Page 18 - Phoenix Vol 11 No 1

BILL GALLAGHER | Chiropractor
IME: Insurance Mock Examination
Opinions based on invalid testing are invalid opinions.
Any doctor or attorney whose practice is focused on personal injury has known the challenges of deal- ing with an IME. Since “insurance” is a word not allowed in a courtroom most attorneys have gone from calling this independent/insurance medical exam to a de- fense medical exam, DME.
Having observed over y of these exams in the past three years I have gone back to calling them IMEs; Insur- ance Mock Examinations. e defense will ask for such an exam since an actual examination by a doctor carries far more weight than a le review. Unfortunately, more times than not, the examination is so cursory or improperly per- formed that the report still comes down to being more of a le review.
It is for these reasons that I am usually able to spot the aws in these examinations. For all the medical specialists I have observed performing these examinations, I have seen few board-certi ed neurologists or orthopedists who actually do a decent examination. Even with these, I can list what parts of the examination they performed incor- rectly. is problem is so rampant that there was one doc- tor who impressed me with their examination to the point that when I met them at a di erent setting I congratulated them for having actually done an examination.
When the doctor is forming opinions based on invalid testing, their opinions are invalid. Not that this is all that important because for the most part even the IME doctors
will write a report that is based primar- ily upon what is in the written record.
As of August 1, 2018 in Arizona, these examinations can be video recorded by the plainti ’s representative. Given the video recording there is now documen- tation of how testing was performed incorrectly. e average personal injury
attorney would never see the errors. For that matter, the average physician would be hard-pressed to point out the de ciencies in the testing.
As a trained observer, I do have that advantage in the exam room. I also carry the advantage on the rebuttal as I usually nd glaring misrepresentations that do not match the patient les. Most common among these is the exam- ining doctor’s opinion that these injuries are just a mild strain that should have resolved within six weeks. is is a common tactic but it is a glaring error when the le shows an MRI with a herniated disc.
With the American Academy of Motor Vehicle Injuries, half of our 150-hour program is on examination and di- agnosis. When I teach exam classes it is done so in terms of knowing not just which test to do but what might be found in a positive or negative nding on each of those tests. Even so, the most skilled clinician will miss tests that could have given more information and likewise the most skilled observer could miss one or more mistakes that oc- cur in the examination.
At Arthur Cro ’s medical legal seminar in LA a few years ago Alex Gelman, a high-powered personal-inju- ry attorney was lecturing on the legal aspects. During a break, a young doctor came down and asked him, “How do I build a PI practice.” Without hesitation I o ered, “Ob- serve IMEs.” e attorney was puzzled by that remark and asked why and I told him that sending your client to an IME without a trained observer who knows what to look for is like giving them the phone number for the adjuster and saying “see how well you can do.”
A er the break, he got back to the podium and opened his lecture with the conversation we had just ended and told the class that any attorney who sends a client to an IME without a trained observer is guilty of legal malprac- tice.
Scottsdale chiropractor Bill Gallagher has taught personal injury seminars in ten cities this year through the American Academy of Motor Vehicle Injuries. He also offers support to attorneys with Phoenix Medical Legal Ser- vices and the Concussion Recovery Center. He can be reached at [email protected] or (480) 664-6644.
ATTORNEY AT LAW MAGAZINE · PHOENIX· VOL. 11 NO. 1 18