Conflict Between Insurance Medical Examiners and Injured Workers

Hundreds of workers are injured on the job everyday. Companies in New York spend a significant amount on workers’ compensation, many of them are believed to be false injuries. These injured workers are being sent to worker’s compensation insurance independent medical examiners, retired doctors, paid by insurance companies and unregistered insurance brokers to exam injured workers and decide whether or not workers require medical care and/or compensation. Many of these doctors were unregulated until a 2001 state law that requires doctors to be registered with the Workers’ Compensation Board, conduct exams in medical offices, and allow patients to videotape or record their exam or have witnesses present.

Cases claiming that doctors are filing false reports have been appearing at an increasing rate. Patients have video taped their exams as evidence showing doctors confirming an injury during the quick and inadequate exam then reporting the opposite on their reports to the insurance company. Doctors often blame the overwhelming volumes of patients for their errors on their reports; if asked about a patient, they cannot recall patients they see the day before, vague checklists and notes that clerks review are misread, or transcription companies who create the reports from the doctor’s checklist and notes have no experience in medicine.

Independent exams by insurers were created to filter exaggerated injuries and determine who truly needs medical care and compensation. However, independent medical examiners are paid large amounts by these insurance companies to file reports in the insurers interest. Doctors are paid twice the amount by insurance companies to exam injured workers than they are examining their own injured patients.

If you have a New York or New Jersey business, make sure you follow the Occupational Safety and Health Administration regulations to reduce work-site injuries and make sure your business is protected with New York Business Insurance, New Jersey Business Insurance, New York Worker’s Compensation Insurance, or New Jersey Worker’s Compensation Insurance.

Metropolitan Risk Advisory specializes in risk management and insurance solutions. Feel free to pick up the phone and contact us if you have any questions or concerns about your business, insurance, or workers compensation.