Re: IMEs

September 26, 1999

Both the Natioanl ME/FM Action Netowork's " Quest " and The National CFIDS

Foundation's " National Forum " ran an article by Attorney Bernard Kansky

anwering the question, " What should I do for an independent medical

Examination coming up? " If you'd like a copy of this article, that covers an

answer throughly, you can privately e-mail me your name and address (and

remind me of the request!!) and I'll send it out to you. It applies to both

CFIDS and FMS.

Gail

July 28, 2000

Dr. Bolin:

I was happy to see your reply today. The most important point of your

message was the statement " I am still treating over 100 appointments a week

in my practice. " That is exactly the point. You treat people, do a great

job and get people better. The doctors who you trained in your office while

they were going through chiropractic college respect you. You are not in

the same league as the IMEs I am talking about. I have a client right now

who described one chiropractic IMEs office as " a fake doctors office " and

the chiropractor as " scary. " Is this the type of reputation we want for

chiropractors in our community? The concerning thing is that you have spent

your entire professional career helping to make the profession better and

these people are destroying chiropractic as fast as we all are trying to

establish its benefits. I view that as a serious problem, and I believe

that when you really think about it, you will too. My grandfather spent

nearly 60 years of his life at endless meetings to further the chiropractic

profession. I'll be damned if I let all that hard work go to waste because

a few DCs want to make a lot of money for themselves at the expense of other

people. Lets come together and do the right thing for the profession and

the people we serve.

DeShaw, D.C., J.D.

IMEs

> Regarding the income from doing IMEs, I am certainly glad that I do not

> have to depend on that income for a living. It is barely lunch money,

> but then I am not asked to do an IME as often as perhaps some others. I

> am still treating over 100 appointments a week in my practice and I have

> treated over 21,700 people during my stay in Oregon and have never

> thought of doing IMEs for the money. Certainly it is nice to have a

> little pocket change, but it is definitely not enough money to act as a

> bribe.

>

> Only one time have I been asked to change my opinion by an insurance

> company and that one time I told them that I would not change my opinion

> because it was based on facts. I fully agree with what Dr. Deshaw

> has stated and if I do an IME in my own office, video taping will be

> permitted. However, other companies that I have worked I know will not

> allow any recordings. Certainly I have been videotaped in depositions in

> my office and in attorneys' offices a number of times and I have no

> problem with that.

>

> I sincerely believe that there are insurance adjusters who want an

> objective conclusion that is independent and not biased and willing to

> accept the conclusions.

>

> My hat is off to Dan who deserves a vote of confidence from this

> profession for fighting for what is right and succeeding in his efforts.

> Dan's first experience with chiropractic was as a patient in my office in

> 1974. He has been a champion for chiropractic since that time.

>

> Bravo-Bravo for Freeman on what he has done at the Willamette

> Spine Center. Finally a place we can refer our patients and know that

> there is no prejudice and that the patients will receive excellent care.

> A first class operation, if I ever saw one!

>

> Darald Bolin DC

> ________________________________________________________________

> YOU'RE PAYING TOO MUCH FOR THE INTERNET!

> Juno now offers FREE Internet Access!

> Try it today - there's no risk! For your FREE software, visit:

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>

July 29, 2000

,

I reinforce your comments made about Dr. Bolin.

As a former patient of Darald Bolin, I can say that he saved my life. All other methods had failed until I came under his care in 1981. I had lost 25 pounds and 4" of girth off my right thigh. I literally thought I was dying as none of the other experts had an explanation as to my decline. I traveled from Eugene to Salem to be treated each day. He fixed me when all other specialists had missed the mark. He is a traditional chiropractor who knows how to restore health and turn-on the life force!

I would welcome an IME by this advanced examiner and clinician of fourty years.

