I just finished a file review of a client, and every time the family doctor rejected the opinions of the panel examiners for the Washington State Department of Labor and Industries (L&I), he was challenged by the claims manager as well as by the vocational person hired by L&I. This family doctor just wanted to provide care for the patient, he did not want to have to fight for his professional medical diagnosis at every turn of the claim. L&I went so far as to even send out its medical director from the west coast to a small town near the Idaho border to meet with the family doctor to challenge his opinions. L&I couldn’t seem to fathom how this reputable family doctor could have an opinion different than the tired, old, and often retired, doctors L&I had hired. This kind family doctor is the type who, if he advocates too much for a patient, may well find himself defending his right to even treat injured workers.
In Grant County, Chelan County and Yakima County, I am familiar with doctors that cared for their patients, were considered too patient sympathetic, and then faced not just the criticism of L&I, but L&I then filed complaints with the medical licensing authority, hired doctors to review and critique their files, and most of these doctors simply gave up the fight, and then went off to different states or practices. One doctor filed suit in federal court, and the case was resolved in favor of the doctor. He had been criticized for really being too worker friendly, yet at the same time L&I was asking him to treat injured workers, do independent assessments of those workers, and provide input on whether the patient could or could not work. After decades of doing this, this doctor was told he was not going to be allowed to treat injured workers under the Washington Industrial Insurance system.
As with many alleged improvements, the changes in the law as of January 2013 under the Washington state workers compensation system, also known as L&I, were used not to improve the system, but were used as a sword to rid the system of doctors that dared to be patient friendly. Ask your doctor, why do you not want to treat workers under the industrial insurance system of Washington State?
It is not just the rate of pay, but is the harassment of one letter after another asking the doctor, challenging the doctor, as to why they dare fail to accept the position of the claims manager or the hired/panel doctors that the Labor and Industries system uses, that is, how does the doctor actually treating patients dare disagree with tired, old doctors hired by L&I that all too often seem to render opinions for L&I, knowing who pays their bill for those reports. A good way to keep these doctors in check that are doing what are called IMEs (allegedly Independent Medical Exams) is to file a complaint: www.lni.wa.gov/FormPub/Detail.asp?DocID=2034
The form for a complaint is enclosed: Complaint against IME examiner
If there is anything the worker can do, it is to communicate with the legislature how difficult it is to find a caring doctor, and how the doctors should not be micromanaged by a state agency or self-insured employer.