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 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.

 

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