Independent medical examinations - know your rights

What is an Independent Medical Examination?

WC: An independent medical examination is an examination conducted by
an independent medical examiner which provides your WorkCover Agent or
self-insurer* with more information about whether you have a work-related
injury or illness.

Workcover Victims: Independent, yeh right, these doctors are hired by
workcover and paid for by workcover so these doctors are not independent
at all and why does it take up to a dozen of these examinations for workcover
to be able to decide whether or nor you have a work related injury?
Are they really that stupid!

WC: This information may be used by your Agent or self-insurer to make
a decision about your entitlement to weekly payments and medical and
like services. It may also assist them in supporting your return to work.

Workcover Victims: May be used of course its used, but against you.
WC constantly expect victims of workplace injuries to see many of these
doctors until they get a report they like and can use against you.
Supporting your return to work would have us back at work and not still
in the system years after the injury occurred and WC should also be seen
providing legislation enforcement at a much higher rate than they are at
present.

WC: The Accident Compensation Act 1985 (the Act) allows for a WorkCover
Agent or self-insurer to request that a worker attend an examination
conducted by an independent medical examiner, that is approved by the
Victorian WorkCover Authority (VWA), at reasonable intervals.

Workcover Victims: The ACA allows for workcover to force you into
these ridiculos examinations and some of us many years after our original
accidents and under the proviso that they are independent but, WC also
states that these specialists need to also be approved by WC so how are
they independent?

WC: Who is an Independent Medical Examiner?
Independent medical examiners are independent medical experts
approved by the VWA, based on strict criteria. They are not employees
or representatives of the VWA, its Agents or self-insurers, however
they are paid by the VWA for their services to provide independent
medical advice.

Workcover Victims: Independent medical examiners are independent
medical experts approved and hired by the VWA. Therefore they are
enployees!! Their independent medical advice is bais towards WC
and you can see this by their whole impariment percentages handed
out to victims who are now cripples but are being told that they have
less than a 30% whole person impairment! Independent my arse!

WC: An independent medical examiner’s role is to review your medical
condition and/or treatment and provide Agents with an independent
medical opinion about your injury or illness. They do not provide you with
treatment. Answers that independent medical examiners give to Agents or
self-insurers may help them determine whether you are entitled to weekly
payments and/or medical services.

Workcover Victims: Answers that these alledged independent examiners
provide are used to assess you ability, to return to another job, deny your
entitlement to benefits and to cut off medical and alike care, nothing else!

WC: Independent medical examiners are subject to a rigorous quality
assurance program by the VWA to ensure the ongoing quality of their work.
You may be required to attend an independent medical examination
conducted by a registered medical practitioner, physiotherapist,
psychologist, osteopath, chiropractor or dentist.

Workcover Victims: The quality of these examiners is not monitored
to ensure the ongoing quality of their work. Its so as WC can maintain a
listing of doctors that will play into WC's hand when assessing a victim.

WC: Do you have to attend the Examination?
You must attend an independent medical examination that is arranged
for you. If you are unable to attend the examination for a legitimate
reason, alternative arrangements can be made.
If you unreasonably refuse to attend or co-operate during the
examination, your WorkCover payments may be suspended until you
attend. You may also lose any payments you would have received if you
later attend an examination.

Workcover Victims: WC states that it is a no fault insurer yet the above
clearly states that if you dont attend you will lose your benfits. Last time
I checked that is not "no fault insurance for injured workers rather a
bullying position taken by the VWA.

WC: How often do you need to attend and examination?
If you make a WorkCover claim, you may be asked to attend an independent
medical examinationat reasonable intervals. The reasonable interval will depend
on the nature of your injury and you may have to attend more than one
examination. If you have any questions about how often youwill need to
attend an independent medical examination, contact your Agent or self-insurer.

Workcover Victims: What is a reasonable interval? once every 3-6 months,
6 examinations 10 examinations? How many examinations does a workcover
victim have to endure before WC can decide that it is work related or not?