Shephard

IMEs> Regarding the income from doing IMEs, I am certainly glad that I do not> have to depend on that income for a living. It is barely lunch money,> but then I am not asked to do an IME as often as perhaps some others. I> am still treating over 100 appointments a week in my practice and I have> treated over 21,700 people during my stay in Oregon and have never> thought of doing IMEs for the money. Certainly it is nice to have a> little pocket change, but it is definitely not enough money to act as a> bribe.>> Only one time have I been asked to change my opinion by an insurance> company and that one time I told them that I would not change my opinion> because it was based on facts. I fully agree with what Dr. Deshaw> has stated and if I do an IME in my own office, video taping will be> permitted. However, other companies that I have worked I know will not> allow any recordings. Certainly I have been videotaped in depositions in> my office and in attorneys' offices a number of times and I have no> problem with that.>> I sincerely believe that there are insurance adjusters who want an> objective conclusion that is independent and not biased and willing to> accept the conclusions.>> My hat is off to Dan who deserves a vote of confidence from this> profession for fighting for what is right and succeeding in his efforts.> Dan's first experience with chiropractic was as a patient in my office in> 1974. He has been a champion for chiropractic since that time.>> Bravo-Bravo for Freeman on what he has done at the Willamette> Spine Center. Finally a place we can refer our patients and know that> there is no prejudice and that the patients will receive excellent care.> A first class operation, if I ever saw one!>> Darald Bolin DC> ________________________________________________________________> YOU'RE PAYING TOO MUCH FOR THE INTERNET!> Juno now offers FREE Internet Access!> Try it today - there's no risk! For your FREE software, visit:> http://dl.www.juno.com/get/tagj.>> >>>>--------------------------------------------------------------------<e|-Help influence the future of medicine and healthcare by participatingin medical research surveys. Our honorariums range from $25 to$200 per survey.1/7302/3/_/141981/_/964835397/--------------------------------------------------------------------|e>-

July 31, 2000

Dr. Bolin,

A chiropractor friend of mine was asked earlier this year to do a paper

review. For the work that he did, this chiropractor received $1,000.00

as payment. Not bad for a little pocket change and it certainly sounds

like a bribe to me. As a side note, he wasn't in practice at the time

and did this out of his home with zero overhead.

L. Underhill, DC

On Fri, 28 Jul 2000 14:21:00 -0700 " Darald E Bolin, D.C. "

<besthandschiro@...> writes:

Regarding the income from doing IMEs, I am certainly glad that I do

not have to depend on that income for a living. It is barely lunch

money, but then I am not asked to do an IME as often as perhaps some

others. I am still treating over 100 appointments a week in my practice

and I

have treated over 21,700 people during my stay in Oregon and have never

thought of doing IMEs for the money. Certainly it is nice to have a

little pocket change, but it is definitely not enough money to act

as a bribe.

Only one time have I been asked to change my opinion by an insurance

company and that one time I told them that I would not change my

opinion because it was based on facts. I fully agree with what Dr.

Deshaw has stated and if I do an IME in my own office, video taping will

be

permitted. However, other companies that I have worked I know will

not allow any recordings. Certainly I have been videotaped in

depositions in my office and in attorneys' offices a number of times and

I have no

problem with that.

I sincerely believe that there are insurance adjusters who want an

objective conclusion that is independent and not biased and willing

to accept the conclusions.

My hat is off to Dan who deserves a vote of confidence from this

profession for fighting for what is right and succeeding in his

efforts. Dan's first experience with chiropractic was as a patient in my

office in 1974. He has been a champion for chiropractic since that time.

Bravo-Bravo for Freeman on what he has done at the

Willamette Spine Center. Finally a place we can refer our patients and

know

that there is no prejudice and that the patients will receive excellent

care. A first class operation, if I ever saw one!

Darald Bolin DC

______________________

July 31, 2000

,

Exactly that is my main complaint about IME's. Where the ins. company uses

someone who is not in practice either retired or new. Someone who is in

practice like Dr. Bolin has hands on experience not just book experience and

besides as Dr. Bolin pointed out he is still seeing 100+ patients a week,

thus he is financially able to stand up to adjuster and not change a rpt in

order to keep the adjusters business.

Steve Kinne

Re: IMEs

> Dr. Bolin,

>

> A chiropractor friend of mine was asked earlier this year to do a paper

> review. For the work that he did, this chiropractor received $1,000.00

> as payment. Not bad for a little pocket change and it certainly sounds

> like a bribe to me. As a side note, he wasn't in practice at the time

> and did this out of his home with zero overhead.

