Defense Base Act Compensation Blog

The Modern Day DBA Casualty

Posts Tagged ‘Independent Medical Examinations’

Defense Base Act: The Weaponization of the Defense Medical Examination

Posted by defensebaseactcomp on May 15, 2012

The Defense Base Act Insurance Company is entitled to have Defense Base Act Claimants see a physician that they choose to provide them with a second opinion regards the injuries that you have filed a claim for.  These examinations are in no way Independent Medical Examinations as the Insurance Company and their Attorneys deceptively refer to them as.

These Insurance Company Second Opinions, or Defense Medical Examinations, come at a heavy price to the US Taxpayer.  The Insurance Companies pay much higher amounts to hire doctors that will give them a report unfavorable to your claim and also be willingly to back up these statements in Depositions or straight to a Judges face at hearing.  You are entitled to reimbursement for the expenses you incur attending these.  The DME can be a very expensive undertaking.

Very few DBA Claimants exercise their rights to have these doctors researched by a professional, not travel outside of their geographic area, take an advocate with them (preferably your attorney or a nurse), have the scope and purpose of the Examination clearly defined, or most importantly to video the examination

It must be you who pursues these protections because your DBA Attorney is not likely to suggest or pay for them despite your entitlement to them.  Your attorneys failure to assert your rights only enables the insurance companies and their bloodthirsty attorneys and claims adjusters.

You are required to “cooperate” not play dead.

One very prudent restriction on these DME’s used to be that the Insurance Company could not make you attend one more than every three years.  At some point that we cannot ascertain this restriction was removed. 

So  began the Weaponization of the DBA Defense Medical Examination.

Currently the DME is being utilized as a weapon to intimidate DBA Claimants to accept negligent settlements.

Even though you have an order in place you are told if you do not immediately attend a DME your payments will cease immediately.

Even though your claim is currently under the jurisdiction of an ALJ awaiting a decision you are told to fly across country for several days of DME’s.   Just prepping you for the settlement offer.

Your attorney presents to you a ridiculous offer for settlement along with the threat that if you do not accept it the Insurance Companies Attorney promises you DME’s every year and surveillance by their private dicks $$$ for the rest of your life.

We cannot always be certain who is manning the weapon.  As of late there is a barrage of Friendly Fire.

No doubt that the casualties are always the DBA Claimant and the US Taxpayer.

It has never been more true that After Injury the Battle Begins

Or more clear that this program is lacking oversight of any kind

Posted in ACE, AIG and CNA, Civilian Contractors, DBA Attorneys Fees, Defense Base Act, Defense Base Act Attorneys, Defense Base Act Insurance, Defense Base Act Law and Procedure, Defense Base Act Lawyers, Defense Medical Examinations, Department of Labor, Dropping the DBA Ball, Follow the Money, Independent Medical Examinations, LHWCA Longshore Harbor Workers Compesnation Act, Misjudgements, Political Watch, PTSD and TBI, Racketeering | Tagged: , , , , , , , , , , | 2 Comments »

Nuclear Workers Data Breach Revealed

Posted by defensebaseactcomp on March 29, 2012

Nuclear Workers Data Breach RevealedHuntington News  March 29, 2012

Craig, CO – The Alliance of Nuclear Worker Advocacy Groups (ANWAG) has learned and is “extremely disturbed” that the Department of Labor’s Office of Workers’ Compensation Programs (OWCP) failed to inform claimants that one of their medical contractors, Impairment Resources LLC, had computer files stolen on December 31, 2011.

These files contained claimant names, addresses, social security numbers, and medical records. ANWAG was alerted to this issue by a claimant’s authorized representative, Gary Vander Boegh, who forwarded this article on the break-in: http://www.databreaches.net/?p=23593.

I confirmed with OWCP Division of Energy Employees Occupational Illness Compensation that they were notified of this breach in early February. Yet almost two months later they are still trying to identify which claimants have had their records breached,” stated Terrie Barrie of ANWAG. “I’m appalled that OWCP did not immediately issue a general warning that some of their claimants may have had their protected information stolen.”
“The lack of timely notification to the affected people seems egregious,” added Faye Vlieger of CWP. “I am highly indignant with OWCP withholding the facts. It shows a certain highhandedness of OWCP to assume there will be no damage done by the break in.”

Please see the original and read more here

Posted in Department of Labor, Independent Medical Examinations | Tagged: , , , , , , , | 1 Comment »

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.