WC: Who arranges the Examination?
An independent medical examination may be organised by one of the following:
Your Agent or self-insurer
Lawyers representing your Agent or self-insurer.
You may be contacted by telephone to discuss the purpose of the examination,
the specialty of the examiner, and any other arrangements. You will receive a
letter from your Agent or self-insurer confirming these details.
If you need special assistance with travel or access requirements,
you should advise the person arranging the examination.

Workcover Victims: There they go again using that word independent again!

WC: Who will be at the Examination?
The independent medical examiner may have a nurse or attendant present.
A relative or friend can accompany you to the examination rooms, but it’s up to
the independent medical examiner whether your support person can be present
during the examination. If you prefer a support person to be present, speak to
your Agent or self-insurer before attending the appointment.

Workcover Victims: You are entitled to have someone present during
these examinations whether or not the examinaer likes it or not.
Do not attend these without a support person, its your right!

WC: A psychologist or psychiatrist examiner will rarely allow a family member
or friend to attend an examination because of the personal nature of the
questions that may be asked. The family member or friend may speak to the
examiner after the consultation.

Workcover Victims: You have this legal right and you should inform your
examiner of this fact and insist that your support person has your permission
to be there. It's not up to these doctors to tell you, who can and who cannot
support you. You are already vulnerable and need this support, so dont give
up your rights!

WC: If a physical examination is needed, you may ask another person to be
present during that part of the examination. When another person is present,
he or she should not take an active part in the examination.

Workcover Victims: A physical examination is more invasive than having
a chat so why do they allow your support person in this instance and not in
others? It again show WC inconsistancies within this legislation.

WC: What do you need to take to the Examination?
You should take any items that may help the independent medical examiner
assess your condition. This may include: X-rays, scans, reports

WC: The examiner may have already read or reviewed some of your documents.
If the examiner needs results or reports you don’t have with you, you may
be asked to sign a consent form. This will either authorise the release of
information directly to the examiner or authorise your healthcare professional
to discuss your details with them.

Workcover Victims: I would expect that the examiner would have read the
provided documents before he/she sees you and has familarised themselves
with your claim but as we know WC's choices of examiners has alot to be desired.
I would expect that level of examiner working for the VWA to be in the minority.
These examiners have piles of folders on their desks that are all workcover victims
and I for one am sure that they have no idea who they are seeing daily but
they fully understand the $ benefits of working for WC. One Examiner told
me that he recieves $800.00 per claimants file he sees and he had about 30
files on his desk that morning so, his daily income would have roughly been
$24,000.00 for his days work not bad ay! No wonder WC dont want to pay
the injured victims, their examiners bills are enormous and it seems that all
themoney that should be paid to victims of workplace injuries is being spent
on Barristers and Specialists working for the VWA!. Bugger the Victims!

WC: What if you are running late for the Independent Medical Examination?
It is important that you are on time. You should allow plenty of time to get to
the location of the examination. If you are running late, you should ring
the examiner’s rooms or contact the person who arranged the examination.

Workcover Victims: Its ironic that you as the claimant cannot run late
when they make your appointments in the city and you live in the country.
I for one had two appointments 2 hours apart on the opposite sides of the city
and they say dont run late or your appointment will be cancelled and your
benefits will be lost, but if the examiner is running late you will just have
to put up with that and they wont appoligize for it either, yet we are expected
to crawl up their butts if we are late! again this shows WC's inconsistency
with the injured workers they are supposed to protect.

WC: What if the examiner is running late?
The independent medical examiner is expected to see you on time, but
emergency or unscheduled work may cause delay. The examiner’s
receptionist should let you know how long you may have to wait.
If there is a delay, you should wait at least 30 minutes from the arranged
appointment time (not the time you arrived).
Leaving any earlier may be considered unreasonable and could put your
payments at risk. If you decide to leave after waiting the recommended
time, you should immediately notify the person who arranged the
examination.

