Really confused about IME's

[aqualina56]

Hello. I was sent for an IME back in February 2008. The insurance company gave me the run around saying they didn't get the report for months. About a month and a half ago they contacted my lawyer and told him they wanted to work on a settlement. They even came up with a figure. I received a brain injury at work 5 years ago from hitting my head on a steel beam. I am in PA. Just giving you the details so maybe you could help me better. Anyway, the insurance company called me the other day and wanted me to go have an IME in 4 days. Just 6 months after my last IME.
Some of my problems include--seizures, anxiety, depression, balance problems, memory problems, daily headaches that are sometimes crippling. I can't drive, I can't do my own checkbook, I can't cook without assistance, I can't go anywhere without someone being with me due to my brain being overwhelmed by lights and noise, etc. You get the picture.
My question is--Is it normal for the IC to want another IME after just 6 months. I have had one every year or so but now this one is only 6 months after the last one and after talks that they wanted to settle.
Why do you think they are asking for another one so soon after only having them once every 12-14 months before?
Do you think they are trying to get the doctor to say I could do certain jobs so they don't have to settle or what?
The doctors report was basically in my favor because the IC was saying my problems were pre-existing and just getting worse. (I had headaches before but none of the other problems which I do have a report from 4 months before I got hit in the head. In the report he said I could do sedentary work with no driving, 1-2 hours daily of standing, no restrictions on sitting. I was not allow to lift over 10 pounds and only 10 pounds for short periods of time. I am not allow to do fine manipulation work, climb, squat, or twist. He has a couple other things written that I can do for short periods of time but also says he feels I need to be in a supervised setting and that I have reached MMI (maximum medical improvement).
I know that this doctor works for the insurance company (they paid him $1200) but the insurance company was trying to say that I had problems before and the problems I am having now are just because my disease is progressing. He said my problems are caused for me getting hit in the head. One doctor they sent me to went so far as to say he believed I had MS even though a number of test proved that wrong before he even saw me.
So what do you all think is up? Thank you in advance for your help.

[Bad Boy Bad Boy]

IME's are common every 6 months.

[sparkey]

Or it could very well be they want their doctor to see you again so they can get more information from the doctor for their side to compare and lower your rating. They will do anything to lower your rating, and even if they can get their doctor to look at you and come up with more reasons why they are saying it is not work related etc.

Remember they will do anything to save paying you a large settlement of your claim and the more they can come up with the better they are off. I just do not trust them when it comes to IME's anymore after what their doctor did to me. Although I at least got a 10% out of 32. It could of been much worse with the doctor saying 0.

[Still in Limbo]

I'm from Pa., also, and I Believe the i/c has the Right to Send You to an IME Every 6 Mos. They May be wanting to get another Opinion since they are Talking Settlement, maybe a Scare Tactic to get You to Accept a Lower Offer. I spent 2 Years Fighting the First Portion of My Case, and I Won 11 1/2 of the 12 Petitions Filed, and We are awaiting an Appeal Decision on My Pay Rate, and they Scheduled Me for another IME,and I believe they May try and get the 500 Week Clock started on Me. If they could do this, it would Lower My Settlement Value, so they May be doing the Same to You. They have not Spoken Settlement to Me Yet, but they Continue to Harass Me, even After the Judge, in a 50 Page Decision Stated that I can't even Work 4 Hours a Day!!! Best of Luck, I Hope You Settle, and Receive the Amount You are Looking for!!

[Lilly]

You fight like heck if they try to lower your rating! You are the one left with very severe and life long impairments, and it's horrible of them to try to get out of it by saying it was pre-existing!
Prayers going up for you!, Lilly

[aqualina56]

The thing that is confusing me is why all of a sudden are they sending me back to the same doctor that I had an IME from 6 months ago. In the 5 years I've been hurt, I have only gone for IME's once every 12-14 months. I apologize if I don't understand, that's one of my problems also. I don't understand reading sometimes.
The insurance woman told my father that they wanted the last IME to prove that I haven't changed and they can offer a settlement that is fair.
I personal think it's crap.
What is the funniest thing about my case is--the doctor that has reported to the IC that I am totally and permanently disabled is the doctor they sent me to. Now, they are trying to say he isn't right.
They took me in front of a WC judge because they wanted to reduce my income or have me work part-time for different companies they found. They lost and the WC judge wrote a 8 page letter about the things the IC failed to prove. He really let them have it. One of the places they wanted me to work was a video store as a cashier. I can't even do my own checkbook and they wanted me to handle someone else's money. Then another place was at a front desk of a hotel in the area. I would have to answer the phone, take reservations, greet people, etc. and I can't even organize my own life and have slow speech now. People that called the hotel would be annoyed because it would take me 2 minutes to relay instructions or something to them. (If I could even give them instructions.)
Another funny thing about them sending me to this doctor again is-my case worker told my dad that they weren't even going to pay this doctor for the IME (the first one) because it took him 4 months to give it to them. Then, they said all this negative stuff about him and they are sending me back to him. Maybe they are going to pay him more than the $1200 they did the first time just so he says, "yes she can work."
I'm just tired of dealing with the IC. The meds I take are for seizures, I take Aricept for my memory, lorazapam (sp), for anxiety, and others but every month when I go to the drug store to pick them up I get nothing but crap from the IC. I take 1500 mg of Neurotin for seizures and they weren't going to pay for my pills. That could make me go into convulsions or kill me not taking them after almost 5 years. It's just something all the time. I want it to be over. I don't want to get rich. I want to be able to live and just not have to deal with the IC anymore.

[sparkey]

That exactly is what they are trying to do. They will get him to say you do not need your medications now or that it has nothing to do with your work injury so they do not have to pay for them. It happened to me. They stopped paying all my medications for pain/depression because they said carpal tunnel recurrance does not require narcotics and my depression is something that has nothing to do with work. I never had depression till I got hurt. I did not just have recurring carpal tunnel, I had been diagnosed with RSD, Neuropathy, Tendonitis, arthritis, you name it, I have been diagnosed with it, but yet nothing but meds and injections have been done.

If I were you, I would go to a doctor of your choice and have a IME done. You may have to pay for it, but be prepared for when their doctor comes back saying what they want to hear. Also, back it up with your doctor that is careing for you.

[aqualina56]

Thank you Sparkey. I wish you the best with your case. God bless.

[snowbear]

Sorry you're going through all of this. Yep, it sounds like they're sending you to IME docs until they hear what they want to hear (or read how they want your report to read). That's how I take it anyway since they're sending you back to an IME doctor that they weren't impressed with. Best of Luck to you and God Bless you!! Stand strong!!!

[Cycler]

Aqualina,
I am wondering if your Dr. has ever had you evaluated by a neuropsychologist to objectively measure your cognitive deficits and how they may or may not be due to a head injury ? While it entails a battery of testing for a few hours it really is the only means to put the matter to rest as anything else is just opinion without data. Generally this type of evaluation is availble at large rehab hosptials or brain injury centers by a PhD neuropsychologist.

Simply sending you to one IME after another is unlikely to add any information of value as the majoruty of practicing physicians, let alone IME hired guns, have neither the training nor expertise to offer a factual and valid opinion on head injury impairment as a physcial examination and standard imaging studies are completely normal more often than not.
Rather than a he said-she said biased IME report battle, objective and medically factual data is availble to you and offers a path for neurorehabilitation and return to normalcy at a head injury clinic. Medications rarely work alone.