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Bummer Knees · 03-23-2009, 03:33 PM

At my last hearing per the judge's request I am scheduled for an IME later this week.

I still have some paper work to complete for this appointment, problems with the carpal tunnel keeps me from doing much writing.

And I have at my computer desk things I should do in preparing for the IME, this info was sent to me by Bad Boy.

The IME is for the eval of my carpal tunnel & back as I am trying to add this to my claim.

My friend, the injured nurse is going with me to this appointment, she use to work with the IME doctor & staff when she worked as a floor nurse.

I called my attorney and he advises me to cooperate with the doctor's staff, he said if they want to do x-rays, or blood test to let them do it.

Bummer Knees

Bad Boy Bad Boy · 03-23-2009, 03:48 PM

I hope all goes well. I would agree with the Attorney also, as it being a court appointed IME.

Bummer Knees · 03-23-2009, 05:02 PM

Bad Boy, that is what my attorney said, cooperate.

The PA is doing this IME, my attorney knows this person and said he will be fair.
This will be my 12th IME.

Cycler · 03-23-2009, 05:18 PM

Since your IME is on the issue of casual relationship I cannot imagine how the limited primary care training of a PA can stand in for the depth of training and knowledge of an MD. There is no way that a PA understands the nuances of an exam or diagnosis let alone the highly controversial literature of flow through conditions versus genetic pre-disposition and natural course.

While this may in fact work in your favor in this instance of linking CTS to a remote knee injury it should never be allowed to occur. The rules of evidence would seem to be thrown out the window when a PA is allowed to act as a like expert in a litigation matter and no good can possibly come of this sort of thing. Maybe you'll get lucky but to me it stinks and I would never participate in such a sham.

Bummer Knees · 03-23-2009, 07:19 PM

I agree with you cycler, the judge's order has the doctor's name on it not the PA.

According to Red this can be done and is done in the medical community.

I called the doctor's office and this PA is the staff person that does all of the IME's in this office, and does a lot of IME's for the court.

My attorney said he will likely appeal the IME in court.

Just a note, I've already had one IME on the back (orderd by the insurance company) and this IME doctor linked the back to the wc injury.

Cycler · 03-23-2009, 09:07 PM

And I bet the payor is paying a DR rate for the IME.

My very first question to the PA would be something along the lines that since this is litigated issue with a lot of money on the line just exactly what are his qualifications to be doing an IME given your MD's opinion on the matter and is he prepared to defend a rigorous cross examination as to those qualifications against your MDs opinion on the witness stand should it come to that? Otherwise no sense wasting everyone valuable, albeit low paid in this case, time. eh ?

Bummer Knees · (This post was last modified: 03-24-2009 09:11 AM by Bummer Knees.)

I checked on the training required of a PA to do IME's in (Kansas only)

The law is very specific in the training requred of the individual doing the exam, not only do they have to meet specific IME training requirements, but there are additional requirements of the license they hold.

I went to my daughter's orthopedic for this information, he has a PA in his office and is also a work comp doctor.

Cycler · 03-24-2009, 01:03 AM

BK,
I understand that a PA is Allowed to do the exam, just as your family doctor or GYN is allowed to do brain surgery if someone would let them. My meaning was SHOULD they; ie. how qualified is qualified ? Good luck.

Bad Boy Bad Boy · (This post was last modified: 03-24-2009 09:45 AM by Bad Boy Bad Boy.)

Cycler, an IME is just what it means. It is a simple Evaluation, and in most cases is based on Measurements and documents. In being said, this PA does the research with the Patient. Then makes all the reports up to be sent out. Now, the Attending Doctor that will sign off will do a total review of all documents, and measurements. If it fits properly to the patients medical conditions being exam, then they sign off on it and it's sent out.

Now, the (P's) and the (Q's) come out. Bummers Attorney knows a PA is doing this. Being said, it's a two-fold from there. Meaning either party in her case can now dispute this IME visit if they don't like the results brought to the hearing. It's that simple.

So, in other words, it could wind up being simply tossed.

But, she is only being sent to the IME to determine if she needs further treatment and will it benefit her. If the IME states further treatment will not benefit her, then that part of her case is done with. That is unless the (p's) and (q's) come out.

Cycler · (This post was last modified: 03-24-2009 10:04 AM by Cycler.)

B4.
I disagree to an extent but only because I thought the issue was on claiming new and as yet5 unrelated conditions.

My understanding of IME's is that they are used to answer one of two specific questions. either causal relationship or extent of disability; i.e MMI status vs need for further treatment.

Now maybe, just maybe, a PA could research particular file and perform an exam and come to the correct conclusion on MMI/ treatment. It could be very straightforward, surgery is over, rehab is over and no other care is being offered, symptomatic or that a newly recognized condition should respond well to a given treatment recommendation. If that is the case here then fine, and ignore what follows as likely controversial.

..never mind. I deleted it.