New law targets workers’ comp doctor abuses
SALEM — Senate Bill 311 is the first help injured workers have gotten from the Oregon Legislature in a long time, says injured worker Ernie Delmazzo.
Delmazzo, a former Teamster truck driver, helped found the Injured Workers Alliance in 1998 after his own experience showed him Oregon’s workers’ compensation system is stacked against the working person. Delmazzo said it hasn’t been easy to win reform in Salem, where normally the interests of employers and insurers trump those of injured workers.
But SB 311 was an exception: a response to a growing scandal, and a way for insurers to stave off bills even less to their liking.
The bill deals with Insurer Medical Examiners (IMEs) — doctors hired by insurance companies to judge workers’ claims of on-the-job injuries.
Continuing complaints from workers and their attorneys led the governor-appointed Workers’ Compensation Management-Labor Advisory Committee to request a study last year. The study, conducted by staff of the Oregon Department of Consumer and Business Services, revealed a scandal in the making.
Nine months of surveys of injured workers, attorneys and physicians helped make an overwhelming case that IMEs are biased against workers. Even among IMEs themselves, over half said IMEs were biased toward insurers.
And the study validated what injured workers like Delmazzo had been saying for years.
There is no requirement that IMEs have any specialization in the kinds of injury they diagnose. Insurers send workers to a handful of IMEs who earn all or nearly all their incomes from these exams and otherwise have no physician practice. One-fifth of the workers were made to travel more than 100 miles each way to their appointment.
Doctors reach their conclusions after very short examinations, and often ask very few questions. And they’re rude, many respondents said. Workers frequently report that they are physically and verbally abused during the exam. Over a sixth of the workers said their exam caused physical pain that lasted two days or more. What’s more, there is no process for handling such complaints or holding the IMEs accountable.
“Money does things to people,” Delmazzo said. “These people are paid upwards of $1,000 an hour, and most do it full time. Many of these doctors have not treated people for years or even decades.”
It’s an invitation to medical fraud, Delmazzo said.
SB 311 addresses some of the problems uncovered by the study. It requires IMEs to receive special training and certification, and creates a process for reviewing and investigating complaints about IMEs — and for revoking certification in cases of abuse. It allows workers to have a witness present during the exam, and gives them the right to appeal the exam location to a more reasonable distance.
SB 311 passed the Legislature unanimously and was signed into law by the governor on July 29.
Two years ago, a tougher bill, SB 812, didn’t make it. SB 311 doesn’t go far enough, Delmazzo said, but it’s better than nothing — it’s a small step forward in a long campaign to win back a bit of justice for injured workers.
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