Imagine you hurt your back at work lifting a box. You feel a pop and immediate pain which eventually starts shooting down your leg. You do everything the right way. You report the injury to your supervisor. It’s the first accident you’ve ever reported even though you’ve been hurt many times before. You are a great employee. You seek immediate medical attention. You pass the drug screen. You get referred to a top orthopedic doctor who orders an MRI that shows you have a herniated disc. You try physical therapy and an epidural steroid injection, but your pain is still there and your doctor says you can’t work. After a couple of months he recommends surgery.
Before surgery gets approved, the workers’ compensation insurance adjuster wants you to see one of their doctors. You attend because it’s the law and you have nothing to hide. Besides, your medical records are crystal clear, the MRI doesn’t lie and your treating doctor has a great reputation.
You show up to the IME and are rushed in to an exam room. You sit for a while and then in comes a doctor. You don’t have a timer on you, but he’s in and out of the room in barely two minutes and he hardly asked you any questions or even examined you.
A week later you get a letter from the insurance company saying that they won’t authorize any more treatment and you should return to work because this doctor said you are fine.
Sounds nuts, right? Well, we get this type of call all the time.
Independent medical examinations (IME) are a cash cow for some physicians. They get business often because they tend to favor the insurance companies and in some cases are hired guns. There is a very famous, well respected doctor in Chicago who makes extra money through IME’s. I’ve been told by multiple people that not only do his exams last less than two minutes, that his physician’s assistant writes all of his reports for him. That of course greatly impacts his credibility.
The bottom line is that these doctors are very busy with their own practices and many of them don’t care about the IME, the lives they are impacting with their paid opinions or providing an honest exam. So if you go to an IME and the exam only takes a minute or two, you can expect that the doctor will find against you. Part of his exam is also reviewing your records, but when he doesn’t take a history from you or do a thorough physical exam it can be a sign that the fix is in.
Don’t panic though. The good news is that if you have a credible doctor in your corner, this will be just a delay, not the end of your case. By having a case on file before the IME takes place, we can get you in to court quickly and often get you the benefits you need without a trial. And most Arbitrators know who the hired guns are. When you see the same doctor on case after case after case and every report reads the same it kills your credibility.
This of course is still frustrating and kind of pathetic, but it’s the system we have to deal with. The key is having someone in your corner who is aggressive and has a track record of going to trial and winning.