After many years in business we have attended over 800 IME’s. We continue to be
amazed at what we find observing IMEs and in IME reports. Here are two examples of
what can be accomplished by having a physician observe the IME, review the IME report
and write an IME Rebuttal.
Case 1
Jane Doe, a 42-year-old woman, was involved in a rear-end auto crash resulting in her
developing unremitting low back pain with radiation into the left leg accompanied by
numbness, tingling and loss of sensation in the foot. Jane described her average pain
level as 5-6/10. Jane also complained of depression starting after the accident due to her
constant pain.
Jane had worked as a laborer before the auto crash and has been unable to work since her
symptoms started approximately 48 hours after the accident. It should be noted Jane had
worked for the same company for 15 years without incident and cared for two children
before getting injured. She had no previous accidents and her health had been good.
The client had an excellent primary care provider. Jane had appropriate treatment after
the accident which, unfortunately, was not effective. Early on in Jane’s care, this led one
IME provider to report Jane was having an exaggerated pain response or perhaps outright
malingering and a “delayed treatment response.”
It was our opinion these assertions were made due to the fact Jane’s case was difficult to
sort out. Jane’s primary care doctor got a consultation from a spine specialist and a
discogram was done. The discogram showed anterior and posterior annular tears at L3-
4 and L4-5. Annular tears by definition are herniated discs. In our opinion given that
Jane had never complained of back pain and now had a positive discogram the
mechanism of injury and diagnosis was clear and the findings was directly related to the
accident.
Two years after the accident the defense asked for another IME. Jane was sent to a well-
known IME provider. We observed the IME. In reviewing the IME report the evaluator
made a case for the client having a Somatization Disorder unrelated to the accident.
The evaluator’s arguments were compelling except he completely left out of his report
the two lumbar herniated discs found on discography! We were able to pick up the flawed
IME findings helping the attorney to get the client a substantial settlement.
Case 2
This client had a Workers Compensation claim due to a work-related accident and
subsequent injuries. When observing the IME we noticed the evaluator asked a number
of questions concerning the minutia of the client’s past medical history and questions
about minute details of the work-related accident. The client had difficulty remembering
the small details asked of her. We noticed the evaluator became more and more overtly
angry at the client as the client was unable to answer questions about minutia which in
our opinion was not medically significant to the medical issues at hand.
In the IME report the evaluator stated the client was not forthcoming in answering
questions and determined the client either had secondary gain issues or was
malingering. We were able to report the nature of the questions asked by the evaluator
in our IME Rebuttal Report and we were able to comment on the evaluator’s obvious
angry reaction to the client which we opined caused her opinions to be biased.
We opined it was the evaluator who had secondary gain issues and because of her anger
the evaluator’s report was biased and should be thrown out. The client went on to receive
a settlement for injuries sustained in the work-related accident.
What other services can MD Medical Consultant provide:
- Review of Case Validity and Value
- Medical Summary Reports
- Interpretation of Meaning, or Lack thereof, of Medical Reports & Records
- IME Observation & Rebuttal Reports
- Answers to Specific Medical Questions in Cases
- Standard of Care Reviews
- Medical Case Coordination
- Liaison to Treating Doctors
- Assessment of Causation
- Referral to Appropriate Medical Experts
- Determination of Future Medical Care and Costs
- Medical Research and Delivery of Medical Journal Articles
- Facilitation of Communication with Clients, Families, Professionals and Service & Governmental Agencies
- Independent Record Reviews
- Help Developing Medical Theories
- Deposition & Court Assistance-Table-side or Question Preparation
