Recently, The New York Times began putting together a series of articles on the New York State workers’ compensation system. One of the articles printed in the April 1, 2009, edition was entitled “a world of hurt: exams of injured workers fuel mutual mistrust.” The article was written by N.R. Kleinfield and can be seen here.
The whole gist of the series is the decline and unfairness of the New York workers’ compensation system. However, this article specifically focuses on the doctors who are used by the insurance companies as so called “independent” medical examiners. As this article proves, these examiners are nothing at all close to being "independent.” As one of the doctors indicated in the article, in order to be certified as an examiner in workers’ compensation cases, “basically, if you haven’t murdered anyone and you have a medical license, you get certified.”
Another aspect of the article talks about the significant disparity between the opinions of the treating physicians and the opinions of these insurance doctors or more commonly referred to as IMEs.
Although this article dealt specifically with the New York State workers’ compensation system, it has been my experience that these insurance company doctors permeate throughout the country. Actually, here at Carroll & Carroll, P.C., we like to refer to them as Defense Medical Examiners or DMEs.
Insurance adjusters know which doctors are favorable to them and which doctors are not. They know it based upon their own experience. Therefore, the doctors who will write an opinion that is favorable to the insurance company more often than the claimant will get more business.
I know some doctors who have their own private practice and actually see patients but also make over a million dollars a year merely doing insurance company work. They obviously know who pays the bills.