Injured employees receive evaluations from doctors hired by employers or insurers.

After Department of Health psychologist Saul Podhorzer blacked out at the State Hospital in 2008, he filed a workers' compensation claim, saying the incident was related to two previous workplace injuries, including a 2004 episode in which he collided with a co-worker responding to an emergency, smashed his head against a brick wall, lost consciousness and suffered a seizure.

A neurologist hired by the state to do a so-called independent medical examination, or IME, concluded that Podhorzer's blackout was not linked to the previous injuries, but was a new one that likely resulted from a congenital heart condition. His claim was denied.

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How would you feel about your spouse, parent or child being sent for a medical examination by a strange doctor who is beholden to the insurance industry? It happens every day to injured workers throughout the state. Why not refuse? Insurance companies reserve the right to terminate coverage for medical care and wage loss benefits if you don't show up. That's why.

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Some of the relevant AMA ethical and confidentiality guidelines are set forth below.

E-10.03 Patient-Physician Relationship in the Context of Work-Related and Independent Medical Examinations

When a physician is responsible for performing an isolated assessment of an individual's health or disability for an employer, business, or insurer, a limited patient-physician relationship should be considered to exist. Both "Industry Employed Physicians" (IEPs), who are employed by businesses or insurance companies for the purpose of conducting medical examinations, and Independent Medical Examiners" (IMEs), who are independent contractors providing medical examinations within the realm of their specialty, may perform such medical examinations.

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A

fter working 17 years as a stock clerk in a warehouse on Dillingham Boulevard, Keoni felt a sharp, shooting pain in his back as he lifted a 50-pound box. Not wanting to let down his co-workers, he kept working. The next morning, he could barely get out of bed. He called to make an appointment with his primary care clinic of 11 years but was told that it does not take workers' comp. The receptionist gave him three numbers, but on the first pass he could not get through. He lay there, staring at the ceiling, feeling helpless. Read more...