|Author||Subject: MLAC Can Do Something About IMEs|
|Concerned|| Posted At 22:17:38 12/21/2000
Workers in Oregon need to rally around the Independent Medical Exam issue. The management labor advisory committee, the group that decides most workers comp issues in Oregon, is set to review a proposal to change the law about the way IMEs are conducted in Oregon in preparation to the upcoming legislative session. Governor Kitzhaber created a group of labor and management people to make recommendations about the workers' compensation system here in Oregon. This group made several recommendations about how the system could be changed. This has been talked about a lot on this message board. There is an important issue at stake as part of this bunch of agreements, the so called insurer medical examinations. This is really important and management is about to screw us over unless we speak up. Kitzhaber put out a press release about the recommendations from this group. There was no more important issues than the issue of insurer medical examinations. This is where the insurance company gets to send us to a doctor or doctors of their choice to answer questions they get to ask to get answers they want in order to close your workers' compensation claim or to lower your benefits. This is a big business and sometimes workers end up in front of biased doctors who only care about getting more business from insurance companies. This IME stuff is one of the big ways that insurance companies are able to get out of paying injured workers, period. You can review the Governor's press release about what the agreement was at their state of Oregon web site. But, here is the agreement on IMEs, in 5 parts-
-The department (this refers to state employees who regulate insurance companies here in Oregon- for some of us it will come as a surprise that workers compensation insurers are regulated at all given how they treat us-will maintain and manage a list of certified providers of IMEs.
-The Department will promulgate rules that outline the criteria, including medical qualifications, about the certification of IME providers, for inclusion and remaining on the IME list.
-The insurance company gets to select 3 choices of doctors to perform the IME from the list maintained by the department.
-The injured worker is provided the list of 3 choices from the insurance company and gets to select 1 of them to perform the exam.
-The insurance company sets up the appointment and pays for it.
Thats it. Big deal, right? But this is no longer acceptable to management. At the last meeting of the management labor advisory committee management submitted a whole new proposal that will mean there is no regulation except if the doctors that they buy don't send their reports in on time!
Here is the real deal on this. Management is going back on the deal they made. There is no two ways about it. They just can't give up anything important to workers and this is important because they use these bought doctors to write reports that let them cut workers benefits. Unless we do something about it, next year at this time workers will still be getting screwed by insurance companies using biased doctors to cut them out of the claims they legally should be able to make. So what can we do? Call the Governors office and let them know we want them to stick with the deal that was made on the IMEs. The number is 503 378-4582.
Re: MLAC Can Do Something About IMEs (Currently 0 replies)
Posted At 22:51:52 12/21/2000
That's all fine and dandy, you know you are right.
Trouble is, a real doctor would need to do 90-95% real doctoring. They have plenty of doctors, to cover all the bases. The frying pan, the kettle, or the fire, the fox guarding the hen house.
The next problem is your attorney, not putting up the real fight, loosing on purpose, to set the insurance company up.
He knows the whole system is set against the worker. Administrative Law Judge, Appelate Court, Arbitration, Mediation. Just how is a man supposed to win, can't do it.
What was that article just last week, 14 people were determined to be disabled, last year, in Oregon. Find that a little hard to believe. And I think there was 11 who were and then weren't disabled, what's that, Dimitri?
You know when you go to court, and your doctor has one paragraph, and the IME, CME, LIE has 13 pages, there's something wrong. And why should a man have to go to court for medical anyway?
Governor Kitzhaber (Osterich, cares a whole lot more about the spotted flying salmon, then a man being able to return to a decent way of making a living. What's he call it minimum health coverage? It's minimum all right!
I would say to initiate a partition, and it would need to be nation wide. It's not just SAIF, or Liberty, it's all the insurance companies. Denie all claims, settle in court for 10-cents on the dollar.
I saw a young man just yesterday, arm hanging down, elbow at about 35 degree's, wrist scewed to Ulna Deviation. I says Radial Head Fracture, no he's says he has lost the nerve connection between the spine and the arm. What's this poor guy supposed to do? Cut the arm off or fight?
Frankly I don't know what is a compelling story.
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