>

> L. Underhill, DC

>

> On Fri, 28 Jul 2000 14:21:00 -0700 " Darald E Bolin, D.C. "

> <besthandschiro@...> writes:

> Regarding the income from doing IMEs, I am certainly glad that I do

> not have to depend on that income for a living. It is barely lunch

> money, but then I am not asked to do an IME as often as perhaps some

> others. I am still treating over 100 appointments a week in my practice

> and I

> have treated over 21,700 people during my stay in Oregon and have never

> thought of doing IMEs for the money. Certainly it is nice to have a

> little pocket change, but it is definitely not enough money to act

> as a bribe.

>

> Only one time have I been asked to change my opinion by an insurance

> company and that one time I told them that I would not change my

> opinion because it was based on facts. I fully agree with what Dr.

>

> Deshaw has stated and if I do an IME in my own office, video taping will

> be

> permitted. However, other companies that I have worked I know will

> not allow any recordings. Certainly I have been videotaped in

> depositions in my office and in attorneys' offices a number of times and

> I have no

> problem with that.

>

> I sincerely believe that there are insurance adjusters who want an

> objective conclusion that is independent and not biased and willing

> to accept the conclusions.

>

> My hat is off to Dan who deserves a vote of confidence from this

> profession for fighting for what is right and succeeding in his

> efforts. Dan's first experience with chiropractic was as a patient in my

>

> office in 1974. He has been a champion for chiropractic since that time.

>

> Bravo-Bravo for Freeman on what he has done at the

> Willamette Spine Center. Finally a place we can refer our patients and

> know

> that there is no prejudice and that the patients will receive excellent

> care. A first class operation, if I ever saw one!

>

> Darald Bolin DC

> ______________________

>

August 4, 2000

I've always felt that there are two main issues with respect to these exams...

#1 Orthpods should never do them for chiropractic care of course, as they are

not qualified to render a decision on a mode of care that they are not

licensed to perform/practice. (I had one recently in a work comp case and the

ortho guy clearly did not know the difference between a functional and

structural scoliosis...he rambled on in his letters about how he had 23 years

experience in emergency rooms and chiros don't work in emergency rooms so how

could we be as qualified yada yada...you just throw your hands in the air and

laugh, you know what I mean?)

#2 For an IME/paper review etc. there should be 'certified' random-selection

of 3 chiros( from a large pool of at least one hundred or more experienced,

practicing chiros) who do the work. It would be voluntary and yes, they would

get paid for their time, but at least it would be more 'independent' and

'objective'. Some smart chiro should pursue this in the private sector and

'shame' the insurance companies (because they should be ashamed) into using

such an obviously superior ( to the current system) service for case review.

Hey, I'd like to review the orthopods and neuro-surgeons who cut without

having the patient undergo one single trial of conservative care...that is

still happening almost daily...where do i sign up for those exams/paper

reviews ??

J. , DC

Springbrook Chiropractic Clinic

Newberg, Oregon

August 4, 2000

Dear Dr. Underhill,

Did your friend who received $1000.00 for a paper review buckle into the

bribe or was he objective and gave intelligent answers. I get $200.0 for

a paper review and I am lucky if I average one review per month.

I always preface my conclusions with please be advised that the following

conclusions are made without the privilege of examining the patient and

are based on information gleaned from the file.

You have to realize that no company is going to use me as an IME examiner

or a file reviewer unless they want objective answers, I guess that is

why I do not do very many examinations/reviews.

Darald E. Bolin, D.C.

Dr. Bolin,

A chiropractor friend of mine was asked earlier this year to do a paper

review. For the work that he did, this chiropractor received $1,000.00

as payment. Not bad for a little pocket change and it certainly sounds

like a bribe to me. As a side note, he wasn't in practice at the time

and did this out of his home with zero overhead.

L. Underhill, DC

On Fri, 28 Jul 2000 14:21:00 -0700 " Darald E Bolin, D.C. "

<besthandschiro@...> writes:

Regarding the income from doing IMEs, I am certainly glad that I do

not have to depend on that income for a living. It is barely lunch

money, but then I am not asked to do an IME as often as perhaps some

others. I am still treating over 100 appointments a week in my practice

and I

have treated over 21,700 people during my stay in Oregon and have never

thought of doing IMEs for the money. Certainly it is nice to have a

little pocket change, but it is definitely not enough money to act

as a bribe.

Only one time have I been asked to change my opinion by an insurance

company and that one time I told them that I would not change my

opinion because it was based on facts. I fully agree with what Dr.

