| Author | Subject: IMEs' |
| Susan | Posted At 11:04:24 06/01/2000
According to my research....ALL doctors have to have 900 active hours of patient care to keep their license.....Meaning the 900 active hours has to be hands on patient care... How in the world can these ime doctors keep their license, by just doing "written opinions"? I personaly know of imes' that do this sort of thing...Write an "opinion" and never examine the patient, nor do they examine their x-rays! Anyone have any comment on this disturbing matter??? How can the AMA or the Medical Board let them get away with this?? |
| Bernie |
Re: IMEs' (Currently 0 replies)
Posted At 14:49:53 06/01/2000 From research that I have done into these dr's, they all actively see patients, not just perform IME's. |
| Tarzan |
Re: IMEs' (Currently 1 replies)
Posted At 15:38:28 06/01/2000 I've now had 4 IME exams, only once did I see paitents other than IME, second opinion type patients. They say right on their report, there was no doctor, patient relationship, sought or obtained. Also when you get your paper work to see the pseudodoctor, it says they, want them to use their expert opinion. And examine the excepted conditions, when you are trying to get more things excepted. And they are not beyond making things sound vague, or an outright lie, to make the insurance company's position seem better. Not only by my own experience, but read the Workman's Comp. Board and Administrative Law Judges Decisions. This also seems vague, there is a lot more than meets the eye. And an IME pseudodoctor, doesn't have to be right, he has immunity to say what ever the insurance company wants to hear. The last exam I was on, there was about 4 pages I didn't get to see at all. The IME doctor, Radecki appologised, for all I've been threw. But it is quite clear, they are told exactly what to say. Upon seeing Corvel, another IME set of pseudodoctors, they had the look of disgust on their faces, it was 2 months and 1 week after bilateral carpal tunnel, combined with bilateral distal ulnar resection. Which is the most painful thing you can imagine. And of coarse my strength was still 5 X 5, when I could barely use my hands at all. I had to put braces on my hands, just to get to the exam. I couldn't pronate, supenate. Which is palms down, palms up. Which they did make note of. The real problem with these exams is, it gives the insurance company an excuse to close your claim. Once this is accomplished, then it is your burden of proof, to prove they closed your claim early. There again, look at the Board Decisions, and you will see case after case, where the victim lost. When your case is first accepted, they might say such as in my case, right elbow fracture, they know and are prepared to denie. That there are a whole lot of other problems associated with, an elbow fracture. Read the Wheeless Text of Orthropedics, and Nershels Sports Medicine, they talk in doctors language, all about the other problems associated with elbow and wrist. How to fix, by the cook book. And case studies on the outcome of different procedures. And don't forget about starvation litigation. They'll starve you out until you accept some small portion of what your claim is really worth. And you are right, they don't look at your x-rays. Even if they did, they probably wouldn't know what to look for. And you will see the same pseudodoctors poping up, time after time, read the board decisions, it's boring but you might just find the case which is very simular to yourown. |
| Tarzan |
Re: IMEs' (Currently 0 replies)
Posted At 15:42:38 06/01/2000 I've now had 4 IME exams, only once did I see patients other than IME, second opinion type patients. They say right on their report, there was no doctor, patient relationship, sought or obtained. Also when you get your paper work to see the pseudodoctor, it says they, want them to use their expert opinion. And examine the excepted conditions, when you are trying to get more things excepted. And they are not beyond making things sound vague, or an outright lie, to make the insurance company's position seem better. Not only by my own experience, but read the Workman's Comp. Board and Administrative Law Judges Decisions. This also seems vague, there is a lot more than meets the eye. And an IME pseudodoctor, doesn't have to be right, he has immunity to say what ever the insurance company wants to hear. The last exam I was on, there was about 4 pages I didn't get to see at all. The IME doctor, Radecki appologised, for all I've been threw. But it is quite clear, they are told exactly what to say. Upon seeing Corvel, another IME set of pseudodoctors, they had the look of disgust on their faces, it was 2 months and 1 week after bilateral carpal tunnel, combined with bilateral distal ulnar resection. Which is the most painful thing you can imagine. And of coarse my strength was still 5 X 5, when I could barely use my hands at all. I had to put braces on my hands, just to get to the exam. I couldn't pronate, supenate. Which is palms down, palms up. Which they did make note of. The real problem with these exams is, it gives the insurance company an excuse to close your claim. Once this is accomplished, then it is your burden of proof, to prove they closed your claim early. There again, look at the Board Decisions, and you will see case after case, where the victim lost. When your case is first accepted, they might say such as in my case, right elbow fracture, they know and are prepared to denie. That there are a whole lot of other problems associated with, an elbow fracture. Read the Wheeless Text of Orthropedics, and Nershels Sports Medicine, they talk in doctors language, all about the other problems associated with elbow and wrist. How to fix, by the cook book. And case studies on the outcome of different procedures. And don't forget about starvation litigation. They'll starve you out until you accept some small portion of what your claim is really worth. And you are right, they don't look at your x-rays. Even if they did, they probably wouldn't know what to look for. And you will see the same pseudodoctors poping up, time after time, read the board decisions, it's boring but you might just find the case which is very simular to your own. |
