Abstract
Independent medical examinations (IMEs) theoretically construe a means of “independently” assessing a claimant’s physical and psychological status, as well as to determine whether treatment that has been and will potentially be provided is reasonable and necessary. IMEs may be undertaken both for the plaintiff and defense or related adversaries. In the present case, we focus on IMEs that are requested by insurers. One can query the degree to which IMEs are actually “independent.” It has been posited that one of the ways in which claims managers contribute to potential bias against claimants is through a process of selectively providing examiners with medical records, which has been described as “cherry-picking.” Despite the existence of rules and laws that are designed to prevent cherry-picking, the practice still occurs. This analysis discusses the legal as well as ethical implications of cherry-picking and its potential to cause or exacerbate psychological injury that a claimant may experience. The authors propose that psychologists as well as attorneys can advocate for their vulnerable patients/clients in cases of cherry-picking. A recent case study from the clinical practice of the first author in which he so acted is provided. We conclude with a discussion of the ethical implications of the psychologist’s intervention.
Similar content being viewed by others
References
American Medical Association. (2005). Standards for independent medical examinations. Available at: http://www.aimehi.com/PDFs/IME%20standards%20for%20AIMEHI%20web%20site.pdf. Accessed 1 December 2013.
American Psychological Association. (2010). Ethical principles of psychologists and code of conduct including 2010 amendments. Available at: http://www.apa.org/ethics/code/index.aspx. Accessed 26 January 26, 2014.
Appleby, K. S., & Tarver, J. (2006). Medical records review (4th ed.). New York: Aspen Publishers.
Baer, M. A. (2005). Opinion piece: is an independent medical evaluation independent? Forensic Examiner, 14, 33.
Benner, D. E. (2007). Ethical issues of chronic pain from a patient’s perspective. In M. E. Schatman (Ed.), Ethical issues in chronic pain management (pp. 15–32). New York: Informa Healthcare.
Black, H. C., & Nolan, J. R. (1999). Black’s law dictionary: definitions of the terms and phrases of American and English jurisprudence ancient and modern; [with pronunciations] (7th ed.). St. Paul: West Publ.
Brown v. Superior Court (1949), 34 Cal.2d 559, 564 [212 P.2d 878].
Bush, S. S., & Heilbronner, R. L. (2012). The neuropsychological IME. In S. S. Bush & G. L. Iverson (Eds.), Neuropsychological assessment of work-related injuries (pp. 280–302). New York: Guilford Press.
Colorado Department of Labor & Employment. (2013). Rule 11 – Division Independent Medical Examination. Available at: http://www.colorado.gov/cs/Satellite?c=Page&childpagename=CDLE-WorkComp%2FCDLELayout&cid=1251567882380&pagename=CDLEWrapper#Rule_11-6. Accessed 1 December 2013.
Comunale v. Traders & General Ins. Co. (1958), 50 Cal.2d 654.
Dersh, J., Polatin, P. B., Leeman, G., & Gatchel, R. J. (2004). The management of secondary gain and loss in medicolegal settings: strengths and weaknesses. Journal of Occupational Rehabilitation, 14, 267–279.
Eisendrath, S. J., Rand, D. C., & Feldman, M. D. (1996). Factitious disorders and litigation. In M. D. Feldman & S. J. Eisendrath (Eds.), The spectrum of factitious disorders (pp. 65–82). Washington: American Psychiatric Association Press.
Gaughwin, P. C. (2004). Beyond the noise and smoke: some challenges for mental health professionals entering the forensic arena. Psychiatry, Psychology and Law, 11, 44–49.
Green, S. (2011). The medicalization of episodic regional backache. Ethics in Biology, Engineering and Medicine, 2, 237–251.
Greve, K. W., Ord, J. S., Bianchini, K. J., & Curtis, K. L. (2007). Prevalence of malingering in patients with chronic pain referred for psychologic evaluation in a medico-legal context. Archives of Physical Medicine and Rehabilitation, 90, 1117–1126.
Gruenberg v. Aetna Ins. Co. (1973), 9 Cal.3d 566, 575.
Hilker v. Western Automobile Ins. Co. (1930), 204 Wis. 1 [231 N.W. 257, 258] (aff’d on rehg., 204 Wis. 1 [235 N.W. 413].
