Multi-millionaire Insurance Doctors Who Report Fake Independent Medical Examinations

Greg Boles
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Partner at The Boles Firm | Experience Matters

           At some point the insurance company may ask you to undergo a so-called “Independent Medical Examination” or “IME”, which is a special evaluation in which the insurance company gets a “hired gun” doctor to examine you.  The doctor they choose is going to give the insurance company the benefit of the doubt.  Though an IME doctor may support you, many IME doctors will say anything to collect lucrative fees from insurance companies. 

            According to the New York Times, Hershel Samuels, M.D., a New York orthopedic surgeon, was videotaped performing an IME of an injured trucker, stating that he detected tenderness in his neck and mild spasm bilaterally when he palpated his back.  When he submitted his report, however, he cleared the driver for work and stated that he had no back spasm or tenderness in the neck.  The Times reported his outrageous explanation:  "If you did a truly pure report, you'd be out on your ears and the insurers wouldn't pay for it.  You have to give them what they want, or you're in Florida.  That's the game, baby." 

            Although the fees charged by doctors like Dr. Samuels charge for examinations varies widely, they can get anywhere from $400.00 to $1,000.00 for an examination that usually lasts about 30 minutes or less.  In Pennsylvania, most doctors charge deposition fees of $2,000.00 or higher.  Physicians who perform Independent Medical Evaluations typically charge $3,000.00 to $4,000.00, and some perform so many examinations and testify in so many cases that their total income for medical-legal work often exceeds $500,000.00 yearly. With so much easy money at stake, it’s not surprising that many of these doctors take ethical shortcuts. 

            Fortunately the judges know the reputations of many of these physicians.  If you’re being treated with a reputable doctor and the insurance company chooses a physician who with a poor reputation to evaluate you, a workers’ compensation judge is more likely to rule in your favor. Check with your lawyer concerning the reputation of the IME doctor.              

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