Received IME Report Today

[Bummer Knees]

I received the judge's appointmed IME report in the mail today.

If I didn't know better I would say a person other then the doctor and PA wrote this report.

Here is what it says:

Causation
Right hand/wrist
It is my medical opinion within reasonable degree medical probability the right upper extermitiy is not related to the work injury.

(This is what I expected the doctor to say)

Causation
Right knee
It is my medical opinion within reasonable degree medical probability the continue sympyoms are related to the work accident.

I recomnmend treatment of cortisone injections, viscosupplementation injections, physical therapy for range of motion and strength modalities of 2x a week for 10-12 weeks and she would be at MMI after that.

Back
Examination
There is limited range of motion with flexion & extension. There is tenderness to palpation of the lumbosacral paraspinals right worse then left. There is tenderness over the right SI joint as well as the L5-S1 spinous process. There is decresed sensation in her right leg nondermational in character.

Causation
It is my medical opinion within reasonable degree medical probability, majority of the back complaints are due to the aging process. However the patient states that she has had the back pain since the injury when she fell. (The following part I do not like)
If you believe this to be true I would say a portion of it would be related to the work injury. If that is the case the the treatment recommendations I would recommend would be to do an NCT?EMG of the bilateral lower extermities and a consultation with a spine surgeon.

I do not feel the patient is at MMI with the back.

I have an appointment with my attorney Thursday. I am upset with the report on the back, as the doctor told me "I am going to recomend treatment on the back"

I do not feel that is what he is saying in this report.

[UndercovrAngel]

Bummer,

What a bummer ~LOL~ It never ceases to amaze me when a Dr says that they will recommend one thing to a patient, and then write something entirely different. They should be forced to record everything that they do as far as testing and what they say to a patient as they test, and results MUST be transcribed from that. It's the only way..other than wasting more time waiting to depo the Dr and see who the judge feels is more believable. And in the meantime, the patient continues to worsen to where eventually nothing is going to help.

I hope that you can get this straightened out. I will keep you in my prayers.

Angel ^j^

[Bummer Knees]

UA
I did take my friend to the appointment with me. She is a RN and physical therapist and has worked professionally with this doctor and PA.

She is no longer able to work due to her work injury.

Don't know if it makes a difference but the doctor wc sent me to in November links the back problems to the work injury.

[UndercovrAngel]

Bummer,

Was she able to tape the examination at all ?? If not, I would have your attorney do a deposition on her ASAP while it is all clear in her head what took place at your IME. That way you will have someone that can testify on your behalf as to what was said and done while you were being examined.

On my injury out of Vegas, a paralegal accompanied me and took notes (darn good ones at that) as well as asking the Dr all kinds of questions in regards to why he was doing certain procedures. I think that the Dr was afraid to tell anything but the truth .. the whole truth.. and nothing but the truth. Did this PA/DR know that your friend as an injured nurse when they did the exam ?? If not, I bet they just said a lot of things to appease you for the moment, and wrote whatever it is that they felt would work for some treatment and injuries, but not all.

Angel ^j^

[Bummer Knees]

My friend worked as a floor nurse at the local hospital. She was often the nurse in charge of this IME doctor's patients admitted to the hospital.

She also worked with the PA, this is why I took her to the IME with me.

She and I have the same wc attorney.

[Bad Boy Bad Boy]

First of all, I never knew this Court appointed IME was to make a judgement call on any relations to your 1st reported injury. For all you told me, was they were to basiclly state if you would need treatment or not. However, I can say, the doctor is very correct. You are just missing it.

Carpal Tunnel, was not a result of your injury. But, it could be the result of applying to much weight onto the hand using the cain, from the problem knee (s). This then is a true statement is all.

As for treatment with your back, I agree also. They had said, in a general sense testing and consultation first. Meaning how and what treatment you would need and so on, needs to be properly DX first. For, if it wasn't done that way, what treatment plan would you then get. I can understand that to be true.

Then the IME also recomnmended treatment for the knee. Now if the IME's choice of treatment is the proper treatment, I wouldn't know that.

I have a feeling your Attorney is going to agree with me on this that I said here. Let me know...

Other than that I'm just wondering if you or someone else feed the IME too much information on the carpal tunnel and such. For it seems that their report is following that path for some reason. Maybe the IC feed them too much, or someone else, I don't know.

[Bummer Knees]

On the carpal tunnel I answered the questions that were asked of me by the doctor.

What do you feel the judge will say about this report?

[Bad Boy Bad Boy]

I don't know what they hearing Officer will say. But, they will review all reports, and make the most possible reasonable judgement call. Since you have documents showing a relation to such other body parts being affect from the knee / s and cain use. The hearing officer could or might rule in your favor. The down fall, is the IC might then appeal. This is why I had times before, said let the Carpal Tunnel go, and not report it as a relation to WC. Adding to much in, will bring on appeals, or the chances of appeals.

Sorry to say that, but those are the odds.

[Bummer Knees]

I am willing to give up the carpal tunnel to receive treatment for the back.

I really do not think the right knee is an issue as it has already been approved for treatment. WC just dosen't want to pay for additional treatment.

I can understand that since they refused the 6 month post op appointment for the replacement.

[Bad Boy Bad Boy]

But you see Bummer, the issue of giving up the Carpal Tunnel now, isn't in your hands anymore, but in the hands of the Hearing Officer now, and what ever they decide to do. In other words it's to late to give up the Carpal Tunnel now, for it has been driven into it's full course now.