Victorian ombudsman damning of work safe agents and some IMEs

September 20, 2016

The Victorian Ombudsman has released a report regarding an “Investigation into the management of complex workers compensation claims and WorkSafe oversight”

This report is very critical of practices of WorkCover agent’s particularly with regard to doctor shopping and is unsparing in its criticism of certain IMEs in particular with regard to their bias and poor quality reports. The report is a damning with regard to actions taken by work safe about IME reports that are inadequate. Based on the reports the following recommendations relevant to psychiatrist were made. A copy of the full report is available in publications and a summary is also available.

Recommendation 14

Implement changes to the current IME system to:

prevent agents from selectively using ‘preferred IMEs’ or
provide injured workers a choice of the IME with the appropriate speciality, by whom they are examined.

Recommendation 15

Amend its IME complaint handling policy to provide scope for examination of complaints where a worker does not provide consent for the complaint to be provided to the IME, which may include the referral of the matters raised to the IME quality assurance division for intelligence gathering purposes.

Recommendation 16

Amend the IME quality assurance process to:

ensure IMEs subject to a high number of complaints are peer reviewed
document the process by which WorkSafe will review an individual claim file where significant deficiencies are identified in relation to an IME’s report, to ensure a worker’s entitlements have not been unreasonably rejected or terminated based on the

Victorian ombudsman damning of work safe agents and some IMEs