Topic: Neurologic Exams (Earmarks Narrative and Examination)
treepatrol
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Neurologic Exams (Earmarks Narrative and Examination)
The Earmarks of an Insurance Company IME (Independent Medical Examiner) Hired Gun: "Narrative" and "Examination"
1) It will *almost* conform to the truth. but, over all, it will be inconsistent with itself and with known and measurable fact.
2) The IME will not read like what you remember from the examination. The actual examination will be perfunctory and short, including a few attacks with pins and hammers to make it look official.
The report will call this a "complete neurological examination". Radiologicals will be gone through quickly and casually.
Radiologists' reports will be criticized, their findings declared unimpressive or inconclusive, and dismissed. No conclusive tests will be either recommended, suggested or ordered. Often they will even be advised *against*.
3) There will be innuendoes concerning your physical symptoms or aspects or your personality.
Unimportant things will be declared "interesting". The patient's symptoms might even be subtly ridiculed, even being referred to as bizarre.
The point of this is, of course, being to call you a liar, without actually doing so.
Implications will be made that you are either stupid or delusional, by comparing what you may have said about a particular test, and what the IME states actually happened; what he states happened will, of course, be a total fabrication.
Of course, the IME hired gun is the expert and knows better than the patient and the patients extensive list of treating doctors who actually treat patients on a daily basis with the disease under analysis by a doctor that may have treated one case in his entire career.
4) Innuendoes can be conveyed simply by putting certain words like "pain" or "stress" in quotes, implying, without saying, that that these symptoms are not real, or may not exist.
A distinction will be made, said outright or implied by innuendo, between pain and pseudo pain, stress or pseudo stress, as if the two were objectively distinguishable; they are not.
Pain is pain. The word stress is used in vague ways, that will confuse heavy duty stress with minor annoyances so as to make your serious stress *appear* to be a minor annoyance. There is no way (not even in autopsy) of distinguishing between pain and "pseudopain" (quotes meaning to imply that there is no such thing).
5) Quotes will be attributed to you; about half will be erroneous in one way or another, sometimes quoting you as saying the opposite of what you actually did say.
Sometimes a slight change of word or phrase that by itself appears harmless. Nothing that a medical IME does is harmless. Many times in your records you will find that they have lied out right about test results and clinical results.
6) There will only be results reported that are subjective to the to the examiner, like reflexes and muscle strength.
No objective evidence will be present, even though some numbers may be present.
No objective tests will be made. The examiner simply makes up the numbers anyway he chooses.
7) Irrelevant remarks will appear such as "the patient didn't elaborate" (Of course, the whore will not have asked for elaboration.) while important statements by you will be completely ignored and absent from the narrative. You might see, "I found it interesting that, ..." purporting to cast doubt on a particular result, or an importance where there is none. The report will consist mainly of what was "apparently" felt or said by you the patient (ignoring any existing documentation) and what was "interesting", without any explanation ofwhy a particular thing may have been interesting; more innuendo.
8) Any previous diagnosis will be denigrated indicating that your complaints are not due to the disease or that your problems may even have been caused by a treating physician. The key word here is "iatrogenic". The most perverse tactic is simply the declaration that there is nothing wrong with you.
9) The IME will occasionally step out of the room and bounce back into the room with a patronizing remark to illicit a quick response.
10)There will be a high density of "medical" assertions with few if any corroborative facts or explanations. Assertions and conclusions may often exceed the actual area of alleged competence of the "examiner". A neurologist is NOT a psychiatrist. An orthopedist is NOT a rheumatologist, etc.
11) Scientists cite literature references, IME's never do.
12) There will be *no* suggestions for further tests ruling out other possibilities. The whore knows what the answers "are" before ever laying eyes on you; he does not want the truth known.
13) There will be an attempt to shift a physical cause to an ill defined psychiatric cause, which is not so secure with regard to damages in court. The key words here are "psychosomatic" (rarely used) and "somatoform", the implication being that there is nothing physically wrong with you.
14) Laboratory tests will be said to be "inconclusive" or "equivocal" even if the tests results show the highest positives for the diseases yet reported. The hired gun is paid to discredit you and your injury
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"Independent Medical Examiner experts & expert witnesses - A physician not otherwise involved in the examinee's care who performs an impartial examination to evaluate injury, disability, or impairment in regard to legal or insurance issues"
And
"IMEs are not done for the purpose of treating a patient's medical condition, but to provide information to the client who requested the evaluation."
Hm-mm-mm. Now, I just wonder if an IME would still get paid if he found *against* the client (the person who hired the IME).
Food for thought
"Since a treating physician/patient relationship is not created, it's more appropriate to refer to the subject of the evaluation as the "examinee" rather than as the "patient."
The examinee waives the right to the traditional doctor/patient confidentiality, so the report includes information gathered from the examinee that may be conveyed to the client requesting the exam.
Results of the IME that are sent to the requesting authority include:
Overall medical history
History of injury or illness with summary of the treatment and recommendations Updated medical evaluation Recommendations regarding possible need for further diagnostic studies Assessments of whether the injury is permanent or temporary, if modified duty assignments are appropriate, and if rehabilitative services may be beneficial.
****************************
And for a bit of money you can buy that will teach you how, as an IME, you can receive practical solutions to everyday problems and challenges associated with IMEs such as dealing with:
challenging examinees,
minimizing risks and liabilities,
assessing symptom magnification and malingering
structuring your practice in the most cost-effective manner,
writing excellent reports,
better promoting your expertise,
and generating and collecting a premium fee in a timely manner." You'll also learn this:
Here is the view of an attorney who is acting for a patient in a medical dispute:
"Some physicians who perform independent medical examinations, however, perform hundreds of these each year for the insurance industry, and make this service a large part of their practice.
Their bias for the defense is notorious. It is not unusual for some of these physicians to charge between $500 - $1,000 for such examinations and record reviews.
If they give testimony, the bill doubles or triples. How much can they earn in a week, month or year doing such examinations? You do the math. It pays better than clinical medicine in some cases!"
And
"Such physicians often present an obstacle to a just resolution of the controversy, because they predictably and regularly come to conclusions, write reports, and provide testimony quite slanted in favor of the defense and against the claimant.
And
" The modus operandi of some of these examiners to defeat the claim is obvious - attack the credibility of the claimant, making the claimant out to be dishonest."
-------------------- Do unto others as you would have them do unto you. Remember Iam not a Doctor Just someone struggling like you with Tick Borne Diseases.
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