors who have a clinical practice.

Create a pool something like medical arbiter pool where there is a list of doctors that both sides have access to, and comp system pays for ime, not insurance company. A fairer system is worth the extra penny an hour. Allow claimants to ask for an ime as well.

One of the problems is that we are relying more and more on medical evidence. Takes less to be a judge in the system now because med experts are deciding the case. The only important element is the doctor's opinion, and the person with more money will have a leg up in generating the medical evidence. Not a level playing field in the generation of medical evidence; this disadvantages the iw who is poorer. Insurance companies can pay for exams.

The California system allows the claimant to have an ime for each ime that the insurer asks for, and insurer pays for it.

Imes should be more local for the convenience of iws.

Would help if ime doctors were dealing with the specialty that relates to the claim at hand.

Very insulting when insurers have psychiatric ime when no psychiatric claim has been made. This should not be something initiated by insurer, only the treating physician. Insurers use it to undermine the credibility of the claimant.

none.

Develop some kind of workshop for IME doctors to help them build better patient relationships, learn to be kind to the folks coming to them. Would make IMEs more effective.

If insurer wants an ime, it should be from a doctor selected at random by WCD, similar to medical arbiter process. Panel should be made up of all doctors who treat injured workers.

Find a way to eliminate businesses that are solely dedicated to imes.

If there was a panel process of doctors who generally both claimant and defense side have a positive view about, then the ime process would be improved.

Create a more independent system. Or call them a defense medical exam. Maybe develop an independent list.

Get an open-airing of the relationship between doctors and insurance companies showing how many imes the doctors do and what they make from doing them.

Additional notice explaining process should be sent out, laying out the nature of the ime. Simple straightforward bullet items, outlining the nature of the exam.

Would be better coming from the Dept.

The system itself creates the problems of the system. Prefer to see ime physicians chosen by an independent party. Better results. A lot of ime doctors do not practice medicine, and are on the way out to retirement. Not many new doctors in the ime process.

Ime office should send 10 previous reports to attorney representing the claimant with names redacted to show how they are doing reports. Should also get financial relationship of ime doctors through normal course not through deposition.

Scrap the whole system and start over

Don't allow carrier to select the IME and don't allow IMEs who are not full time practicing physicians to act as IMEs. Do not allow carriers to pay IMEs. Let the Division pay them out of carrier assessments.

Do away with or have state impartial doctors, not same doctors who do it now.
Having IMEs who don't routinely review claims for insurers

Do something about 1. Old retired physicians who no longer practice medicine but need IME income. 2. Claimants have no input in the selection process of IME doctors. 3. IME doctors offering opinions outside of their area of expertise (psych).

1. Not allow doctor who have not practiced in Oregon to perform examinations. 2. Require organizations such as Dr. XXX's to make public disclosure of income from IMEs. and follow-up 3. Allow claimants attorney to (illegible) certain doctors.

Doctors who obtain the majority of their income from IMEs should be excluded. Too much bias and pressure from insurer to obtain truly objective exams. Even the appearance of bias can taint the outcome.

I explain the process to my clients

Remove the assignment and payment functions form the insurer/employer and process request for IMEs through the WC division like medical arbiter exams.

None - insurers lobby legislators (illegible) which is profit-driven and not claimant supportive

Allow a choice of physicians, require the carrier to also pay for an IME of claimant's choosing.

Only doctors with their own non-IME practice should do them. They should do it as a small part of their practice, not a large economic supplement.

The IME mills are more concerned with attracting and retaining business from the insurers than they are with having an impartial exam and report. One of the main reasons I no longer practice work comp law is the IME process. That sort of bias is beyond what is expected in the civil system.
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