Howard, K. J., Kishino, N. D., Johnston, V. J., Worzer, W. E., & Gatchel, R. J. (2010). Malingering and pain: Is this a major problem in the medicolegal setting? Psychological Injury and Law, 3, 203–211.
Kornblau, B. L., & Burkhardt, A. (2012). Ethics in rehabilitation: a clinical perspective (2nd ed.). Thorofare: SLACK Incorporated.
Kulich, R. J., & Baker, W. K. (1997). Psychologic evaluation in the management of chronic pain and disability. Current Pain and Headache Reports, 1, 116–125.
Ky, P., Hameed, H., & Christo, P. J. (2009). Independent medical examinations: facts and fallacies. Pain Physician, 12, 811–818.
Law Society of New Brunswick, College of Physicians and Surgeons of New Brunswick, New Brunswick Medical Society, Canadian Bar Association—New Brunswick Branch. (2002). Interactions Between Lawyers and Physicians in Litigation. Available at: http://www.lawsociety-barreau.nb.ca/assets/documents/INTERACTION%20Lawyers%20Physicians.%20English.pdf. Accessed 1 December 2013.
Lax, M. B., Manetti, F. A., & Klein, R. A. (2004). Medical evaluation of work-related illness: Evaluations by a treating occupational medicine specialist and by independent medical examiners compared. International Journal of Occupational and Environmental Health, 10, 1–12.
Martelli, M. F., Zasler, N. D., & Grayon, R. (1999). Ethical considerations in impairment and disability evaluations following acquired brain injury. In V. R. May & M. F. Martelli (Eds.), Guide to functional capacity evaluation with impairment rating applications (pp. 204–270). Richmond: NADEP Publications.
Maryland Workers’ Compensation. (2013). Workers’ Compensation Medical Records. Available at: http://www.mdcomplaw.com/info/medical/workers-compensation-medical-records/. Accessed 30 December 2013.
National Association of Insurance Commissioners, Model Regulation Service – July 1997, Model 902 Available at: http://www.naic.org/store/free/MDL-902.pdf. Accessed 19 January 2014.
Ochoa, J. L., & Verdugo, R. J. (2010). Neuropathic pain syndrome displayed by malingerers. Journal of Neuropsychiatry and Clinical Neuroscience, 22, 278–286.
Oregon Department of Consumer and Business Services. Guide to Providing Independent Medical Exams. (2011). Available at: http://www.cbs.state.or.us/wcd/communications/publications/4913.pdf. Accessed 30 December 2013.
Schatman, M. E. (2011). The role of the health insurance industry in perpetuating suboptimal pain management. Pain Medicine, 12, 415–426.
Schatman, M. E. (2012). Workers compensation and its potential for perpetuation of disability. In R. J. Gatchel & I. Z. Schultz (Eds.), Handbook of occupational health and wellness (pp. 341–361). New York: Springer.
Schatman, M. E., & Sullivan, J. (2010). Whither suffering? The potential impact of tort reform on the emotional and existential healing of traumatically injured chronic pain patients. Psychological Injury and Law, 3, 182–202.
Schofferman J. (2007). Opinions and testimony of expert witnesses and independent medical evaluators. Pain Medicine, 8, 376–82.
Stempel, J. W. (2009). The “other” intermediaries: the increasingly anachronistic immunity of managing general agents and independent claims adjusters. Connecticut Insurance Law Journal, 15, 599–721.
Sullivan, M. D., & Loeser, J. D. (1992). The diagnosis of disability: treating and rating disability in a pain clinic. Archives of Internal Medicine, 152, 1829–1835.
Sullivan, M. J. L., & Main, C. (2007). Service, advocacy and adjudication: balancing the ethical challenges of multiple stakeholder agendas in the rehabilitation of chronic pain. Disability and Rehabilitation, 29, 1596–1603.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Schatman, M.E., Thoman, J.L. Cherry-Picking Records in Independent Medical Examinations: Strategies for Intervention to Mitigate a Legal and Ethical Imbroglio. Psychol. Inj. and Law 7, 191–196 (2014). https://doi.org/10.1007/s12207-014-9194-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12207-014-9194-y