the IME doctor spent 11 minutes with me and cleared me for "full duty" 5 months after rotator cuff surgery. my actual surgeon says light duty only. now comp is cutting off my checks
i need to vent because im about to lose my mind. tore my right rotator cuff (full thickness supraspinatus, confirmed on MRI) in january pulling a pallet jack that a coworker had loaded way over spec. comp claim accepted no problem, surgery in february, been doing the PT protocol religiously ever since. my surgeon, the guy who was literally inside my shoulder, says im at maybe 70% and cleared me for light duty only. no lifting over 10 lbs, no overhead work. my job is a warehouse position where i lift 50+ lbs overhead all day. employer says they have no light duty available, so ive been on TTD checks.
three weeks ago the insurance company sends me to an "independent" medical exam. independent my foot. the guy didnt examine my shoulder so much as wave at it. ten, eleven minutes tops, half of which was him typing. he had me raise my arm twice, squeezed my hand, asked if i could drive. last week i get the letter: IME physician finds claimant "capable of returning to full duty without restriction." and just like that the carrier filed to terminate my TTD benefits based on his report over my treating surgeons.
how is this even legal. one doctor did the surgery, has seen me 9 times, has the operative report and all the PT notes. the other doctor met me for 11 minutes, billed the carrier for the visit, and somehow his opinion wins by default? my surgeon was so annoyed he wrote a rebuttal letter the same week pointing out the IME report didnt even mention my positive impingement signs or the strength deficit they measured in PT two days before the exam.
i have a hearing date in 5 weeks. talked to a comp attorney yesterday who took the case on contingency and says this is "tuesday" for this particular carrier and this particular IME doc, who apparently finds basically everyone fit for full duty. meanwhile i have a mortgage and the checks stop in 2 weeks. just needed to scream into the void with people who get it.
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