I went through the exact same thing, you have one month to object to it, i think they do it to everyone. i was lucky i had all my surgery done before this happened, are you 6 months away from the 3 year mark where they have to stop paying you? Did you get all your benefits before the 3 year mark, just make sure because it will be hard after that mark.

Sorry i just looked at your profile and saw your accident was in 2004, but you still have an month to object. Will the medicare pay for the surgeries, or only part of future ones. I just recently got on medicare so i dont know to much about what they do and dont pay for. I am still on meds, and the insurance dropped me so i have to pay for them all out of pocket, when i first got in the accident my benifits said for life, but we know that is all BS, i have been to 3 IME and you are right they maybe talk to you for 5 minutes and that is it.

First of all, Do you have a lawyer? If you do, this is a matter for you lawyer to take care of, he represents you and he is your advocate, so you need to get on the phone so he can call the insurance company and fight this for you.
If you don't have a lawyer, then is time to get one! Unfortunately, things like this happen, insurance companies are in to save every single penny they can, and those Doctor's that they use for IME's aare a bunch of crooks!

If you have a lawyer and he is not handling these matters for you, then you have the wrong lawyer! You need to find one that is going to fight for you all of the way, not one that is just going to be there to collect the final check. Good luck and I hope that your lawyer can solve this whole issue for you.

Thanks guys! I have been such a wreck over this for days! I called the firm that initially handled the accident. I'm not too crazy about the atty. who took over my case when the initial one left the firm, but I spoke with him anyway. He said that this was what they eventually do to everyone, and that in order to file a motion for arbitration, I have to have them refuse to pay a bill. I see my pain specialist tomorrow and will have them bill the ins. co. and see what happens. I have more surgeries ahead of me. One is a major surgery on my lumbar spine which wil need hardware on both front and back of the spine. My PM doc told me to hold off as long as possible because with all that hardware I'll have more daily pain afterward, even though it will stabilize the spine.
Manny, I never knew about the 3 year limit? I thought it was until I has used up the $250,000. cap? I just got Medicare too, so I think they pay 80% and I pay 20% after the deductable, which I just paid recently for medical not accident-related. It's just so hard to cope with this stuff when you're daily fighting the pain.
I also worry that the lawyers aren't too interested in this part because there isn't any money in it for them. I'm beginning to feel that compassion (outside of this site) is a thing of the past. Sad.

Tipper is right! if you have a Lawyer then this needs to be addressed asap! This "dr" made a false office note, that is a big big no no.. If you don't have a Lawyer you need to get one asap. If it were me I would try calling this drs office and ask them to make some corrections. If they refuse then at least you tried to rectify the issue on your own first. Regardless of everything else... this is a false medical record and needs to be corrected! I had this happen to me once were the dr put in my note I stated I was raped at the age 14?? I was like what??! I never said that where did that come from. I called the drs office and the nurse had it corrected asap. That wasn't supposed to go on my chart note and was an error. Luckily I review all my notes yikes! Definately consult with a lawyer.. good luck hun hope it works out for you.

I think every state is different i live in MI, and also insurance companys are different i had AAA, my insurance agency had a right to send my to a IME every 6 months which they did, and i got so fed up with it after i got midicare and i have private insurance i didnt bother, they had to pay me work loss for 3 years which they did and the had to pay me 600.00 a month in household services which they did and pay for all medical services and they did until that 3 year mark, my lawyer said the same thing they do this to everyone after a certain amount of time.

I just didnt want to fuss with it just for medical because i was already covered, but if you need more surgeries you will probably want to object to the IME report, mine he worded every thing really careful in these reports, did you get a copy did you say, when i got mine he did write i can not work, and all the restrictions i had but he also wrote that the have exhausted all aspects to make me better and in a sense he was right. I did everything surgeries and IES, and PT. so he really did make a false statement on mine.

They are a pain, and you are right lawyers do not want to help after you got your settlement, and they might want additional fees if they have to take your insurance company to court. You are going to want to ask just to make sure were you stand as far as payment goes. Because when i sued i sued the other insurance company totally different law suit.

Hun,
Every State is different, I don't know what State you live in, but go by the laws of your specific State. If your Doctor is recommending a 360 fusion, that is what I had done, and yes for about 2 years you are going to be in terrible pain, but it gets better. I had a 360/3 level fusion, from L2 to L5 (360 means front & back). The surgery lasted about 10 hours and I was in the hospital for 12 days after surgery, 5 of those in ICU due to the blood lost, so yes, I can tell you that it is a HUGE surgery, but there is hope after a few years of recovery.

I recently started working part time, 3 days a week, I lost over 100 Lbs. since after my surgery, I walk with a cane, but I do about 7 miles a day, so Hun, I am here to tell you, that there is hope after a HUGE 360 fusion, so do not despair, you can recover from it!

If your lawyer does not seem that interested in your case, you can always find another lawyer, they are a dime a dozen, and most of them LOVE to sue the insurance companies due to MVA's, so it shouldn't be that difficult to find a good "bulldog" lawyer that will go bat for you. So, don't stay the mediocre one because he is the "one that you have", go find yourself a good one that will fight all the way for you. Take care and don't forget that you have all the right in the World to be treated fairly and with respect, if you are not getting that then is time to move on!

