A musing is a period of reflection or thought. thinking, contemplation, deliberation, pondering, reflection, rumination, preoccupation, brooding, wool-gatherings, in our case… about the workcover system
A muzzling means preventing (a person or group) from expressing their opinions freely
A Criticism is the expression of disapproval of someone or something on the basis of perceived faults or mistakes.
Musings Muzzlings and Criticisms about the workcover system
‘DENY, DENY, DENY’ or ‘DELAY, DELAY, DELAY’is a very common’ workcover insurer’s tactic, or modus operandi.
In fact, we have come to refer to workcover insurers’mantra as ‘SSS’– Stall the claim, Starve the injured worker, then Settle the claim.
For example, even a thoroughly well supported medically claim is no guarantee that the WorkCover insurer, no matter where in Australia, and no matter which insurance company, will honour their policies and, more importantly, will honour and follow the legislative rules as per the relevant state workers compensation Act!
Insurers use a variety of dirty tactics to deny and/or delay genuine WorkCover claims, in the name of greed! One of these tactics is the over-use of independent medical examinations. By over-use, we refer to actual doctor-shopping (IME-shopping) until the insurer receives a favourable report, which can then be used to deny certain benefits. In a fairly recent legal case, the IME was criticised by the Magistrate for being reluctant to diagnose the injured worker with [his condition] despite the radiological findings (which he referred to as being possibly false positives).
The WorkCover insurer will try even harder to deny and/or delay legitimate benefits when seriously injured or ill workers require benefits for an extended period or on a permanent basis. In 2016, for example, the Ombudsman found that Victoria’s workers’ compensation scheme had failed some particularly vulnerable people – many cases were found in which WorkSafe agents were working the system to delay and deny seriously injured workers the financial compensation to which they were entitled. ( See for example the Victoria Ombudsman Report into the investigation of workcover, and her current re-investigation/follow up).
Does this mean that most seriously injured workers are ‘scammers’ or what?
Many injured workers are absolutely shocked by what they’re up against and this adversely impacts their already fragile health, so most give up. And that’s exactly what the WorkCover insurer wants!
How come the public is mostly unaware that there are many incidences where workcover insurers will misportray injured workers? How come the public is not aware that WorkCover insurers use many deceptive tactics against way too many legitimate injured or ill workers?
We don’t hear about it because the very injured workers who have been denied rightful benefits, or those who had to fight for years to receive benefits, don’t really have a public voice. In addition to that many cases are settled with ‘gag‘orders and/or specific privacy statements. Many injured workers are also all too often utterly exhausted after their ordeal with the WorkCover insurer to want to talk about what they’ve experienced, even if they could. Their primary focus is on survival and self-preservation. Furthermore, many injured workers are afraid to speak out because they fear reprisals from WorkCover and worry that their cases may be jeopardised.
We muse a lot about the workcover system, pretty much all the time
The public is mostly unaware that there are many incidences where workcover insurers will misrepresent injured workers as fraudsters and that WorkCover insurers use many deceptive tactics against way too many legitimate injured or ill workers.
We don’t hear about it because the very injured workers who have been denied rightful benefits, or those who had to fight for years to receive benefits, don’t really have a public voice. In addition to that many cases are settled with ‘gag‘orders and/or specific privacy statements. Many injured workers are also all too often utterly exhausted after their ordeal with the WorkCover insurer to want to talk about what they’ve experienced, even if they could. Their primary focus is on survival and self-preservation. Furthermore, many injured workers are afraid to speak out, because they fear reprisals from WorkCover and worry that their cases may be jeopardised.
Gag Orders – Workcover and Co. put a Muzzle on it!
1. What happens when the evidence or opinion of the medical experts or independent medical examiner is challenged?
First of all, many WorkCover claims don’t reach a Court of law. As such adverse criticism and scathing opinions made public by a Judge or Magistrate about the evidence presented by certain ‘expert witnesses’ – IMEs who give evidence – are fairly scant. We do however read as many Legal Case as possible, and from now on will be keeping a record of publicly available adverse comments about certain IME doctors. But even when certain IMEs are reprimanded in a Court of law, they essentially get away scot-free or with a little slap on the wrist! Fair, NO!
To our knowledge, when the evidence of an independent medical examiner or expert witness is challenged, we believe that regulatory bodies such as the Australian Health Practitioner Regulation Agency (AHPRA) which supports the 14 National Boards that are responsible for regulating the health professions; and whose primary role is to protect the public and setting standards and policies that all registered health practitioners must meet, and the relevant WorkCover Authority (eg WorkSafe Vic) actually appear to keep SILENT about complaints about these so-called IMEs or Expert Witnesses. It appears that no matter how many complaints have gone to AHPRA and WorkCover Authorities, and those submitted to the Ombudsman, the specific information (as in names) is quashed through private and confidential decisions about the quality of the work some of these for-hire ‘experts’ churn out by the thousands in respect to injured workers. Professional colleagues also remain silent!
