You Did What??

I tore the ACL (anterior cruciate ligament), the medial meniscus in my right knee on 6-2-09 when I slipped/fell backward off a 10" step. A microfracture of the femoral condyle was also discoverd. I felt a very painful pop on impact and another pop when up-righting myself again. It's a very common injury to both pro and weekend warrior athletes. I tore the meniscus in this same knee in 2007. I'm an active woman and a delivery person for a major company so it is imperative that I'm 100%. This is the story of my ACL surgery on August 18, 2009. To start reading from the beginning click and at the bottom of the page there is a "newer post" link.

Wednesday, January 20, 2010

The IME Report and Dr Anderson's response

I was going to enter a different post when I noticed that I never posted on the IME report. Put simply, it's crap!

WOW, this my friends is why you record everything! On top of the IME guy getting a lot of little details incorrect; he must have forgotten that he didn't actually do 12 of the 20 or so tests that he actually did do, but his report says he did and that I was fine in all tests. He lied and he reported falsely. I called him out on it and WILL be reporting him to whomever I can.

He reported that while I have pain in both knees upon squatting that in his opinion I have reached maximum medical improvement and can return to a "very strenuous activities". His recommendations for my left torn meniscus is home exercises. Interesting.

While I could really rant on and on about how Independent Medical Evaluations work and about how the doctors are as crooked as they come, I won't.

Normally a report like this would trump anything my ortho has to say regarding my restrictions and work status. But, since I called him out on his lies and discussed it with the head of workman's comp at my job, I was granted an extension on my current status until I saw Dr Anderson again on January 11 and he commented on the IME's report.

See the red tape rolling out?

So I waited. No more physical therapy had been approved during the waiting time... When I saw Dr. Anderson on the 11th we discussed the IME report and I asked him some more technical questions about the possibility of the micro fracture not having filled in.

Dr Anderson's response and comments about the IME report went something like this as he told me. "I 100% disagree with the IME doctor's report". He asked me if this guy even practices which I got a chuckle out of.  In regards to the left meniscus he pretty much stated... "There is no pill you can take, no amount of time you can take, and no amount of exercises you can do that will ever heal a horizontal meniscus tear." Of course I knew that... gee I wonder why the IME guy thinks I just need to do some home exercises?

So the saga continued and now the ball is back in the hands of the insurance company. Will they deny me medical treatment based on the IME report when a highly reputable doctor completely disagrees with his findings? Will they risk a lawsuit since I have documented everything and even recorded the evaluation? I don't know.

The last I knew, before what I'll put in my next post, is that I was waiting for my claim rep from the insurance company to get back with me after they got with their vendor who was to get a response from the IME doctor regarding Dr. Anderson's response to the original IME report.

Everybody got their @ss covered now?

(this post was a recollection of events up to 1/20/10... in case someone cares)

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