Workcover Victims: How is leaving after your appointment time
unreasonable? If we are expected to arrive on time then I expcect the
same respect from WC too!

WC: What will happen at the Independent Medical Examination?
The examiner will ask you a number of questions about your injury during
the examination. These questions may be about:
The medical history of your injury (e.g. what treatment you received and
the results of that treatment)
Your work history (e.g. your duties at the time of your injury, whether you
have returned to work, or your capacity for work)
Treatment you have had or are receiving
Your current symptoms
Your relevant personal or social history
Your daily activities and interests.

WC: As part of the examination, an independent medical examiner may
ask you questions that do not directly relate to your injury. It may be
necessary to ask you in-depth questions about your family and personal
history to better understand your circumstances. These types of
questions are morelikely to be asked by psychologists and psychiatrists.
The independent medical examiner may need to conduct a physical
examination to properly assess your injury. The examiner must obtain
your consent before conducting the physical examination.
You should wear clothing that will allow the examiner to easily examine
your injury. If you are required to remove your clothing for the
examination, the examiner should provide you with a gown or sheet for
cover. If a gown or sheet is not provided, you may ask the examiner to
provide one. Examiners may request that you remove the gown or
sheet during the examination so they can conduct a thorough examination.
The examiner is required to protect your modesty as far as practical.
The examiner may find it necessary to examine other parts of your
body that may not appear to relate to your injury.

Workcover Victims: The examiner is only required to examine your
injury and nothing else. Your personal and family situation is not work
related so dont discuss it with them, it only gives them more to add to
the report and in some cases another excuse to deny you benefits.
Just discuss the work related injury and nothing else.
The examiner has no need to examine any other part of your body,
that is not directly related to the injury! If you are required to have
a physical exam then have your support person present to verify
that the exam given was appropriate!

WC: Why would you be asked to attend an Independent Medical
Examination with a psychologist or psychiatrist?
Your Agent or self-insurer may ask you to attend an independent
medical examination with a psychologist or psychiatrist to establish
or review the link between your current circumstances and
your injury. If you are unsure why you were asked to attend a
psychological or psychiatric examination, talk toyour Agent or self-insurer.

Workcover Victims: These examinations are only used to see if the
insurers can say that your injury is not work related. They will attempt
to link your injury to another incident or another health issue that you
may have had particullary if you have a stress claim or bullying claim
so dont share anything not work related. Be carefull with your medical files
and dont consent to WC or any of their representatives gaining access to your
whole medical file only consent to your injury information being accessed.

WC: What is expected of you?
To ensure your claim is managed effectively and efficiently, you should
cooperate with the examiner. You may ask questions during the
examination and if you feel uncomfortable with any part of the
examination, you should tell the examiner.

Workcover Victims: Co-Operating is only telling them work related
information. That what you are there for so dont let them intimidate
you into thinking you are being unreasonable because you choose not
to share unrelated details with them.

WC: Who will receive a copy of the report?
The independent medical examiner will prepare a report based on
the examination. The examiner will send a copy of their report to the
person who arranged the examination. If you wish to obtain a
copy of the report, you should request this in writing from the person
who arranged the examination.

Workcover Victims: Rule 101 is get copies of everything related to your injury.

WC: What standard of conduct does the VWA require of the Independent
Medical Examiner? The independent medical examiner has entered into an
Agreement with the VWA.
The Agreement requires the examiner to:
Be polite
Be professional
Be sensitive to your concerns
Obtain your consent to any physical examination before proceeding.

Workcover Victims: These doctors are being paid a fortune to see you
so make sure you are receiving the above treatment from them.
You are entitled

WC: What costs can you claim?
You may be entitled to claim the cost of travel and accommodation to
and from the examination.These costs must be approved by your Agent
before you make any arrangements. Talk to yourAgent to find out what
costs you can claim.

