Defense Base Act Compensation Blog

The Modern Day DBA Casualty

How much does an Independent Medical Examination Cost?

Posted by defensebaseactcomp on May 10, 2011

An Independent Medical Examination as ordered by the Department of Labor or a Defense Medical Examination (Second Opinion) are paid for by the insurance company.

We’ve not yet seen or heard of anyone going to an Independent Medical Examination as ordered by the DoL according to the LHWCA/DBA.  There are guidelines to be followed for an Independent Medical Examination which ensure that the doctors are not insurance company regulars.

We have seen paperwork on DME’s on DBA Casualties starting at $800 and going up to $1,200 per DME.

Expensive for a single examination it would seem.  Often done offsite of the Doctors regular office if they even have one.

And the ante goes up if your exercise your right to have the examination videographed.   We do not mean the charges you will incur for the videographer.   The added charges are more like “risk coverage” or a deterrant to keep the injured from ensuring that the examination is fair.

Your DME is much more than simply the unbiased second opinion that it is represented to be.

The DME Doctor is an expert witness for the insurance company.

They may be asked to submit to a Deposition under oath or to testify in person on behalf of the insurance company for which they will be paid even larger sums.

The IME/DME business is a very lucrative one for those Doctors who choose to do them.

The Insurance Companies can afford them.

Injured Contractors and/or their attorneys are seldom in a financial position to deal with DME’s properly.

This is why so many of you are sent to DME’s by your very own lawyers with no advocate or videographer present even though these costs are legitimate expenses which would have to be reimbursed.

This is ONE reason why the Dr Griffith’s of the DBA have been utilized repeatedly even after being exposed under oath in depositions.

7 Responses to “How much does an Independent Medical Examination Cost?”

  1. The following quotes were written by Honorable U.S. District Judge Richard Alan Enslen in ZANNY v. KELLOGG COMPANY and METROPOLITAN LIFE INSURANCE CO.)

    “And What About those “Independent” Medical Exams and Reviews? Overall, the Tacl report is explainable only as the product of a professional who has been directed to reach a conclusion, has focused on data only in support of such conclusion, and who has scrupulously ignored all contrary data.”

    Those quotes are from a disability case in the U.S., but the same criminal ignoring of evidence is happening in medical reviews that insurance companies conduct on injured war zone contractors !

    Right below are more quotes from the case just mentioned, and you can also click on my name to learn how many of us are victims of identical organized crimes that are being committed by multiple insurance companies in five different areas of insurance !!

    More Quotes from U.S. District Judge Richard Enslen :

    “Metropolitan Life Insurance Company has arrived at a formula for operating a profitable insurance business. It simply does not allow piddling things like facts to intrude upon its employee benefit claims decisions. Witness Zanny v. Kellogg Company and Metropolitan Life Insurance Co.”

    “What is most shocking about the Report is the underlying context. In this instance, Mr. Kooi made the object of videotaped surveillance and spying at her home, on the road, and at her therapist’s offices a woman suffering extreme depression, paranoid symptoms, anxiety toward strangers and a history of repeated suicide attempts.”

    “MetLife and its henchmen should appreciate that such conduct may itself precipitate the suicide death of a person who has placed implicit trust in their organization to foster mental health. MetLife should investigate the conduct of Mr. Kooi to insure that its agents are not either wittingly or unwittingly subjecting mentally-ill claimants to untoward risks of suicide death or other preventible injury.”

    “This record is an open indictment of MetLife’s practices and treatment of the mentally-ill and long-term disability benefits. In this case, MetLife regularly reviewed the client’s file with an open intention to deny benefits despite the profound and compelling evidence of serious and prolonged mental illness.”

    “On May1, 2002, MetLife requested Ann Tacl (a rehabilitation counselor) to provide a written report concerning Plaintiff’s employability. The Tacl report, for the most part, completely ignored medical information supporting disability, psychiatric hospitalization records, or the reports of examining psychologists and previous rehabilitation counselors who concluded that Plaintiff was not employable at any occupation nor able to operate a for-profit business. (Id.)”

    “Tacl’s report is dated May 14, 2002. In it, she concludes that there is “no objective evidence that she [Plaintiff] has cognitive deficits . . . .” This conclusion is wildly inaccurate and wholly ignored the opinions of every psychiatrist or psychologist who has physically examined Plaintiff, including the most recent such examinations.”

