Florida Personal Injury Blog: January 2010

Whether you’re a physician or an attorney, you’ll have to agree, IME doctors are for the most part like the kids we all knew as a child who would throw a stick in your spokes when riding your bike. If they truly offered an “independent” decision, that would at least be fair and probably a miracle.

By now, most of you are well aware of one major South Florida IME doctor who was committing his own brand of fraud and was called to task on it.

After years of having IME hatchet-men prostitute their opinions for a few measly dollars, I decided to take matters into my own hands. I was tired of my patients coming back from an IME telling me “the insurance company doctor saw me for 4-5 minutes, made me bend and touch my toes and didn’t even touch me”….and then getting back a 4-5 page report with all kinds of physical examination & orthopedic testing on it. All of which, the patient said never happened.

So, what is a poor ole’ treating physician to do?

Documentation is the key. But this time, you’re going to involve your patient in the process.

Below is a form I give my patients when they go for an insurance medial examination (the word “independent” dropped intentionally). It allows them to take notes intelligently and in the sequence of events that they would typically occur. It allows them to document their experience with the “I’M.E. They are instructed to bring it back with them following the insurance exam and we go through it together. I will then follow up with an examination of my own and write a report of my findings. The completed form is kept in the file and sent on to the patient’s attorney.

When there is a major difference between the IME doctors report and the patients notes, well, let’s just say now we have a bone to pick with them.

To date, I’ve had 1 doctor render what I consider a good competent examination. I actually agreed with his conclusions, the patient’s form matched perfectly what the report said and I called him to thank him. The phrase “1 in a million” comes to mind.

Here’s a tool I use, try it and see if it works for your patients/clients. Please post your results here on the Florida Personal Injury Blog.

Dr. Todd Narson

Diplomate, American Chiropractic Board of Sports Physicians

Self Report of Medical / Chiropractic IME Evaluation

Patient's name: ____________________________________________ Date of Examination: _____________

Examining doctor: _______________________________ Address ______________________________________

What time did you arrive at the office? _______________ AM PM

How long did you wait to see the doctor? __________________

How long were you actually with the doctor? _______________

How much time was spent: answering questions? ______________, for the actual examination? ________________

What time did you leave the doctor's office? ____________AM PM.

Were you questioned by a nurse/staff member before seeing the doctor? YES NO

If yes, for how long? _______________

Were any x‑rays taken? YES NO If yes, of what part of the body? _______________

Please list any questions you remember the doctor asking you and your response to the question:

________________________________________________________________________________________________

Please list any comments the doctor made to you about your case, your injuries or his (the doctor's) opinions:

_____________________________________________________________________________________________

________________________________________________________________________________________________

Other comments or information: _________________________________________________________________

The Examination:

Please note if the insurance company’s doctor did any of the following orthopedic, neurological or chiropractic tests on you:

Did the doctor tap your reflexes

1. At your forearm? qYes qNo

2. At the inside of your elbow? qYes qNo

3. At the back of your elbow? qYes qNo

4. At your knees? qYes qNo

5. At your Achilles’ tendons (back of your foot/heel) qYes qNo

Did the doctor roll a mini-pinwheel on your arms? qYes qNo and/ or on your legs? qYes qNo
Did the doctor check the strength of the muscles in your shoulders, arms and forearms? qYes qNo

Did the doctor check the strength of the muscles in your legs? qYes qNo

Did the doctor have your bend your neck forward and backward? qYes qNo

Did the doctor have you bend your head/neck from side to side? qYes qNo

Did the doctor have you turn your neck from side to side? qYes qNo

Did the doctor use a device to check your range of motion? qYes qNo -or-

Did the doctor watch you as you bent through the various motions? qYes qNo

Did any of these tests cause you any pain? If yes, which one? ____________________________________________________

Did the doctor place his hands on your head and apply downward pressure into your neck? qYes qNo

· How did this make you feel? ______________________________

Did the doctor do this again while your head was bent to the right? qYes qNo or left? qYes qNo

· How did this make you feel? ______________________________

Did the doctor put his hands under the back of your head and gently traction or lift your head up qYes qNo

· How did this make you feel? ______________________________

Did the doctor have you bend over to try and touch your toes? qYes qNo

Did the doctor have you bend your torso(low back) backwards? qYes qNo

Did the doctor have you bend your waist to the right? qYes qNo and/or to the left? qYes qNo

Did the doctor use a device to check your range of motion? qYes qNo -or-

Did the doctor watch you bend through the various motions? qYes qNo

Did any of these tests cause you any pain? If yes, which one? ____________________________________________________

Did the doctor have you bend backward while turning to the right? qYes qNo And/or to the left? qYes qNo

Did the doctor have you lay down on your back and hold both of your legs in the air at the same time? qYes qNo