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Why mandatory IME (independent medical exams) are a joke

Federal judge renders blistering assessment of notorious insurance IME Dr. Greiffenstein: ‘A very biased witness’ and ‘especially lacking in credibility’

IME insurance medical examiner

Why do we allow the courts and attorneys to continue to perpetuate a fraud that IME (independent medical exam) doctors are somehow fair and independent? The entire IME industry of go-to doctors who are routinely picked by insurance companies, defense lawyers and claims adjusters is completely broken. Most insurance companies give adjusters a pre-approved list of doctors that they must pick from.

And pick they do. Today in nearly every serious automobile accident and workers compensation claim, it’s common practice for people to be sent out for compulsory “second opinion” exams by an “independent” doctor that the side defending the case and is responsible for paying compensation gets to pick. These doctors are most often called  IME doctors, which stands for either an insurance  medical exam, or independent medical exam.  If the person is being sent by a defense lawyer who is defending a tort case, these exams are sometimes called defense medical exams.

But these  “independent” doctors are selected by a claims adjuster or an insurance defense attorney, and they’re paid a lot of money to find “nothing wrong” with seriously injured people.

When it comes to biased doctors, Dr. Manfred Greiffenstein (he recently stopped going by Manfred, apparently thought it would increase his jury appeal) has the distinction of being singled out by one federal judge as being among the worst.

Among attorneys and brain injury professionals,  Dr. Greiffenstein is rather notorious for his pro-insurance company reports. I speak from personal experience, having had to protect more than one of my clients from his malevolent findings. In a previous blog post, I described Dr. Greiffenstein’s testimony in one of my client’s trials:

“After saying my client did not have TBI, and that he was consumed with his injuries (my client had already had eight surgeries), Dr. Greiffenstein admitted under oath that he was not treating any current patient for traumatic brain injury and had not treated a patient for brain injury in more than a decade. He also admitted he was hired as an IME by every insurance company, workers compensation carrier and defense insurance law firm in town.”

Significantly, Dr. Greiffenstein’s bias  is so bad that it’s even grabbed the attention of a federal judge. In a recent  case, the federal judge hearing the case noted the following about our friend Dr. Greiffenstein:

  • He “maintains [a neuropsychology] practice … performing mostly one time assessments”; and,
  • “[H]is forensic work typically comes at the request of an insurer.”

Things got worse from there.

Of Dr. Greiffenstein’s credibility, reliability and, essentially, his integrity, the federal judge made the following blistering observations:

  • “Dr. Greiffenstein was especially lacking in credibility. The Court found his testimony to be highly tendentious and at times disingenuous and misleading.”
  • “[H]is answers to questions from defense counsel were often nonresponsive, argumentative, and unreasonably dismissive of anything at all which might suggest a different conclusion from his own. Throughout his testimony, Dr. Greiffenstein revealed reliance upon techniques of dubious validity …”
  • “Dr. Greiffenstein proved to be a very biased witness. One could in fact be forgiven for thinking that Dr. Greiffenstein never even attempted to engage in a truly objective evaluation of Defendant, but instead undertook a results driven evaluation designed to deliver the conclusion [sought by the prosecution on whose behalf he was testifying].”
  • “[I]t very much appears that he purposefully ignored data and possible inferences so as to avoid even having to acknowledge the possibility that [the defendant’s position may have merit].”
  • “The problems with Dr. Greiffenstein’s work are legion.”
  • “Dr. Greiffenstein continued his pattern of disturbing conduct by then misrepresenting to Defendant the nature of his visit. … Instead of stating that he had come to conduct a mental retardation evaluation, Dr. Greiffenstein asserted that he was there to learn about Defendant’s ‘personality.’”
  • “Even more troubling is the fact that Dr. Greiffenstein administered Defendant three tests—none of which is designed to measure IQ. … Given that Dr. Greiffenstein testified that most of Defendant’s prior IQ scores should be disregarded as not truly indicative of Defendant’s intelligence, the real motive for not giving Defendant an IQ test is readily apparent: Dr. Greiffenstein did not want to run the risk that Defendant would achieve a score of approximately 70 or below—which would be consistent with most of his other prior performances—and thereby undermine the Government’s position that Defendant is not mentally retarded. Dr. Greiffenstein’s contention that he possessed no such ulterior motive is not believable.”
  • “Most problematic of all, however, is that Dr. Greiffenstein’s evaluation is tainted by woefully unjustified and inaccurate conceptions of how mentally retarded individuals are expected to act and appear … Dr. Greiffenstein seemed incapable of fairly identifying and assessing whether Defendant’s capabilities were truly consistent with those of a mildly mentally retarded individual.”
  • “[T]he Court finds that Dr. Greiffenstein’s testimony is wholly lacking in credibility as well as reliability, and thus it is not helpful in evaluating the critical issues in this case.”

(Source: U.S. v. Shields, U.S. District Court, Western District of Tennessee, Western Division, “Order Granting Defendant’s Motion For Pretrial Determination of Mental Retardation And Precluding  Government From Seeking Death Penalty As To Defendant Shannon Shields,” May 11, 2009)

“Independent” medical examinations

As I wrote above, the term “IME” is shorthand for “independent medical examination.”   The big problem is that it’s a huge and lucrative industry for the doctors on the insurance company “go-to” lists because, at least in Michigan where I practice law,  auto insurance companies force nearly every single auto accident victim to attend one of these exams.  Some are scheduling them almost immediately, others within the first couple months, as a condition for continuing to receive No Fault insurance benefits, such as reimbursement for accident-related medical expenses and for lost wages.

However, the ugly truth is just about every insurance company-ordered IMEs is really being done as a way for auto insurance companies to find a reason to deny or otherwise terminate an auto accident victim’s No Fault benefits. Or it’s being done as a way for a defense attorney – who’s job it is to mitigate the damages that his client has to pay if they’ve injured someone – to have someone to contradict all of the treating doctors and say the person is fine, often faking, and no longer disabled.

The problem is, we’ve grown so accustomed to this unethical practice that attorneys and judges just take it in stride.  These doctors – who are often regarded with utter disdain and as pariahs in the medical community – cause utter devastation to people’s lives. They perform these perfunctory examinations with outcomes are effectively predetermined:

Make up any reason but the car accident to say that the person being examined isn’t injured or wasn’t injured in the car accident.

Again, the truth about IME’s is that there’s nothing “independent” about them. They are performed by doctors – like Dr. Greiffenstein – who are paid vast amounts of money by all of the auto insurance company and workers compensation carriers out there.

For many of these biased IME doctors, the money they make from being a hired gun for the insurance companies is a major – if not the entire – source of their income.

Related information:

Why insurance company IME exams are no laughing matter


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Blog Author Steven M. Gursten
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