Deshaw has stated and if I do an IME in my own office, video taping will

be

permitted. However, other companies that I have worked I know will

not allow any recordings. Certainly I have been videotaped in

depositions in my office and in attorneys' offices a number of times and

I have no

problem with that.

I sincerely believe that there are insurance adjusters who want an

objective conclusion that is independent and not biased and willing

to accept the conclusions.

My hat is off to Dan who deserves a vote of confidence from this

profession for fighting for what is right and succeeding in his

efforts. Dan's first experience with chiropractic was as a patient in my

office in 1974. He has been a champion for chiropractic since that time.

Bravo-Bravo for Freeman on what he has done at the

Willamette Spine Center. Finally a place we can refer our patients and

know

that there is no prejudice and that the patients will receive excellent

care. A first class operation, if I ever saw one!

Darald Bolin DC

______________________

August 8, 2000

Dear Dr. Bolin,

His recommended further treatment for a limited time frame. I can't say

for sure since I did not read his report. However, he has been asked to

do more of them. It is possible that he is on the Oregon DCs list serve

and if so, I suggest he jump in with his experiences.

Yours In Health,

L. Underhill, DC

On Fri, 4 Aug 2000 11:44:22 -0700 " Darald E Bolin, D.C. "

<besthandschiro@...> writes:

> Dear Dr. Underhill,

>

> Did your friend who received $1000.00 for a paper review buckle into

> the bribe or was he objective and gave intelligent answers. I get

> $200.0 for a paper review and I am lucky if I average one review per

> month.

>

> I always preface my conclusions with please be advised that the

> following conclusions are made without the privilege of examining

> the patient and are based on information gleaned from the file.

>

> You have to realize that no company is going to use me as an IME

> examiner or a file reviewer unless they want objective answers, I

> guess that is why I do not do very many examinations/reviews.

>

> Darald E. Bolin, D.C.

>

> Dr. Bolin,

>

> A chiropractor friend of mine was asked earlier this year to do a

> paper review. For the work that he did, this chiropractor received

> $1,000.00 as payment. Not bad for a little pocket change and it

> certainly sounds like a bribe to me. As a side note, he wasn't in

> practice at the time and did this out of his home with zero

> overhead.

>

> L. Underhill, DC

>

> On Fri, 28 Jul 2000 14:21:00 -0700 " Darald E Bolin, D.C. "

> <besthandschiro@...> writes:

> Regarding the income from doing IMEs, I am certainly glad that I do

> not have to depend on that income for a living. It is barely lunch

>

> money, but then I am not asked to do an IME as often as perhaps

> some

> others. I am still treating over 100 appointments a week in my

> practice and I

> have treated over 21,700 people during my stay in Oregon and have

> never

> thought of doing IMEs for the money. Certainly it is nice to have

> a

> little pocket change, but it is definitely not enough money to act

> as a bribe.

>

> Only one time have I been asked to change my opinion by an insurance

> company and that one time I told them that I would not change my

> opinion because it was based on facts. I fully agree with what Dr.

>

> Deshaw has stated and if I do an IME in my own office, video taping

> will be

> permitted. However, other companies that I have worked I know will

> not allow any recordings. Certainly I have been videotaped in

> depositions in my office and in attorneys' offices a number of times

> and I have no

> problem with that.

>

> I sincerely believe that there are insurance adjusters who want an

> objective conclusion that is independent and not biased and willing

>

> to accept the conclusions.

>

> My hat is off to Dan who deserves a vote of confidence from this

> profession for fighting for what is right and succeeding in his

> efforts. Dan's first experience with chiropractic was as a patient

> in my

> office in 1974. He has been a champion for chiropractic since that

> time.

>

> Bravo-Bravo for Freeman on what he has done at the

> Willamette Spine Center. Finally a place we can refer our patients

> and know

> that there is no prejudice and that the patients will receive

> excellent

> care. A first class operation, if I ever saw one!

>

> Darald Bolin DC

> ______________________

January 17, 2002

Doctors;

Before the Ins Co orders an IME, suggest you refer your slow healing Pt to a

collegue for Consult and recommendations.

We do consults on occasion for other DCs and usually are able to suggest

additional technic/treatment procedures to assist the pt for faster

recovery.

