In "A World of Hurt: Exams of Injured Workers Fuel Mutual Mistrust" the New York Times today examines the role of "independent medical examiners" hired by workers compensation insurance companies to examine and report on injured workers. One doctor, a prolific "independent medical examiner," explained the difference between his written report stating that the claimant was not injured and videotaped statements while he was actually examining the injured employee as follows:
"If you did a truly pure report," he said later in an interview, "you'd be out on your ears and the insurers wouldn't pay for it. You have to give them what they want, or you're in Florida. That's the game, baby."
Fraudulent medical opinions were a focus of a case decided by the Sixth Circuit last year, Brown v. Cassens Transport, which held that a civil RICO claim for money damages may be pursued by injured workers wrongfully denied workers compensation benefits on account of fraudulent medical opinions. Robert L. Abell published an article about the case in The Advocate, the official publication of the Kentucky Justice Association, "Injured Workers May Pursue Civil RICO Claim Based On Enterprise To Deny Them Workers' Compensation Benefits."
