IME Rebuttal Letter

[Guest guest]

So, has anyone been successful in re-opening a PIP case by writing a

rebuttal letter to the IME/insurance company? If so, I sure would

appreciate any pointers.

Thanks!

Barrett

[Guest guest]

,

Your likely not going to get the PIP carrier to change their minds. I perform IMEs and if appropriate can write a rebuttal narrative to the PIP carrier following a review of your file and examination of your patient. Your patient needs a good pro-chiropractic attorney on board and with my expert opinion and yours that substantiates the necessity of your treatment that attorney can sue the carrier in circuit court. This is now possible due apparently to a recent Oregon Supreme Court ruling. This way your patient's attorney gets paid and you and I if I testify must be paid for our time as well...

What I'm being told by at least one attorney is that the PIP carriers who have stopped payment due to an IME are rolling over once threatened with suit....

....but again I can only support your case/continued treatment of your patient is it is indeed supportable...

Vern Saboe, DC., DACAN., FICC., DABFP., FACO

915 SE 19th Ave

Albany, Oregon 97322

541-926-3162 Clinic M-W-F

IME Rebuttal Letter

So, has anyone been successful in re-opening a PIP case by writing arebuttal letter to the IME/insurance company? If so, I sure wouldappreciate any pointers. Thanks! Barrett

[Guest guest]

Dr. Saboe and others:

I agree that most but not all PIP carriers are willing to pay for additional medical expenses that are incurred. It all depends how much longer the treatment lasted after PIP stopped paying. I started appealing the PIP denials a few months ago but I do not threated to sue, I do sue them. However, I FIRST allow my client to complete his/her treatment. When my client completes treatment THEN I request PIP arbitration. However, I do talk to the doctors about this. Should I have to go to arbitration, I am willing pay for the fee for the arbitration, however, SHOULD the testimony of the doctor be needed I do ask that the doctor testify for no additional fee because I will not get paid any for my time and it require me preparing a mini case. Alternatively, sometimes a rebuttal report will suffice for PIP arbitration--it all depends on the case.

PIP arbitration is completely separate from a trial that a client may have later on or another arbitration that s/he may have later on. At this stage of the process, I COMPLETELY agree that doctors should be paid for their time. I feel that we need to be united as doctors/lawyers and help each other out. I know that if I get PIP to accept to pay it also puts my client in a better position.

It is important for doctors to understand that if we want to fight the system we all need to pitch in. I am more than willing to spend my time in pursuing PIP arbitration but doctors also need to help us out. PIP arbitration is better than having to ask a doctor to reduce bills --which personally I despise doing and I only do as a last resort then docs are more willing to work with me and my clients. For a PIP arbitration, most of the time the doctor can testify by telephone and their time needed for testimony is much much less. This also helps us show to the insurance companies that doctors will be aggressive about going after what they are owed.

Also, careful about a rebuttal report. I WOULD never recommend one unless PIP arbitration has already been requested and I am submitting it as an exhibit. I would never recommend one to automatically be sumbitted by a doctors b/c in the cases I have had it happened it has never helped on the contrary it has only made things worse b/c the other side has a better idea of how to prepare.

Also, all docs may know this already, but PIP will only consider rolling over if client underwent the IME. If client did not then the client is in breach of their contract and they have no fiduciary obligation to pay the bills.

Final note, in some cases I do not recommend that my clients undergo an IME because it may be too detrimental to their case. Again, it all depends on the situation this is why the lawyer should be involved early on and know what is going on with the case. If need be the lawyer should consult with the doctor. Sometimes all that the doctor needs is another 30 days to consider the patient medically stationary--when this is the case usually I am able to make an agreement with PIP carrier to avoid the IME. Honestly, if an IME can be AVOIDED it should be. But again some cases are not so detrimental as others. This is why good communication with a client, the doctor, lawyer is needed.

I hope I did not offend anyone.

Enjoy your weekend.

Bobadilla

Attorney at Law

From: on behalf of Vern SaboeSent: Fri 12/14/2007 8:27 PM ; kellybpdxSubject: Re: IME Rebuttal Letter

,

Your likely not going to get the PIP carrier to change their minds. I perform IMEs and if appropriate can write a rebuttal narrative to the PIP carrier following a review of your file and examination of your patient. Your patient needs a good pro-chiropractic attorney on board and with my expert opinion and yours that substantiates the necessity of your treatment that attorney can sue the carrier in circuit court. This is now possible due apparently to a recent Oregon Supreme Court ruling. This way your patient's attorney gets paid and you and I if I testify must be paid for our time as well...

What I'm being told by at least one attorney is that the PIP carriers who have stopped payment due to an IME are rolling over once threatened with suit....

....but again I can only support your case/continued treatment of your patient is it is indeed supportable...

Vern Saboe, DC., DACAN., FICC., DABFP., FACO

915 SE 19th Ave

Albany, Oregon 97322

541-926-3162 Clinic M-W-F

IME Rebuttal Letter

So, has anyone been successful in re-opening a PIP case by writing arebuttal letter to the IME/insurance company? If so, I sure wouldappreciate any pointers. Thanks! Barrett