Posted in Civilian Contractors, Defense Base Act, Defense Base Act Attorneys, Defense Base Act Insurance, Defense Base Act Law and Procedure, Defense Base Act Lawyers, Defense Medical Examinations, Department of Labor, Independent Medical Examinations, Injured Contractors, LHWCA Longshore Harbor Workers Compesnation Act, Racketeering | Tagged: , , , , , , , | 7 Comments »

How far can you be sent to a Defense Medical Examination ?

Posted by defensebaseactcomp on March 29, 2011

Coercion: the act of compelling by force of authority

Forcing an Injured Contractor to drive or fly far out their geographic area to go to Defense Medical Examinations which are falsely referred to as Independent Medical Examinations is among the most abusive tactics in the insurance companies arsenal.

They are often aided by the Department of Labor’s Claims Examiners going against their own rules and regulations.

ALJ Paul C Johnson even aided CNA by ordering that an injured contractor travel outside his geographic area.  Not because there weren’t plenty of doctors in this injured contractors area, just because CNA’s hired guns were not there.   The injured would lose his claim by not “obeying” this biased order.

What happens when the insurance company defies an order signed by an ALJ to provide medical to an injured contractor?  Nothing.  This is not to say that the order was his idea, we’ve never seen him award anything to anyone in a decision.

It is so blatantly obvious why the insurance company does not simply hire a doctor in the injured contractors geographic area for an unbiased second medical opinion.  They are hiring expert witnesses who will provide them with a report in their favor then provide testimony that will back them up if necessary.

Longshore Procedure Manual

e. The Employee shall submit to any special examination as may be requested by the employer at such place as is designated by the DD but at a place reasonably convenient to the employee.

(See section 7(d) of the Act and 20 C.F.R. sections 702.403 and 702.410.)
20 CFR 702.403 – Employee’s right to choose physician; limitations.
The employee shall have the right to choose his/her attending physician from among those authorized by the Director, OWCP, to furnish such care and treatment, except those physicians included on the Secretary’s list of debarred physicians. In determining the choice of a physician, consideration must be given to availability, the employee’s condition and the method and means of transportation.
Generally 25 miles from the place of injury, or the employee’s home is a reasonable distance to travel, but other pertinent factors must also be taken into consideration.

Injured Contractors have been flown or told they had to drive from as far as five and six states away to see AIG’s Fabulous Four Defense Medical Examiners in Houston or they would lose their claim.

Many of them traveled to see the notorious Dr John Dorland Griffith because their attorney told them they had to.

Threatening an injured contractor with the loss of benefits due them under the Defense Base Act if they do not travel unreasonably to see the insurance companies defense medical examiner/expert witness amounts to Coercion under any legal definition.

Worse, many  injured contractors are not being provided necessary medical by these companies while being coerced into traveling to see these whores.

Posted in AIG and CNA, Defense Base Act, Defense Base Act Attorneys, Defense Base Act Law and Procedure, Defense Base Act Lawyers, Defense Medical Examinations, Department of Labor, Dropping the DBA Ball, LHWCA Longshore Harbor Workers Compesnation Act, OALJ, Racketeering | Tagged: , , , , , , , , , | 2 Comments »

AIG’s Fab Four Defense Medical Examination Doctors Take Another Hit

Posted by defensebaseactcomp on October 18, 2010

Not long before Dr. John Dorland Griffith was exposed

Dr Bryan Drazner was Suspended from the easy money  Designated Doctor List in Texas, only not for long enough

Update:  It was for long enough

Official Order of the State of Texas Workers Compensation

Drazner, Bryan Scott M.D. Dallas, TX Lic #J0945

On August 26, 2005, the Board and Dr Drazner entered into an Agreed Order requiring Dr Drazner to complete at least 50 hours of Continuing Medical Education in the areas of medical records, risk management, ethics and physician patient confidentiality and accessing an administrative penalty of $3,000.  The action was based on allegations that Dr Drazner breached patient physician confidentiality by dictating a note for the medical record of a patient while on an airplane flight, which was overheard by another passenger.

