Workers' comp exams need reform to ensure fairness
By Ira Zunin
POSTED: 01:30 a.m. HST, Mar 03, 2012
How would you feel about your spouse, parent or child being sent for a medical examination by a strange doctor who is beholden to the insurance industry? It happens every day to injured workers throughout the state. Why not refuse? Insurance companies reserve the right to terminate coverage for medical care and wage loss benefits if you don't show up. That's why.
In Hawaii, statutes provide for the presumption of compensability in favor of the injured worker. This is analogous to the presumption of innocence until proved guilty in the criminal courts. The problem is that although patients are sent to what is called an Independent Medical Examination, the physicians who perform these exams usually work only for insurance companies and rarely engage in the actual full-time clinical practice of medicine.
This is because those performing the evaluations are paid far more than what treating clinicians get paid for their time. These physicians are also well aware that should their opinions be too "patient friendly," the carriers will stop using them.