Independent medical exam on Friday!

Discussion in 'Fibromyalgia Main Forum' started by terra329, Nov 7, 2005.

  1. terra329

    terra329 New Member

    Hi

    If anyone has any more input on this type of exam please bring it forward. I read the very few threads on this topic and a few people were going but did not post (that I can see) what happened after the visit. The exam is for my long term disability company. I have tried to fight them on sending me to a doctor who has clients with CFS and FM to no avail. The name of the place is Occupational medicine
    phsicians - this tells me nothing of who this doctor is. I called the place and they told me to call my insurance company. This smells real bad from where I sit. I went out on the Dx CFS and FM but a few other things have croped up I wonder if I should bring other info into the meeting or just stick to this one Dx. I am bringing a friend as a witness but I am so freaked out it is hard for me to organize myself.

    I have no money for a lawyer - has anyone used leagal aid?

    I feel so alone on this so any feedback is welcome.

    Thanks
  2. elastigirl

    elastigirl New Member

    My friend had a few injuries from a car accident. Being in a no-fault state, her insurance had to pay for her physical therapy and a little dental work. After a few months, they decided to send her to one of "their" so-called independent doctors to see if she was still suffering from the accident.

    She said the doctor asked her a few ~leading~ questions and barely looked at her. Then he ran his finger along her spine as light as a feather to see if this hurt her (of course, it didn't.) That was it. He didn't test her flexibility or even look her in the eyes. He proclaimed she was well and that was that.

    The "independent" doctors always sound like bad news to me. I saw an expose on TV where these doctors are actually pressured by the insurance companies to deny the vast majority of any claims that cross their desks, regardless of what the doctor might really think. These doctors do it for the money. Why do I say that? Because it appeared to me from the expose that the ethical ones quit the insurance programs and/or become whistleblowers.

    But I hope your case is an exception. Others here might have more direct experience with these kinds of doctors. I'm sure that some people do get 'real' exams. There have to be some good doctors out there, right?

    Definitely take a witness. I would be curious to hear your result.
    [This Message was Edited on 11/07/2005]
  3. pamj

    pamj New Member

    I'm glad you're bringing a friend with you. I always have the feeling that these docs are hired to find any reason to deny your claim. I was sent for a functional capacity exam by my insurance company & then originally denied me because of the "findings".

    The problem with our illness, is that many of our symptoms are not clearly visible to other people. We are able to walk and sit, so therefore, they believe we should work. They do their best not to take into account how our other symptoms affect getting through the day. Focus on the other problems you have, besides getting around. Do you have headaches, sleeping problems, cognitive trouble, or other problems that a physical exam would not show? Do you need frequent periods of rest during the day? It may help to focus on these things, or whatever it is that makes it most difficult for you to get through the day.

    Also, it helps if your own doctor is supportive of what is going on with you. If you have been diagnosed with CFS & FM, then you must have found someone who understands the complexities of this illness. No matter what the indepent medical exam shows, it will be most important to have a doctor who is willing to dispute any ridiculous "findings".

    My supportive docs are the reason that I got my denial reversed. They responded in a way that showed that the person who tested me knew nothing about what was happening with me.

    Try not to be too nervous, just be honest about how you feel on your worst days. Also, don't be tricked into thinking that this person is nice or supportive... the person that tested me seemed very sweet when I had to stop & lie down to rest for 20 minutes, but she never made note of it on the report!

    Good luck!
    Pam
  4. Mar19

    Mar19 New Member

    It was back in '99. I was out on short term disability and working for the boss-from-hades at the time, she challenged my claim.

    I got the notice of the upcoming exam in the mail and thought I was in for a hard time. I was pleasantly surprised; I'm sure the Lord orchestrated the entire thing.

    I arrived at the scheduled time, surprisingly, I was taken it w/o any wait at all. Saw the nurse first to explain my symptoms and she was very sympathetic.

    The doctor came in shortly afterward, reading the notes his nurse had jotted down and was shaking his head. ::Gulp!:: I thought I was done for.

