Last year I spent some time discussing the dangers surrounding "independent medical evaluations" by physicians that are employed by insurance companies. It has been my experience that these doctors are paid by the insurance companies to simply cut-off the benefits of insured. Statistically, I’ve seen doctors whose evaluations find the insured to be perfectly healthy on 90-95% of their exams. I’ve also seen companies here in Michigan that match doctors to the insurance company client, advertise their doctors as "cut-off" doctors; essentially ensuring that the insured will be found healthy and uninjured which allows the insurance company to deny benefits.
In cases where the insured has sustained a closed head injury or traumatic brain injury, the insurance companies neuropsychologist is typically hired to assess the insured and more often than not, find that they are malingering [making it all up], suffering from a pre-existing mental illness or perhaps depressed due to some non-accident related event.
When my clients are ordered to undergo neuropsychological exam by the insurance company’s doctor, we fight to make sure that a neutral 3rd party can be present to simply observe and monitor the exam. We’ve had cases where doctors write in their reports that certain exams were performed, when the were never administered or write that the patient performed particularly well on an exam, when in fact, they failed that part of the test.
The main argument we see from the insurance company is that an observer will somehow taint the testing process.
This is a red-herring for the courts, but some judge’s buy into it. Fortunately, the American Psychological Association, through their Committee on Psychological Tests and Assessment, has issued a statement on the impact [if any] of neutral 3rd party observers. They recognized in their conclusion that a neutral 3rd party observer "may facilitate validity and fairness of the evaluation".
Even if a judge disagrees with this attempt to facilitate some fairness and validity into the testing process, at the very least, they should allow video-taping of the exam so that the doctor knows that he is being watched and cannot take liberties with the insured.
I’m curious if Injury Board readers have had experiences with these insurance company doctors. Were you allowed to take a neutral 3rd party with you into the exam? Were you allowed to videotape the exam? Were you treated fairly by the doctor at the time of evaluation and at the time the report was dictated? Did the insurance company doctor come to conclusions after the 15 minute exam that none of your own treating doctors [who had been treating you for months or years] could find or substantiate?
Let us know.
For background on these doctors, check out some of my posts from last year….