    “And What About those “Independent” Medical Exams and Reviews? Overall, the Tacl report is explainable only as the product of a professional who has been directed to reach a conclusion, has focused on data only in support of such conclusion, and who has scrupulously ignored all contrary data.”

    (Quotes from Case 4:05-cv-00074-RAE Document 55 Filed 06/30/2006
    UNITED STATES DISTRICT COURT WESTERN DISTRICT OF MICHIGAN SOUTHERN DIVISION, Case No. 4:05-CV-74 BRENDA ZANNY v. KELLOGG COMPANY and METROPOLITAN LIFE INSURANCE CO.)

  2. http://www.vamedmal.com/library/CNAbrief091401.pdf Page 31 and 32

    “In large part, CNA claimed it could not determine whether or not plaintiff was disabled from any occupation because it could never get an independent medical examination accomplished. The reason the exam never got accomplished was that CNA got caught seriously misrepresenting the credentials of one of it’s examiners. When confronted with that fact it simply gave up trying to schedule the exam.”

  3. superman said

    OK here’s the deal… these doctors they send you to are paid to say your ok. you could show up missing both arms and legs and they will say you have them. Many of these doctors have been caught. Its real simple. You have the right to Video tape your IME’s. They wont like it.. but the Doctors will be less likely to jeopardize their medical license.

    Second and most important !! what ever your condition is.. don’t wait on these insurance carriers to send you… fork over some of your own money and get several diagnosis’s from different doctors. For example, go to three doctors, get your diagnosis. The should all match. Then if the carrier’s IME says your fine.. well that IME doctors going to have some explaining to do.

    For you scum bags from the DOL and AIG & CNA this is just providing overwhelming evidence that can not be disputed unlike you hiring scum bag doctors like Dr. John Grifith…who will contradict anything based off of who pays him the most.. …

    The DOL needs to get their act together because they are truly appearing to be slanting these cases for these insurance carriers.

    Just ask yourself, what is the DOL going to do when the insurance carriers are exposed for the fraud??

  4. superman said

    The DOL’s problem is simple.. the Director has been tape recorded stating that, “we shouldn’t have to pay these contractors so much, they had a $30k a year job then went over to Iraq and got $100k and now they get disability of $65k thats more than they had before”.

    Mr. Director.. SCREW YOU!!

    Let me make it simple to understand.. If you worked at McDonalds working thru college then got a job as say an executive or even a doctor.. weather you work the new position for 1 day or 10 years you don’t go back and take the premise of lets pay them disability off of the McDonalds job…

    Mr. Director if you get hurt on the job should we say .. o he’s getting over lets pay him based off of his previous job?

    I think not.. Wake up and smell the coffee.. You guys are going to go to jail when we expose you..

  5. superman said

    I have something else to say about the DOL. The DOL system is so extremely broken I cannot believe it is a system in the United States.

    The problem enforcing the DBA for medical care is the mentality taken by the DOL. Let me give you an example…

    Lets take CNA for example.. they take care of no-one, and when they are forced to they screw with the treating doctors so that they will eventually get fed up and refuse to treat the patient.

    The DOL says.. to the lawyers…” well your client is getting paid.. so they don’t get prompt care, at least they are getting something!! there are so many not getting anything.. ”

    What the F, Hey Mr. Director the reason these guys are not getting their benefits and being properly cared for is simple.. You dirt bags at the DOL are not doing your job!

    • anonymousonpurpose said

      RIGHT ON!

      WELL SAID!

      I WISH IT WERE NOT TRUE!

      I earned a VERY specific degree which made me invaluable for my position in Iraq…yes more money than I had ever earned before, but NOT BY THE HOUR…only earned that much because of so damn many hours worked, with no overtime by the way. I will NEVER physically be able to perform the job which I have a college degree for because it is physical and I am 100% disabled!

      Thanks AIG, DOL & that little devious prick in Atlanta!

  6. superman said

    And as for that scum bag Roger Levy up there in San Francisco..

    he is going to go to jail with their friends as CNA.

    He is pathetic and will lie about anything he can. I even heard he tried to blame an incident on one of the injured contracts.. unfortunately when he claimed this incident occurred the injured contractor was in his lawyers office. OOPS.. Caught in a lie.

    Levy used that as an excuse to dump a case he couldn’t win. what a joke.

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