Senate Bill 311-B (2005)
In the 2003 legislative session, injured worker advocates sponsored Senate Bill 812 to reform Independent Medical Examinations (IME's), along with House Bill 3591, a similar bill. The Management-Labor Advisory Committee wouldn't support either due to Management member opposition. They did form an IME subcommittee and commissioned an IME study to be conducted by the Department of Consumer and Business Services.
The state study, released December 2, 2004, found that concerns expressed by workers and physicians over several years were valid. In fact, impartial observers would agree that the study is an across-the-board indictment of the IME process. For several years, Injured Workers' Alliance also distributed damning and conclusive evidence of wrongdoing in the IME process.
In particular, Oregon law now allows workers to have observers during IME's, workers can dispute being sent long distances to attend exams, workers must receive a survey about their IME experience, and examiners found to act inappropriately can be barred from performing future IME's within the workers' compensation system.
The following italic text is from DCBS.
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The study found issues that needed to be addressed, including:
- Widespread perceptions of examining physician bias.
- The need for a dispute or complaint process. The Board of Medical Examiners has turned away complaints about physicians due to no doctor-patient relationship in these examinations.
- A lack of standards for physicians conducting independent medical exams.
- Workers with physical disabilities being required to travel long distances to attend exams.
- Worker misunderstanding or lack of knowledge about the purpose of these exams.
- Original diagnostic films not being available for medical examiners to review.
- Workers not showing up for their examinations, nor calling ahead to cancel them.
Senate Bill 311B will require the Department of Consumer and Business Services to develop, in consultation with the medical community and other stakeholders, the following:
- A certification process for independent medical examination physicians, resulting in a registry maintained by the Workers’ Compensation Division of examining physicians who may conduct workers’ compensation independent medical examinations in Oregon. Certification includes training requirements and educational materials for physicians conducting exams.
- Training requirements for insurance claims examiners on appropriate interaction with examining physicians.
- A process for reviewing and investigating complaints about medical examinations.
- A process for removing examiners from the registry.
- A process for referring complaints to the appropriate licensing board, as necessary.
- A process for appeal of actions of the department by an examining physician.
This bill will also:
- Require that insurers may only use medical examiners from the registry when requesting an injured worker attend an independent medical exam.
- Allow injured workers to appeal the reasonableness of the location of the exam for resolution by the department. If such an appeal were pursued, the insurer’s time to accept or deny a claim would increase from 60 to 90 days.
- Establish a monetary penalty to injured workers who do not show for an independent medical examination without notification prior to the exam and without reason. This penalty applies only to injured workers not currently receiving disability benefits because there are already provisions to penalize workers who are on benefits. This penalty would come out of any future benefits.
- Establish sanctions to medical providers who fail to provide diagnostic records to an independent medical examination provider prior to the examination.
This bill still allows the employer’s insurance company and self-insured employers to have the right to require an independent medical examination and to select who will perform the examination. The department will use standards developed by medical associations for determining violations and removal from the registry.
SB 311 holds injured workers accountable to attend independent medical examinations and medical providers accountable to provide diagnostic records in a timely manner so as to not delay the claims process.
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Read about IME's and view statement made by Study participants.
View the 271-page state-conducted IME Study. Free Acrobat Reader require.