But the problem of preferred and biased independent medical assessors is real! As stated in the Ombudsman (VIC) 2016 report (and note that the investigation is ongoing):
“…my officers found that in some cases agents’ choice was plainly motivated by the opportunity to obtain an opinion from an IME who was considered to hold particular views adverse to an injured worker. There was also evidence in some cases of agents ‘shopping’ for an IME opinion by going to multiple doctors until they received an opinion that would allow them to terminate”(p. 157)
“…agents are in some instances selectively using IMEs, “fishing” for certain outcomes by requesting supplementary reports or asking leading questions in order to get a report that would support a termination or rejection.”(p. 157)
“The WorkSafe Excutive advised that WorkSafe is considereing ways to address agents’ selective use of IMEs to reduce the perception that agents and certain IMEs are aligned”. (p 154)
“We found numerous examples of agents unreasonably rejecting and terminating workers’ entittlements and cherry-picking slim evidence to support a decision to reject or terminate a claim while disregarding overwhelming evidence to the contrary. The cases also demonstrated provision of selective, incomplete or inacurrate information to IMEs; leading questions to IMEs; and selective use of IMEs – including those described by agent staff as ‘good for terminations’. (p.157)
“The evidence of unreasonable decision-making is too strong to be explained away by a few ‘bad apples'”.(p156)
It is alleged that when an IME has been complained off several times, the WorkCover Authority does no longer ‘use’ them. But that is not true, for many notorious IMEs are still working and have been for years and years.
When something inappropriate happens or is discovered, it appears that matters suddenly settle, hearings are aborted, confidentiality clauses are placed into releases and no one hears what really happened.
2. What happens when an injured worker speaks out about an independent medical examiner or expert witness?
aworkcovervictimsdiary has, over the years, been sued once for alleged defamation, and has been threatened three times with a lawsuit for alleged defamation, for speaking out about certain IME doctors. In one of those cases, the IME in question had been interviewed by a TV Channel, adverse comments and questions were raised in Parliament, and several newspapers had published articles about this IME. None were sued, but the owner of aworkcovervictimsdiary was sued and relentlessly. Settlement was eventually obtained which included a strict and permanent gagging order.
3. What happens when WorkCover insurance case manager are publicly exposed for ill-treating injured/ill workers?
In short: the answer is the same as what happens to IME Doctors / Expert Witnesses who are reprimanded or commented upon adversely in a Court of Law. Aworkcovervictimsdiary was threatened with a lawsuit for alleged defamation of three NSW WorkCover (Allianz) Case Managers. All we did was copy excerpts of scathing remarks made in a Court of law, yet they came after us (the owner of aworkcovervictimsdiary) and obviously not after the Judge/Magistrate. How interesting?! Rest assured, this was just another way to attempt to muzzle an injured worker and remove adverse findings! What happens to those case managers? At most a slap on the wrist.
- The court case in point is publicly available on http://www.austlii.edu.au/au/cases/nsw/NSWWCCPD/2011/4.html
We know of one such seriously injured worker who wrote an ebook about how to basically fight for your rightful workers’ compensation benefits, which ended in him having to fight another fight with the workcover insurer for his benefits! Most copies of his ebook were given away to friends, but he sold about 17 ebooks (at $12 each). The injured author wrote to us saying that he had received a letter from his workcover insurer stating that he was now ‘working’ and earning money, and that – even though the injured worker had no remunerative work capacity for the future – his earnings would now be deducted from his benefit entitlement! But it turned even worse, as the workcover insurer first cut off all his benefits, then requested a tax return summary for the past 3 years, then deducted the miserly amount he made on selling his ‘ebook’. If that is not pure intimidation?! All he essentially did was share his own experience(s) with the workcover system. He too was gagged, the ebook long gone, …
In another case, a seriously injured worker – the owner of awokcovervictimsdiary– started a blog during her workcover claim. Her psychologist had suggested she started a diary as she was of the opinion it may help her work through her grief and anger and frustration surrounding her life-changing injury. Because she was unable to physically write due to her injury, she opted for an online blogging platform, allowing her to use voice recognition software to dictate the article. When settlement time came, and even though she used voice recognition software, the defence argued that she should not be compensated for loss of earnings as she was ‘able to blog’. This injured worker was assessed with a whopping 43% total permanent whole person impairment with no remunerative work capacity for the future. She lost her office job because of her impairment and yet was punished for dictating blog articles., lying on a chaise and using dictation software. Punished for sharing tips and tricks, for sharing the inner-workings of the workers’ compensation insurance industry. She never made any money by blogging and sharing her experiences, on the contrary, it ended up costing her money to pay for hosting fees, dictation software etc. Another underhanded way to silence an injured worker!
In addition to a costly defamation lawsuit, defamation lawsuit threats, a workcovervictimsdiary.com.au was also subject to several DoS (Denial of Service) attacks, one of which we clearly managed to trace back down to, hang on, WorkSafe Victoria (via IP addresses)! In our cases, they were mainly Flooding attacks, which is the more common form of DoS attack. It occurs when the attacked system (aworkcovervictimsdiary) is overwhelmed by large amounts of traffic that the server is unable to handle. The system eventually stops or crashes and goes offline.
According to a great lawyer with whom we discussed one of the DoS attacks:
There is virtually no doubt that WorkSafe [or agent] tried to bring down aworkcovervictimsdiary’s site trying to download information from it… maybe in contemplation of using it against you [owner, authors, contributors ] in potential proceedings. A lawyer colleague of mine used to work for the TAC and says they [TAC] and WorkCover and insurance agents frequently download Facebook pages, entire blogs, websites etc… in case the “evidence” is later deleted.
It is no wonder that so many injured workers are afraid to sign their name on Petitions to enact legislative change, are too afraid to share their nightmare at the hands of their workcover insurer, and are often even too scared to complain? In fact, the last petition featured on this site only received less than 400 signatures!