| Bernie |
Re: IMEs' (Currently 0 replies)
Posted At 18:10:09 06/01/2000 Oregon law states that the insurance company is only allowed to do 3 IME's for the life of a claim. You shouldn't have had to go to 4 of them??? |
| Susan |
Re: IMEs' (Currently 0 replies)
Posted At 14:11:40 06/05/2000 Well Bernie, You are wrong! I peersonally have been to 6 IME's...With one particular doctor NEVER seeing me nor looking at my x-rays....BUT this doctor did write not one but 2 different "opinions" of my condition.. With my research on these IMEs', according to the AMA and The Medical Board, along with numerous Hospitals they claim to practice at...NONE of these IMEs' are active... |
| C. Strouse |
Re: IMEs' (Currently 0 replies)
Posted At 06:41:48 06/06/2000 Bernie, Only three IME's in a lifetime of injury, thank goodness you do not live in Paa the state signed in legislation that allows the insurance carrier/employer to IME visits every 180 days. It is known here as legal harrassment signed in by our government. |
| Bernie |
Re: IMEs' (Currently 0 replies)
Posted At 10:12:35 06/06/2000 Susan, 6 IME's!!! Have you gotten any legal counsel on that one? They (ins. companies) should only have to make you go to three. that's what it states in the worker's comp laws. I'd try and contact an atty if I were you. that's ridiculous!!! |
| Bernie |
Re: IMEs' (Currently 0 replies)
Posted At 10:14:00 06/06/2000 every 180 days, that sounds terrible! |
| Joannie B. |
Re: IMEs' (Currently 0 replies)
Posted At 03:55:25 06/07/2000 I noticed Corvel was one of the IME providers mentioned, the examiners wouldn't happen to have been Laycoe and Watson would they? I didn't include Dr. or M.D. due to the failure of either of them to appear worthy of the title...I am interested in hearing from anyone that has seen these two individuals for an IME exam. I'm curious to see if they have a set list of "untruths" they include in their reports, or if they personalize each one. |
| Tarzan |
Re: IMEs' (Currently 0 replies)
Posted At 12:01:50 06/07/2000 Corvel would be brian laycoe, scot fechtel, robert cambell, he names must be wrong. There was a woman who could hardly speak english corsomething. Would radecki and fuller, ring a bell, impartial medical opinions. radecki again at St. Vincent Hospital. And smith and hambey, they did confirm a visit to Baltomore, John Hopkins. |
| CAROLINE RAY |
Re: IMEs' (Currently 0 replies)
Posted At 18:09:12 06/07/2000 My claim has been closed for over 2 years. Still I received a notice for IME. Went nuts, called my atty, and ombudsman, and so far have staved off going. Get your atty. to fight it if you work on nothing else and call ombudsman!! THIS IS IMPORTANT. Anyone out there who has been sexually molested by an IME, Please contact me at TIES e mail. I have finally found a REAL doctor who is willing to help us by pushing Medical Board and if no reaction, then the media all over this state will hear about it from him. THIS IS A FIRST AND IT'S TAKEN YEARS. PLEASE REPLY. If you are afraid, I understand. Put any name but include your phone number so I can contact you and explain. LETS TAKE ACTION!!!!! Caroline TIES founder. I CARE ABOUT PEOPLE!!! |
| Susan |
Re: IMEs' (Currently 0 replies)
Posted At 09:05:01 06/08/2000 I have retained legal counsel....guess what??? My attorney has withdrawn on me 2 times in the last four years.....Got any more suggestions?? |
| Del |
Re: Number of IMEs' a worker must attend (Currently 0 replies)
Posted At 11:01:06 06/08/2000 The following answers apply only to Oregon and may have been changed since their official release. You'll notice in (5) that there are several loopholes accorded carrier's to the 3 IME rule. Also we've been told that Managed Care Organizations (MCO's) can demand as many as they want, they get aound it by "not calling them IME's." I have underlined text below that was discussed above or is of significant importance. It's a very good idea to call the Oregon Ombudsman for Injured Workers at (800) 927-1271 when you have any questions regarding WC. The following is on page 21+ at http://www.cbs.state.or.us/external/wcd/docs/436_010.pdf You must have Acrobat Reader to view these files that I've linked to in this posting except the Oregon Board of Medical Examiners letter discussing ..."allegations of sexual boundary violations, especially following physical assessment around the breasts and pelvis of female patients." ---------------------------------------------------------------------- Insurer Medical Examinations (IME) OAR 436-010-0265 (1) The insurer may obtain three medical examinations of the worker by physicians of their choice for each opening of the claim. These examinations may be obtained prior to or after claim closure. A claim for aggravation, Board's Own Motion, or reopening of a claim where the worker becomes enrolled or actively engaged in training according to rules adopted pursuant to ORS 656.340 and 656.726 permits a new series of three medical examinations. For purposes of this rule, "insurer medical examination" (IME) means any medical examination including a physical capacity or work capacity evaluation or consultation that includes an examination, except as provided in section (5) of this rule, that is requested by the insurer and completed by any medical service provider, other than the worker's attending physician. Examinations shall not include invasive procedures without the prior consent of the worker in the form and format as the director may prescribe by bulletin. The examination may be conducted by one or more medical providers with different specialty qualifications, generally done at one location and completed within a 72-hour period. If the medical providers are not at one location, the examination is to be completed within a 72-hour period and at locations reasonably convenient to the worker. (2) When the insurer has obtained the three medical examinations allowed under this rule and wishes to