Cherry Picking - Documents needed for IME's
As an Independent Medical Examiner - and especially as a Psychiatrist, there is significant variation in the quality and quantity of documentation provided for the purpose of completing independent examinations. There are many factors for this, including;
- Type of referral (Compulsory Third Party Claims, Workers Compensation Claims, Personal Injury Claims etc.)
- Source of referral (Insurance Company, Employer, Solicitor)
- Experience of individual referring.
It is often observed that unrelated content in the documentation, or an overwhelming volume of documents in the many hundreds or thousands of pages, can very much assist or hinder the examination process.
How information is provided makes a significant difference. Frequently, there is no categorisation or organisation in documentation. Methods of organising files, in essence creating more of a medical record type document, assist the assessor greatly. Suggested categories of documents include:
- Insurer correspondence
- Treating Doctor/Specialist correspondence
- Previous independent assessment reports
- Investigation results
- Medical records
- Medical Certification regarding the injury
While clearly there are numerous other categories that may be included - such as Workers compensation commission reports, factual statements, motor accident reports, any organisation of such documents can only assist a medical professional.
As would be present in a medical record in private practice or public setting, it is also of great assistance to have documents in categories in date order. It is not unusual to be given a file where documents leap back and forth by years, such that the reader can easily find it challenging to develop a clear narrative about how a case has progressed over time.
At times, where cases go back a number of years, it is not unusual to have documents of little relevance provided from early on in the claim, that by a late stage offer little relevance or even records that do not relate at all to the time of injury or the injury in itself. On other, numerous occasions, fax cover sheets, invoices and email cover documents are included, which of course are of no use, but simply add to the overwhelming document volume, and attention to try to eliminate such documents is always appreciated. This can result in further time required to be sent in reviewing the file and specialist’s requesting additional charges for extra time spent.
Psychiatric Independent Medical Examiners appreciate that it is difficult to “cherry pick” from a referrers perspective, so as not to show any undue bias towards any particular part of a claim, but with consideration and experience, we encourage that documentation is provided in a more thought through, organised fashion, which can only assist the examiner and improve the overall quality of assessment.
Dr Martin Allan – Consultant Psychiatrist
NSW iCare Injury Management Consultant
NSW iCare WPI Assessor, SIRA DRS Assessor