Workcover Victims: Claim everything you can, Keep all your receipts.

WC: Who do you contact if you are unhappy with the Independent Medical
Examination? If you have any concerns during the examination,
talk to the examiner. If you are unhappy about the way the independent
medical examination was conducted, discuss your concerns with the person
who arranged the examination.

Workcover Victims: You can try this approach but it will fall
onto deaf ears! If you wish to lodge a complaint about the examination,
you should do one of the following: Complete the form on the back of the
How to make a complaint fact sheet available from the WorkCover
Advisory Service on freecall 1800 136 089 or (03) 9641 1444 or you can
write and phone the following contacts:

VWA
222 Exhibition Street Phone
Melbourne VIC 3000
Ph: (03) 9641 1444
Fax: (03) 9641 1353
Freecall: 1800 136 089
Website: http://www.workcover.vic.gov.au/

Rehabilitation and Medical Services Division
Manager - IME Services Branch
Victorian WorkCover Authority
GPO Box 4306
MELBOURNE VIC 3001

Independent Medical Examinations for injured workers and
Registered WorkCover Agents

ALLIANZ Workers’ Compensation
(Vic) Limited
Level 26, 570 Bourke Street,
Melbourne 3000
Ph: (03) 9234 3800
Fax: (03) 9234 3760
Freecall: 1800 240 335

GIO Workers’ Compensation
(Victoria) Ltd
Level 1, 468 St Kilda Road,
Melbourne 3004
Ph: (03) 9860 3555
Fax: (03) 9820 5840
Freecall: 1800 817 969

Cambridge Integrated Services
Victoria Pty Ltd
Level 10, 390 La Trobe Street,
Melbourne 3000
Ph: (03) 9947 3000
Fax: (03) 9947 3005
Freecall: 1800 801 070

QBE Workers Compensation
(Vic) Limited
Level 8, 628 Bourke Street,
Melbourne 3000
Ph: (03) 9246 2444
Fax: (03) 9246 2400
Freecall: 1800 817 820

Gallagher Bassett Services
Workers Compensation Vic Pty Ltd
Ground Floor, 50 Queen Street,
Melbourne 3000
Ph: (03) 9297 9000
Fax: (03) 9297 9010
Freecall: 1800 774 377

CGU Workers Compensation
(Vic) Limited
Level 5, 477 Collins Street,
Melbourne 3000
Ph: (03) 8630 1000
Fax: (03) 8804 9429
Freecall: 1800 066 204

If your Agent or self-insurer makes a decision that you believe is wrong,
partly based on an independent medical examiner’s report, you may take
the matter to the Accident Compensation Conciliation Service (ACCS).

To refer the dispute to the ACCS you must lodge a Request for
Conciliation form, within 60 days of being advised of the decision.
Conciliation is a free service. Request for Conciliation forms are available
from the ACCS and completed forms should be sent to:

Accident Compensation Conciliation Service (ACCS)
Senior Conciliation Officer
Level 9 / 460 Lonsdale Street
MELBOURNE VIC 3000
Freecall 1800 635 960 or (03) 9940 1111

Workcover Victims: Dont expect to much from WC's complaints systems.
I have used all of them now and have had no results from any of them.
They all stick together and none of them will go out on a limb to help genuine
victims of workplace injuries.

I have been writing to Mr Tweedly the CEO of the VWA for sometime
now and have found that he has no concerns for the victims either. He will ignore
your letters of complaints and the contents and he will eventually just refuse to
speak with you, so you think you have no where else to go with your complaints.

After this happening to me, I was advised to write to the Victorian
Ombudmans office and formally complain as apparently the VWA answer
to them so, I did this spending many hours drafting up my complaint and
guess what? They defended the VWA! so, dont expect any Justice from any of these
departments, as you more than likely, wont receive any!

Good luck and don't forget to post your stories.