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“Not-So-Independent” Medical Examinations

September 14th, 2011 Comments off

Personal injury plaintiffs are routinely derided by the general public as phonies. Certainly, there are unscrupulous plaintiffs and lawyers who bring smear-job lawsuits. But too few people are cognizant of the dark side of the defendant’s defense.

If you bring a lawsuit for personal injuries, §3121 of the Civil Practice Laws and Rules of the State of New York (CPLR), permits the defendant’s insurance company to hire its own doctors to physically examine you. The purpose is obvious. Defendants have the right to verify whether a plaintiff is actually injured and the extent to which the injuries are permanent and/or disabling. Defendants euphemistically refer to these tests as “Independent Medical Examinations” or “IME’s” because the CPLR gives them the right to evaluate the plaintiff separately from what the plaintiff and his doctors may claim. To describe the defendant’s physical examination as “independent” lends an aura of righteousness to the endeavor as though only the defendant’s doctor may uphold his sacred Hippocratic oath to practice his profession ethically and without outside influences. Nothing could be farther from the truth. The doctors who conduct the examinations are paid by the defendants’ insurance companies. They serve at the whim of the insurance company. In so doing, many take a “hypocritical” oath. The doctor who too often determines that a plaintiff is seriously or permanently injured finds himself out of favor with his patron and unemployed. But certainly not all.

More often than not, the defendant’s doctor renders his services at a bulk rate. He may be paid only $100.00 per examination. How does he do it? Volume. He overbooks his appointments and examines plaintiffs in assembly-line fashion. He doesn’t dictate a full report but uses fill-in-the-blank templates forms to save time. Rare is the occasion when the physician spends more than five minutes examining the plaintiff. Rarer still is the occasion when the physician determines that the plaintiff is truly injured as a result of the defendant’s negligence.

Generally, there are five different methods by which the defendant’s doctor plies his tawdry trade to refute a plaintiff’s claim of injury:

(1) IT’S ALL IN YOUR HEAD: By this approach the doctor pejoratively references the plaintiff’s symptoms as “subjective.” If the plaintiff says that he has pain and can’t move his arm, the doctor claims that he has objectively measured the plaintiff’s range of motion and finds that he is not so restricted or that his range of motion is “within normal limits.” But what is normal? A thirty-year-old athlete can swing his arm in a wider circle than a fifty-year-old fat man who won’t get off the couch unless he needs to reach the cooler. Most times the examiner makes no distinction. God help the couch potato.

(2) NOT MY FAULT: Another twisted method is to claim that the plaintiff’s problems are “pre-existing” or the result of “degeneration.” True, few people more than forty can avoid the aging process. But how may the IME doctor explain that the plaintiff was asymptomatic until his Volkswagon Beetle was struck from behind by a teenager in his father’s Range Rover? Too frequently they ignore such facts or do not let themselves be fooled by the truth.

(3) THIS TOO WILL PASS: Sometimes IME doctors are faced by the physical evidence that the plaintiff is irrefutably and uncontestedly injured. How then may he serve his master? In such a case, the doctor must resort to a fallback position – “the plaintiff’s injuries are temporary.” Sure, little Joey still limps four years after breaking his ankle. Shortly he will fully recover.

(4) HALLELUJAH! JESUS SAVES: Another artifice in the IME arsenal is the technique wherein the defendant’s doctor proclaims the plaintiff remarkable recovery. Like a Pentecostal Preacher, he asserts that the plaintiff may throw away his crutches and walk.

(5) THE RORSCHACH APPROACH: Perhaps most sinister are the physicians who do not physically examine a plaintiff, but “review” the radiological records instead. The doctors who prepare such reports are uniquely positioned to practice medicine without a patient. Behind the cloak of a shadowbox they offer their not-so-professional opinions. Ask one man to look at an inkblot and he sees a monkey with an accordion. The next man sees a ballerina smoking a cigar. So if the plaintiff’s radiologist says that an MRI film shows a herniated cervical disc, the defendant’s doctor may say that the findings are evidence of degenerative osteophyte formations. Put the film in front of the jurors and call it what you want. The average person can’t tell. As Harry Truman said, “if you can’t convince them, confuse them.”