require the worker to attend an additional examination, the insurer shall first notify and request authorization from the director. Insurers that fail to first notify and request authorization from the director, may be assessed a civil penalty. The process for requesting such authorization shall be as follows: (a) The insurer shall submit a request for such authorization to the director in a form and format as prescribed by the director including, but not limited to, the purpose for the examination, dates, times, places, purposes of previous examinations, and reasons why the additional examination is necessary. A copy of the request shall be provided to the worker and the worker's attorney; and (b) The director will review the request and determine if additional information is necessary prior to issuing an order approving or disapproving the request. Upon receipt of a written request for additional information from the director, the parties shall have 14 days to respond. If the parties do not provide the requested information, the director will issue an order approving or disapproving the request based on available information. (3) In determining whether to approve or deny the request for an additional IME, the director may give consideration, but is not limited, to the following: (a) Whether an IME involving the same discipline(s) and/or review of the same condition has been completed within the past six months. (b) Whether there has been a significant change in the worker's condition. (c) Whether there is a new condition or compensable aspect introduced to the claim. (d) Whether there is a conflict of medical opinion about a worker's treatment, impairment, stationary status or other issue critical to claim processing/benefits. (e) Whether the IME is requested to establish a preponderance for medically stationary status. (f) Whether the IME is medically harmful to the worker. (g) Whether the IME requested is for a condition for which the worker has sought treatment or the condition has been included in the compensable claim. (4) Any party aggrieved by the director's order may request a hearing by the Hearings Division of the Workers' Compensation Board pursuant to ORS 656.283 and OAR Chapter 438. (5) For purposes of determining the number of insurer required examinations, any examinations scheduled but not completed are not counted as a statutory IME. The following examinations shall not be considered IMEs and do not require approval as outlined in section (2) above: (a) An examination conducted by or at the request or direction of the worker's attending physician; (b) An examination obtained at the request of the director; (c) A consultation obtained in accordance with OAR 436-010-0250(3); (d) An examination of a permanently totally disabled worker required under ORS 656.206(5); and (e) An examination by a consulting physician that has been arranged by the worker's attending physician in accordance with OAR 436-010-0280. (6) Examinations shall be at times and intervals reasonably convenient to the worker and shall not delay or interrupt proper treatment of the worker. (7) When a worker is required to attend an examination by a physician of the insurer's choice, the insurer shall comply with the notification and reimbursement requirements contained in OAR 436-060-0070 and OAR 436-060-0095. (8) The person conducting the examination shall determine the conditions under which the examination will be conducted. Subject to the physician's approval, the worker may use a video camera or tape recorder to record the examination. Also subject to the physician's approval, the worker may be accompanied by a family member or friend during the examination. If the physician does not approve a worker's request to record an examination or allow the worker to be so accompanied, the physician must document the reasons. (Caroline, as you know, the above OAR is why that ?doctor? knows he can get away with repeated sexual assaults. The State of Oregon has been covering up these incidents for years. We have, in the FTP File Room, here just one of the letters that prove they know what's been going on.) (9) Upon completion of the examination, the examining physician shall send a copy of the report to the insurer and attending physician within seven days. Stat. Auth: ORS 656.726(3) Stat. Implemented: ORS 656.252, 656.325, 656.245, 656.248, 656.260, 656.264 Hist: Filed 12/16/98 as Admin. Order 98-060, eff 1/1/99 Amended 4/28/99 as Admin. Order 99-055, eff 4/28/99 ----------------------------------------------------------------------- 4/15/99 - Mary C. Neidig, Administrator, Workers' Compensation Division The purpose of this bulletin is to prescribe a form to be provided to an injured worker whenever a medical provider decides to perform invasive procedures as part of an IME. During the course of an IME, an injured worker may be asked to undergo an invasive procedure. OAR 436-010-0265(1) states that "[e]xaminations shall not include invasive procedures without the prior consent of the worker." At the time a worker receives notice of an IME appointment, the worker is advised that their benefits can be suspended if they fail to cooperate. Workers requested to undergo an invasive procedure may believe that failure to consent to the requested invasive procedure will result in the suspension of their benefits. The attached consent Form 440-3227, "Invasive Medical Procedures Authorization," has been developed to avoid confusion and to ensure that all workers are fully informed of their right to refuse invasive procedures without jeopardizing their benefits. If a medical service provider intends to perform an invasive procedure as part of an IME, the worker must be given the attached consent form to complete and sign. Insurers must provide the form to the medical service provider when the examination is scheduled. Insurers may produce a computer-generated facsimile (same text) of the attached form. If you have any questions about this bulletin, contact a Benefit Consultant at (503) 947-7585. |
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