Can Independent Medical Examiners Influence Disability Claim Outcomes?

Let’s talk a little bit about the bias of these particular so-called independent medical examiners. I think we have seen through our cases of litigation, through the ERISA appeals and information that we have obtained, after seeing hundreds of disability cases that these doctors are not really independent doctors, they are doctors who are paid to say whatever the disability insurance company wants them to say. So in anticipation of today I did some research of cases that we had as well as other cases that have been around the country and I came across stuff that you guys will probably find interesting.

For example, there was a doctor who was trained at Harvard, he is actually a psychiatrist named Steven Garsen and during a four year period he was paid over 900,000 dollars for solely conducting independent medical exams for insurance companies. And that was only a portion of his income. That’s $900,000. Of that, in 2006, $250,000 of that money was paid to him from Prudential Insurance Company.

Another doctor, in a recent federal case, Dr. Amy Hopkins was paid $493,832 over a three year period just to do insurance paper reviews, these independent medical reviews and paper reviews for the insurance companies. So in one case regarding Dr. Hopkins, the court specifically said that Dr. Hopkins would use a pick and choose approach that ignored evidence that completely mischaracterized the treating physician’s notes in order to deny a claim. So the companies do do this and tend to go to the same doctors but they can’t necessarily pull the role over the judge’s eyes or over jury’s eyes. So one of the things we always try to do in our cases is get this information and get it to the courts. Because if you can’t get it, then you can never be able to expose the bias of the company.

And in a case we just handled actually out of Hawaii, we got evidence to show that the one doctor got paid just in one year $165,000 from Prudential Insurance Company and then when we looked him up even further we saw that he had been getting over several years in a row $100,000 in payments. So you can find out all of these things through a discovery process, through reading other cases around the country and try to find this information which will be very valuable.