Hugs,
Tipper

Yeah Manny, I did receive a copy of the report. That's what sent me over the edge. The other IMEs always stated that I could not work also. This one states that I CAN work and drive (I can't drive either). That's what really bothers me the most I think! He wrote that based on nothing! I brought all the proof (films + records) for that, but he didn't look at any of it!! How could he possibly make that statement?! And how can he say the meds aren't helping?! He just made that up out of thin air! I'm not sure if I'm supposed to contact him or not, but I want to write to him and state what I know to be false in the report and keep a copy on record. I don't want that letter going into my file without any objections on my part. I'm usually pretty easy going, but this has me so damn upset that I've been having anxiety attacks constantly since I received the report. Thank God for Xanax!

I wouldn't write the letter to the Doctor, I would have the law offices write it to him. Remember you are represented by counsel and that is what they are supposed to do.
The one thing that you can do is report him to the Medical Board of your State. Write a good letter stating your case and how your records and how the care that you are receiving right now speaks of your disabilities and how this Doctor LIED on his report to the insurance company!
I would get him into soooooo much trouble, I would make him loose his darn license! If you want revenge and you want him to pay for what he did to you, don't send him a letter telling him how "he lied" on that report, NO! File a formal complain against him! That will teach him to mess with the wrong person!

Well now that is a different story, yes you should get that doctor to retract his report, you dont want his report to go to SSI when you have to renew, i would file with the medical board, do your homework on the internet and call your lawyer and ask him what steps you need to do first. dont wait to long because like i said you have a one month time table to object. he is seriously messed up how can he write that you can work and drive especially if you take meds, that is one reason i got SSI is because of my restrictions and the fact i take meds, you cant drive on them (legally). Did you ask your insurance rep what you need to do to object, mine told me i had to have my primary or surgeon send in a letter. I know you are upset i would be too but remember this is just one IME out of countless reports that you have on your side and he does work for the insurance company so he doesn't have a lot of credibility and the fact he didnt even look at any of your reports he is just going to look like a fool.
Take care

Have any of you ever contacted the medical board before? I do want these statements amended because they are false and I don't want them in my file (thinking of SSI). My atty. said I need to wait up to 60 days to see if they pay or not for today's appt. with PM doc. (?) before filing a motion to arbitrate. He didn't say anything about the one month limit? When I researched this ins. doc I found out he is in the process of getting his degree in criminal law, and he testifies a lot as an expert witness for the ins. co. for ins. fraud and arson(?). His father (also an MD) is self-employed and is a "professional expert witness". Guess there's big money in that, and it looks like the son is following in the father's footsteps! He did add that I could drive, but not on opiates. He said the meds weren't helping much (?!!). I never said that!!!

Do you get RX's, i know when i went to use it one day they said it cut off on dec 1st it was like the 5th, so if you do get a RX filled and see if they decline or accept it.
When i got my letter they wrote right on the letter, all medical and RX will end on dec 1st and they wrote you have 30 days to object, and i called her, so that is how i knew. but like i said maybe different state and Insurance company's.

As far as him writing meds werent helping he didnt write that you should be off, it was just then an opinion and you are still on, so driving should be an no-no. It is interesting that they him and his dad are expert witness's for insurance co. that just shows who is is really working for.
Did you happen to call the insurance co, and ask what they need for you to object to this ruling? Call a lawyer who specializes in this and ask for a free consultation. it sounds like your lawyer is blowing you off for the next 60 days and i am afraid if you do that it will be to late to file anything.

Good advice Manny, about the RXs and driving!! I know I need to re-read the letter from the ins. co. because I was so upset and actually shaking that I'm sure I didn't take it all in. There is a phone# to call if I have "questions" regarding the letter, however, in the past I've found it's very difficult to get a hold of a real person on the phone. I've left messages and never heard back a lot of the time. I think this atty. is blowing me off. I think I will take your advice and contact another lawyer and see if I can get some legal advice on this.
Thanks for all of your support!! At least I don't feel as anxious and alone in this thing! Love you guys!

Yes, I have contacted a Medical Board before. Each State is different, here in Florida, the health department is the one that licenses all
Doc's, and I went through both the AMA (American Medical Association), and the Florida Dept of Health. You need to find out who the licensing board is in your State and go from there, you should also contact the AMA and ask for the steps to go through when a patient wants to follow a formal complaint agaist a Physician. And most definetely get rid of your lawyer!!!! Good luck!

Thanks tipper- My brother is a neurologist in MI and works in an administrative capacity for a major healthcare system...hadn't thought to even ask him about this before now, but I'm going to email him tomorrow and see what advice he has for me too. I really have no confidence at all in this atty. I spoke with the other day, so yes, will talk to another...several if need be! My PM doc was very supportive today and said if I need it he will be willing to write a letter for me. He also pointed out that this guy who did the IME completely avoided the whole pain issue!! I'm trying to channel my anger into some inner strength to fight this.