    He asked me one or two questions, did a brief exam, and then looked at me and asked me if my boss was insane!! He said people like HER really get him furious b/c they "waste his time" challenging claims out of stupidity or meanness!

    Needless to say, I stayed on STD until I could no longer collect. I never applied for long term, because I had not yet been Dx'd with FM and I really really thought I'd be able to work again... Guess I was the stupid one there, eh?

    Mar
  5. Bailey-smom

    Bailey-smom New Member

    Long Term Disability but I did have to go through one for an auto accident. I was just asked questions and put though some mobility testing - ie) laying on back - how far can lift legs w/o pain and others like that.

    I'm sure there are good Drs and bad ones that could do your exam. I do think it is good to take someone with you to the exam. Maybe have them take notes independant of the doctors notes for referance.

    During your exam take time to really listen to the doctors question and process it in your head before answering it. Do not let them put an answer in your mouth. If you can not do something or something bothers you let them know. Be open and honest with them and try not be too nervous - maybe make a list of problems so you do not forget something. I just knew to go from head to toe.

    As far as attorneys - there are firms that take on cases that get paid when you do. Maybe someone with more experience with that will find this and answer that question. It would be scary to take this all on yourself.

    I wish you luck!

    Kelly
  6. Rene

    Rene New Member

    I went to one for CFS twice and he was REALLY kind and gave a lot of sympathy!!!!!!! He was a pulmanary infectious dr so the ins co wants to get you to someone who doesn't know CFS which isn't a hard task.

    REMEMBER after I sued (the IME DR ruled in my favor) you will be followed going to your dr and leaving. They followed me and made a report that I got a burrito and went into Wal greens for 10 minutes.

    I saw also on 60 minutes that they were following a man and did they same thing on his appointments to the dr. My lawyer told me this too. I didn't know this until way later but I was really sick and I still had to sue!

    I wouldn't post stuff like dates of dr appointments ect as the LTD has about $90,000 to lose if you add up your benefits. I was on a lower end job too. No wonder they want off the risk.
  7. Rene

    Rene New Member

    I went to one for CFS twice and he was REALLY kind and gave a lot of sympathy!!!!!!! He was a pulmanary infectious dr so the ins co wants to get you to someone who doesn't know CFS which isn't a hard task.

    REMEMBER after I sued (the IME DR ruled in my favor) you will be followed going to your dr and leaving. They followed me and made a report that I got a burrito and went into Wal greens for 10 minutes.

    I saw also on 60 minutes that they were following a man and did they same thing on his appointments to the dr. My lawyer told me this too. I didn't know this until way later but I was really sick and I still had to sue!

    I wouldn't post stuff like dates of dr appointments ect as the LTD has about $90,000 to lose if you add up your benefits. I was on a lower end job too. No wonder they want off the risk.
  8. terra329

    terra329 New Member

    Just hearing you guys it makes me feel less alone in this mess. I might take something to relax me for the exam as I get very defensive when someone makes a comment that I do not hurt etc. - I have had doctors, like many others of us had, that just looked at my dx and say something like " How did you ever get on disability" without so much as looking at me. I know they set you up to react and this is my weak point.

    I think a big problem is that I do get out of the house to go to three doctors a week -- P. therapy, chiropractor and I get IV drips from my CFS doctor. The insurance lady thought that was a lot of outside time and that is when I got socked with an IME appointment. As I said in my bio I am an A+++ type - if I feel the least bit better I do stuff and pay for it later. This of course is with all the meds I take ( my Rx benefit is tied into my LTD claim)--- who knows what I would be able to do if I went off them!
  9. Rene

    Rene New Member

    remember they want you scared. I didn't file a claim with an attorney until about TWO yrs AFTER they cancelled me. Check with an attorney and ask what the statue of limitations are. They want you to give up. If I had to do it again I would have got a lawyer sooner cause the LTD Co is NOT allowed to call you EVER.

    What is in your IV DRIP from your CFS Dr???????