Drazner:  Insufficient Report


You can see Dr Bryan Drazner listed at the DBA X Files at American Contractors

He also had a Sanction Against him in Illinois

Refusal to Renew License


Also see Doctors Who Work for Insurance Companies

TEXAS DEPARTMENT OF INSURANCE

Drazner, Bryan M.D. of Dallas
Order Number: DWC10-0034
Date of Order: 5/10/2010
Order Final In: May
Action Taken: Fined $15,000; Suspended from Designated Doctor List for six months
Violation: Failed to timely file DWC Form-69 with insurance carrier (72 instances); Failed to provide documentation proving filing of DWC Form-69 (40 instances); Failed to timely file letter of clarification

Posted in AIG and CNA, Civilian Contractors, Defense Base Act Law and Procedure, Defense Medical Examinations, Delay, Deny, Department of Labor, Dropping the DBA Ball | Tagged: , , , , , , | 1 Comment »

Danger: Never attend an Insurance Company Second Opinion Unarmed

Posted by defensebaseactcomp on July 27, 2010

Never attend any medical or psychiatric evaluation on behalf of the DBA insurance company without your lawyer or an advocate that your attorney provides and

Never attend one of these without a videographer.

NEVER

The Insurance Company may have you see a doctor of their choice for a second opinion.  While you must attend these you are afforded many rights under the DBA that are being ignored at your expense by YOUR attorneys, the DoL, and the ALJ”s.   Ask your attorney what your rights are.

This is especially important if you are a TBI or PTSD patient.  You will need an advocate with you at all times who is able to protect you from inappropriate questioning and intimidation tactics.

You are required to attend, you must cooperate within the “scope and purpose” of the examination as it relates to the aspect of your claim you are being examined for.

Your lawyer, your advocate, and your video of the examination are your only defense against manipulative and deceitful Doctors who are paid by insurance companies to help deny your claim.

Shame on you DBA attorneys who send your unsuspecting clients into these ambushes blind, far from their geographic area, without the scope and purpose of the examination clearly defined, on short notice and without even checking the credentials and backgrounds of these insurance company whores.

And even more worrisome are the ALJ’s who set aside the rights afforded the claimant under the very rules and regulations used to set up these deceitful exams on behalf of the insurance company.

Never attend an Insurance Company Second Opinion Unarmed

Posted in ACE, AIG and CNA, Civilian Contractors, Contractor Casualties and Missing, Defense Base Act Law and Procedure, Department of Labor, Dropping the DBA Ball, Misjudgements, OALJ, Political Watch | Tagged: , , , , , , , , | 4 Comments »

Medical experts call for independent oversight in nuke worker program

Posted by defensebaseactcomp on July 12, 2010

Though multiple doctors weigh in, an administrator makes final medical decisions on sick nuke worker’s claim

By Laura Millsaps 5/20/10 6:00 AM

Imagine being sent to get a second medical opinion about your fatal lung disease from the same doctor you went to the first time. Then imagine having the differences of opinion between multiple doctors about your fatal condition resolved by someone who is not a doctor.

Administrator as medical referee

This April, two years after his death, the EEOICP has rendered a final decision to close Michael’s claim for good, unless more new medical evidence can be found.

“Upon review of the objections and the evidence on file, I find that the case is not in a posture for reopening at this time,” stated Rachel Leiton in her letter of final denial to Mrs. Fellinger dated April 22. “Should you or your doctor have viable medical evidence of a convincing and compelling nature that contradicts the findings in this case, the DEEOIC will reconsider its position.”

The problem, according to several medical experts, is that Leiton isn’t a physician. She is a high-level administrative director in the Office of Worker’s Compensation Programs, overseeing the EEOICP.

While a medical decision would be more appropriately rendered by a medical director, the EEOICP hasn’t had one since the departure of Eugene Schwartz, who resigned his position last year. In piece published by ProPublica last August, Schwartz told the media he had been “muzzled,” and said he had warned the Department of Labor that it is ignoring established medical knowledge about the dangers of bomb work.

Dr. Laurence Fuortes, director of the Former Worker Medical Screening Program at the University of Iowa and the advocate for Michael Fellinger’s claim, said he is deeply troubled that an administrator is assuming the authority of a medical referee.

“They are defending the Department of Labor process rather than a rationalized medical opinion,” he said.

According to the Department of Labor, Leiton is not rendering final medical oversight, and it expects to name a new medical director within weeks. The Labor department stressed that the system of independently contracted district medical consultants had been in place for years, with qualified medical specialists rendering medical findings based on the evidence submitted.

Please Read the Entire Story here

Posted in Delay, Deny, Department of Labor, Follow the Money, Hope that I die, Political Watch | Tagged: , , , | Leave a Comment »

 
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