Make Independent Medical Examiners seperate from Approved Medical Specialists

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Ending up on workers compensation is a possibility for any single person who has a job. This convoluted system is designed to benefit the insurance companies under the guise of "assisting" injured workers. 

To establish if an injured worker deserves to continue to get payments they are subject to an appointment with an Independent Medical Examiner who is generally chosen by the insurance company. The insurance company will then cherry pick the medical history they provide to the IME as to encourage a report in their favour. This is often done as a stand alone appointment to cut benefits or in response to an examination done on behalf of your lawyer. Either way, the insurance companies intention is to make sure you get the least amount possible regardless of your injury. 

If any IME report is in dispute, usually if it is in favour of the worker, or the IME for the insurance company has acted unreasonably due to limited information being given to them by the insurance company, the only recourse available is to proceed to the commission to see an Approved Medical Specialist. The opinion of the AMS is binding, you have no other option than to accept it. 

This is where the problem lies. The Dr's who act on behalf of Insurance companies who while they claim are "independent" are paid by the insurance company. If they are the provider of your income, you are not going to give the insurance company an unfavourable report because then they will no longer send clients your way. The worst part about this is that IME's can then cross the line and become an AMS. There is no seperation in powers. So in one day a Dr can be working for an insurance company as an IME, and then in the next appointment act as an AMS, reviewing and critiquing the work of another IME. 

Injured workers are meant to feel secure in the process that they are being treated fairly. This is not happening. Injured workers are being continually ripped off by Dr's who's loyalty lies with the insurance company regardless of which position they are acting in. Given the majority of their work comes from insurance companies, no-one wants to bite the hand that feeds them. 

The solution is having a pool of Independent medical examiners and a seperate pool of Approved Medical Specialists. The AMS needs not to have worked or have been used as and IME by any insurance company within the last 12 months to ensure there is no loyalty to a particular insurance company. 

It is time for NSW State Insurance Regulatory Authority to execute its powers and act in the best interest of injured workers and not favour insurance companies. 

This may seem like it isn't relevant to you, but we are all one work injury away from being thrown into a system that has no intention of protecting you or your rights. 

 

(Photo credit to shutterschock)



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