|
;
|
Reply from Bernard A.
Kansky
The information provided is not legal advice and should not be
construed as such but is a flow of thoughts an ideas from the author, Bernard A.
Kansky, Esq., Kansky & Associates, 468 Commercial St. Suite #100, Boston, MA
USA 02901-1020, and the the information, thoughts and ideas set forth herein are
and do change from time to time and frequently, by locale. Therefore, for legal
advice it is essential to contact one's own personal attorney.
In
addition, as with my featured columns in the National CFIDS Foundation, Inc.'s
newsletter, the Forum, the above material is copyrighted and all rights reserved
i.e. Bernard A. Kansky, Esq. © Copyright 2003 and may not be further reproduced
or published without my express written consent.
Page forms part of www.apls.tk, the information site on ANTIPHOSPHOLIPID SYNDROME (APS or ANTIPHOSPHOLIPID SYNDROME (APLS))
|
|
|
|
REPLY
1. If they are asking her to travel 100 miles round trip from home, they
should be required to provide the full cost of transportation for not only this
woman but a person designated by this woman to accompany, escort and assist her
to and while at the IME and for the return trip back home where she will
probably be in need of most assistance in the days to come following the
IME.
2. If she has become too ill to make the trip, she might call first
thing Monday morning to reschedule it, or if they refuse to reschedule, to tell
them that she will do her best to make it, but to have some transportation
there available should she need any emergency care or treatment at a local
facility or hospital.
3. The person who accompanies her should be a
person who is an out spoken extrovert who is not timid or shy and who, if needed
to, can intervene in behalf of the patient to provide her water, accompany her
to the bathroom or to discontinue the IME in the event she observes the patient
becoming overwhelmingly weakened by the ordeal or in danger of passing out or in
need of assistance in lying her down on a sofa or floor, if her condition at the
time warrants it. "Acting," is to be absolutely avoided.
4. While at the
IME and prior to the actual exam, the patient's aide or escort should attempt to
obtain from the staff or the IME physician, a copy of the MD's curriculum vitae
and the date when his or her medical license issued and by what authority i.e.
state, province, county and/or country. Be sure also to obtain the examiner's
full name including middle initial and if possible, a business card in addition
to the curriculum vitae.
5. Although it is not uncommon for a patient to
be evaluated outside of the presence of the person who brings them to the exam,
there is no restriction as to the other person keeping a written log as to the
time they arrived, the amount of time they had to wait before the IME
accompanied the patient into the examining room , the length of time the patient
was in the examining room, whether or not the phyisician or staff
was/were
cooperative in providing the information requested, and there is no restriction
of taking a picture of the patient before she enters the exam room and when she
comes out. They may exclude the escort from the exam room.
6. In
addition, although it is unlawful in most areas for anyone to secretly audio
tape record the examination by hiding a micromini tape recorder in the patient's
pocket book, hand bag, coat etc., some people do it any way. As an attorney at
law, I cannot and do not recommend it. It might well come back to haunt the
disability claim.
7. I think it is more appropriate and more efficient
for the escort to purchase a composition type note book and keep simultaneous
notes and records as to what he or she observes about the patient from the
departure time to the time of return to the patient's home, as well as keeping
simultaneous and meticulous written records as to times of arrival, waiting
time, length of exam, time of departure. As soon as the escort assists the
person out of the office and into the vehicle, to then immediately take detailed
notes as to what happened during the exam, what tests were administered and what
if anything the MD asked the patient and how the the patient responded. Also
what comments if any the IME volunterred to the patient during the course of the
examination. Also ask the patient and make notes if anyone else i.e. nurse,
insurance adjuster or any one else was in the room at the time of the
examination as well as a detailed description as to the examination itself and
obtain the full names and middle initials as well as titles and office addresses
of anyone else present during the IME.
8. Both the escort and the patient
do have the right to request the MD's qualifications and what percentage of his
practice is devoted to treating patients totally disabled by the disease. It is
also OK to ask the IME whether or not he believes that this disease is a real
physical illness resulting in physical disability, or if not, how does he view
patients who claim to be permanently and totally disabled by this disease. Do
not be surprised if he avoids the questions or just plain refuses to
answer.
Also you have the right to demand a simultaneous copy of the IME
report as soon as it is ready and make sure you ask the IME to mail one to the
patient, to the patient's MD and , if there is one, the patient's
attorney.
9. Have the patient or a relative of the patient carefully
check, line by line, the disability policy before going to the exam to ensure
that the language of the policy which gives the disability carrier or plan the
presumed right to examine the patient, can use the services of any health care
provider or just the services of a licensed physician. And if the policy
requires an IME exam by a licensed physician but the examiner is a psychologist,
by way of example, then the patient has a right to question any opinion
rendered by this non-licensed MD,IME examiner.
10. Also provide this IME
examiner with tons of educational materials describing the nature and effects of
this disease, any and all nedical and scientific journals which have published
serious articles about it and copies of the most detailed narrative reports
prepared by the patient's primary care physician and/or her MD specialist.
Overwhelm the IME with technical information, journal articles, video tapes of
lectures, copies of news articles and anything else to educate this IME as well
as providing him/her with copies of the the multiple previous opinions of the
patient's other treating health care professionals.
11. Arrange
in advance for an emergency visit with the patient's primary care physician or
specialist, after the IME exam so that to the extent that certain adverse
effects of the exertion and stamina of attending and undergoing the IME testing
can be observed by the patient's health care professional and can be medically
documented for future use.
12. Further, whatever side effects the patient
suffers in the next day or two or in the next few days, describe them in writing
in detail and fax a copy of same written by the regular care giver of the
patient to the IME at his office, telephone him to advise him, and then send the
writing to him by Certified Mail Return Receipt requested or by any method which
requires the receipt of said material to be signed by the IME or by a member of
his staff or the staff of the disability benefit payor or its agents.
13.
If as a result of the examination performed upon the patient by the IME, the
patient becomes so much worse than normal (for her) do not hesitate to rush her
to emergency room of the nearest qualified hospital or to her PCP for her own
health safety and protection. And make sure all involved in the process which
resulted in this emergency are placed on formal notice about the side effects of
the IME and indicate that it is the intent of the patient and her family to hold
them all responsible and accountable individually.
14. I personally
would have no qualms in seeking to have revoked the health care professional
license of any health care professional who acts so recklessly in the conduct of
an IME exam so as to cause the patient further harm and suffering. And if death
results, to have the surviving family members seek to file criminal murder /
manslaughter charges against all who participate in bringing about any
deliberate and willful, bad faith IME which results in death. Also, even if
hopefully there is no death, there might be grounds for criminal assault and
battery charges if the patient consented to an IME exam by a licended physician
but was instead examined and harmed at this IME by one who was not licensed as a
physician in the state or province where the exam was conducted.
|
|
|
|
The information provided is not legal advice and should not be
construed as such but is a flow of thoughts an ideas from the author, Bernard A.
Kansky, Esq., Kansky & Associates, 468 Commercial St. Suite #100, Boston, MA
USA 02901-1020, and the the information, thoughts and ideas set forth herein are
and do change from time to time and frequently, by locale. Therefore, for legal
advice it is essential to contact one's own personal attorney.
In
addition, as with my featured columns in the National CFIDS Foundation, Inc.'s
newsletter, the Forum, the above material is copyrighted and all rights reserved
i.e. Bernard A. Kansky, Esq. © Copyright 2003 and may not be further reproduced
or published without my express written consent.
|
|