Re: Carpal Tunnel Nightmare

Author Subject: Re: Carpal Tunnel Nightmare
Marty Posted At 11:45:09 06/23/2000
Zoe,
Use the two WI search engines and type in IME. One is on the navigation bar in most pages, the other on the top of the first message board which you can get to from the top of the index page of this forum. They've also got info in the FTP File Library.
There's lots of good advice about IME's in these places. To put in bluntly, IME's are well-paid whores that exist for no other reason but to give insurance companies a reason to close injury claims. The following is from the Speak Out page from IWA.


3. When an insurance carrier accepts a work injury claim, and many aren't from the very beginning, the injured worker can expect after a few months to be ordered to a legally mandated insurance medical evaluation (IME) arranged and paid for by the insurer. Most workers are sent to facilities that do not treat patients. These facilities exist solely to render medical opinions. They perform basic physicals, yet have full access to workers' tests, such as MRI's, CT's, cervical myelogram, and x-rays. Workers must attend or risk permanent claim closure.

Oregon Administrative Ruling 436-010-0270(8) states that 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 physicians approval," the worker may be accompanied, or remain accompanied, by a family friend or member during the examination. If the physician does not approve a worker's request to record and/or allow the worker to be so accompanied, the physician must document the reasons.

Oregon law and administrative rules do not govern the conduct of physicians performing these examinations. They have no control over the length of examinations or the demeanor of the examiners.

It's common for these insurance company paid examiners' sworn depositions, and courtroom testimonials, to completely contradict medical opinions made to patients during evaluations. Without a recording or witness they have no fears. Washington State law does permit witnesses, and in some cases the recording of evaluations. The literature found at these consultant businesses state that they issue "fair and objective medical opinions," or words to that effect. Yet these firms sole revenue comes from insurance carriers and self-insured employers. Their economic survival is dependent on continuing what is a very profitable business relationship. We believe that this gives added meaning to the old phrase, "the customer is always right." Injury claims are routinely closed due to the findings of these medical evaluators. According to law, IME reports are given equal weight and standing to the opinions of workers' own regularly seen physician(s).


Zoe,
Do research on IME's. How prepared you are for that IME will determine the degree of how badly you'll be treated the rest of your claim. There's a Caroline you should talk with who you can reach through the TIES page of this website.

Good luck, Marty




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