Independent Medical Exams By Insurance Carriers Are Really Not So Independent At All - Many Times A “Sham”
The catastrophic personal injury lawyers at the Philadelphia personal injury law firm of Reiff and Bily call attention to a story posted in The New York Times on March 31, 2009 in an investigative article entitled ”Exams of Injured Workers Feed Mutual Mistrust” detailing the abuse of such exams in the New York Workers’ Compensation system.
Since 1979, the experienced personal injury lawyers at Reiff and Bily have been zealously protecting their clients’ rights by fighting against insurance companies. When one purchases insurance coverage, it is expected that the claimant will be paid when the need arises. Unfortunately, according to another study published by the American Association for Justice this past summer, insurance companies continue to emphasize profits over policyholders’ interests and the name of the game is deny, delay, defend - do anything in fact to avoid paying claims.
The New York Times article revealed clear bias on the so-called “independent” medical exam. At our law firm, we do not refer to these medical examinations as “independent” but consider them company or defense examinations. Some of the highlights of The New York Times article are:
1. Quote from an IME doctor who was videotaped in an exam making positive findings directly contradictory to the report he later submitted. “If you did a purely poor report, you would be out on your ear and the insurers wouldn’t pay for it. You have to give them what they want, or you are in Florida. That’s the game, baby.”
2. “You go in and sit there for a few minutes, and up comes a six page detailed exam they never did.”
3. “There are some noble things you can do in medicine without treating. This ain’t one of them.”
4. “Physicians have regrettably moved away from being neutral observers. They have moved toward one camp or the other.”
5. Often IME doctors are hired by brokers that then have clerical staff prepare reports based on dictation or checklists completed by the doctors who often do not read reports before signing them. This article gives examples of doctors signing reports and exams they never performed.
6. The best protection against this sort of thing is to record or videotape an IME.
In every case handled by our law firm, we send an independent person to monitor the doctor’s “independent” insurance company medical exam. Almost never do the notes taken of the exam match what actually occurred. Lately, the results of the medical examinations have been so removed from the reality of the situation that we are now starting to videotape and tape record them. In one recent case, we had a client with a significant injury and the IME doctor noted that he had never seen a situation as bad and that this was one of the worst medical cases he had ever seen. In fact, he even told our client he had never seen anything as bad or never diagnosed this condition before and that he felt sorry for him and he would have to continue his life in pain. Two weeks later when we received the report from the doctor, it was as if a magician had appeared for our client was determined not to have any symptomology and “be pain free” and in fact, the doctor was now a self proclaimed expert in a disease that he had never before treated or even become familiar with. I have heard about the house of Lourdes “miracle cure”, but this was simply ridiculous findings. When we had subpoenaed the records or obtained records of many of the doctors who perform these insurance medical exams, we have found that many of them are similarly worded with similar findings even though the patients are different. We jokingly refer to many of these physicians in our office as “painted ladies” who will do anything to make a buck. We have even been told by some doctors that another individual is not allowed in the room to monitor the exam or tape record the exam and of course, we ask our clients to leave and file motions with the court. We have had considerable success in blocking and neutralizing defense medical examinations and in fact, have provided instances at trial of exorbitant earnings by such painted lady physicians retained by the insurance carriers.
There is a saying that states “without integrity nothing works”. Many times Judges can and juries do dismiss exam findings. In fact, as The New York Times article notes, many times when certain examiners names come up in hearings everyone knows that the credibility of that person cannot be counted on.
If you or a loved one has been injured in a car accident, please contact the experienced Philadelphia car accident lawyers at Reiff and Bily for a free, no obligation evaluation of your case at 1-800-421-9595 or online at www.reiffandbily.com.
