In the quest to curb costs, the WorkCover system often engages in counterproductive actions or inactions such as delaying care, inadequate care, denial of responsibility and minimization/ downgrading of the injury. Way too often, the depressed injured worker learns that delayed or inappropriate medical care has resulted in a chronic condition, and they are told that this could have all been prevented had you seen a doctor/surgeon earlier, but the (Eg. nerve damage, whatever) is now permanent. The injured worker already felt a sense of frustration, fear, and helplessness, but with that information, they now feel angry and hopeless. In addition to that many WorkCover case managers will take the liberty to fabricate intricate mumbo-jumbo cover letters that are sent to a cherry-picked independent medical examiner, together with some irrelevant medical information. One of the more common cover letters we have seen states that “… it has been alleged that there may be a psychological overlay…“.
If you have been unfortunate enough to have suffered a psychological or psychiatric injury or illness at your workplace, once you start down the workcover claim path, you will soon realise that this is when your nightmare will truly begin. Once your workcover agent receives your claim, they will do just about anything to find ways to either deny or reduce your benefits. One of the unsavoury tactics used by the workcover insurer is to sent you to independent medical examinations.
As we have stated a zillion times, independent medical examiners (IMEs) are not always perfect. Sometimes the IME doctor will make mistakes, these could be genuine mistakes and oversights based on, for example, very selective and outdated “material” your case manager sends to the IME doctor. But unfortunately some IMEs are outright biased, some more than others. So what do you do if you feel your IME report is incorrect, or is missing important information, or has partial “mistakes” and/or “oversights”?
Unfortunately, and despite the fairly recent Ombudsman’s findings and recommendations about WorkCover VIC, we know first hand that people with longer-lasting injuries are still often forced to battle doctors hand-picked by insurance companies to get medical treatment. In other words: injured workers are still waiting in pain!
For any injured worker the prospect of having to undergo an Independent Medical Examination (IME) causes a lot of apprehension and fear. But for those workers who have suffered a psych injury at work ( in particular a primary psych injury) attending an IME can cause even more trepidation!
We have recently been contacted by a couple of seriously injured workers regarding their workcover injury permanent impairment claim. Most are confused about the process and many are quite shocked at the low monetary value put on their case/injury. Some don’t know whether they should accept the lump sum, or take their case to conciliation (and/or a medical panel). Perhaps it’s time we summarised the permanent impairment claim process in order for injured workers to better understand the process and what to expect.
For many injured workers, many medical professionals and even personal injury lawyers, there is quite a bit of scepticism about the workcover system’s use (or abuse) of “expert witnesses” including the (over)use of Independent Medical Assessors. It has been alleged that workcover expert witnesses and the like are not always there to share informed, evidence-based insights or opinions, but rather to “spin” evidence as required (by the insurer).
We recently received a pretty alarming email from a bewildered injured worker, who – unfortunately- was sent to Dr X. This doctor is still practicing and appears to live in Australia in QLD and is allegedly used as FIFO “independent medical examiner”.
Having been in the system for a while, I have inevitably been sent to numerous doctors and IME’s for reports and opinions. The process is a daunting one for both physically and mentally injured workers, no doubt. One thing that has helped me is knowing about the doctor prior to going to appointments.
It has just come to my attention that a Victorian Injured worker was asked to undergo an independent medical examination in Melbourne CBD, BUT with an independent medical examiner that was flown in from QLD! The best medical specialists are in Melbourne, so why the need to fly one in?