Simply notify the carrier you ... " are referring Nnn Nnnnn to Dr XXX

XXXXX for consultation on DDDDD date (2 weeks down the road) and if the Co

has any objection, please contact this office immedeately " .

Make sure Dr XXX XXXX will write an report that the carrier will accept

DrBob

January 17, 2002

I agree!

I try to use our excellent DABCO's and DACBR's for that as they have that

little extra clout as a post graduate specialist.

TTFN

Stover Harger, DC, CCSP

Hillsboro Oregon

Re: IMEs

> Doctors;

>

> Before the Ins Co orders an IME, suggest you refer your slow healing Pt to

a

> collegue for Consult and recommendations.

>

> We do consults on occasion for other DCs and usually are able to suggest

> additional technic/treatment procedures to assist the pt for faster

> recovery.

>

> Simply notify the carrier you ... " are referring Nnn Nnnnn to Dr XXX

> XXXXX for consultation on DDDDD date (2 weeks down the road) and if the

Co

> has any objection, please contact this office immedeately " .

>

> Make sure Dr XXX XXXX will write an report that the carrier will accept

>

> DrBob

>

March 12, 2002

Oregon DC's:

In the law, the third party medical exam has its roots in the state common

law from the days when the physician-patient privilege protected the

patient's medical records from disclosure. The US Supreme Court rejected a

federal common law right to an exam in Botsford v UPRR around the turn of

the century, but decided the Schlagenhauf case in the 1940's and allowed

medical exams under Federal Rule of Civil Procedure 35, similar to most

states' exam rules, and similar to Oregon Rule of Civil Procedure 44's

standards for court-ordered medical exams. In times gone by, most of them

probably were " real " treating doctors who did the occasional exam for

litigation. In more recent times however, the need for cost containment

likely generated the cottage industry we see today.

Re the source of the PIP exam, I suspect it was simply inserted into the PIP

policies at the advent of OR PIP and nobody ever questioned it.

Re the term " independent, " it probably came from the days when most

examiners were independent. In my opinion, it is not true of many examiners

today.

Chris

T. Hill, PC

1020 S.W. St., Ste. 300

Portland, OR 97205

(503) 227-4330

Fax (503) 227-3230

chill@...

www.cthlaw.com

IMEs

Historical question:

Just when and under what circumstances did the use of " IME " develop?

It has been suggested before this was perhaps a tool used to find a way to

terminate care as discussed recently by DeShaw DC JD. His specific

citations seem to support the notion current application is at best, a

suspicious artifact of an adversarial relationship between the injured and

his carrier.

By what process has an IME, with credentials often no greater than the

treating DC (and often less)is transformed and promoted beyond its

credibility, when that report supports what the carrier desires, even in the

face of objective clinical findings by the treating DC?

I've heard for years there was pending OBCE focus on the 'Independant

Chiropractic Examiner'; to date this has not been published as far as I can

tell.

I have other questions.

Jack Pedersen, DC

Sweet Home

December 9, 2004

In a message dated 12/9/04 12:15:32 PM Mountain Standard Time,

SSRI medications writes:

> Has anyone undergone an " Independent Medical Exam " ? Any tips for

> survival, any tricks you encountered? This is to be at least 7 sessions,

> plus 8

> hours of paper and pencil testing. No, it's not against a drug company, and

> not

> specifically drug related, just what caused me to need the drugs in the

> first

> place.

> Any help would be greatly appreciated.

>

Oh, boy, fasten your seatbelts. IMEs are usually rigged. The doctors are

paid to say what the insurance company wants them to say, and they will flat-out

lie if they have to. I wouldn't go alone. I would take someone with you who

will be in the exam you with you and the quack they hired. I would even

suggest taking a tape recorder with you if you can't have a live body there. An

IME will never be in YOUR favor, no matter what. Do not volunteer any info,

but answer questions concisely, and expect that whatever the doctor says to you

or indicates to you will be completely different from what he will write in

his report. Been there, done that. It's how I wound up on Paxil -- because the

IME doctor said I didn't need surgery on my shoulder when he told me to my

face and in the first report that I did. An IME doctor is your enemy. Just

remember that and you'll do fine.

" Blind Reason "

a novel of pharmaceutical intrigue

Think your antidepressant is safe? Think again. It's

Unsafe At Any Dose

December 9, 2004