Excerpted from SEAK’s stream on-demand course, “IME Skills For Physicians: The Masters Program“
Male 1: …opinion, unless there’s an overwhelming amount of medical records, you should always list the records that you reviewed. If you don’t list the records that you reviewed, that’s gonna be a problem because they’re always gonna wave around some record and ask you, “Did you review it?” And if you don’t have a list, then you’re gonna have to go try and go through your long report and see if somehow, it’s mentioned in there. Yes.
Male 2: If you list the records, like if you document, date, review these and everything, then can you make that statement at the end?
Male 1: Well, the question is if you list the records, can you say it’s based upon the records that I reviewed? It would be better to say, “Based upon the above records,” okay? You wanna be specific, “These are the records I reviewed.” And one of the real keys here, to the report-writing and the opinions, is that your report is your best offensive weapon. Because if the answers are in your report, when they ask you a question, you can look at your report. If it’s not in there, then you have to hope and pray for divine inspiration, okay, that you’re gonna on the spot think of the right answer. Now, I don’t about you, but I mean, I’ve been praying for a long time and it hasn’t come yet. A lot of times the divine inspiration doesn’t come. You’re under pressure, there’s a lawyer yelling at you and, you know, it doesn’t come.
If you look at 4B, my opinion based upon pre-medical certainty is not cause-related and I base it on the following five actors. This is a much better example, okay, because it lists five factors, five bullet points, preexisting condition mechanism of injury, imaging studies are all negative. It would be better if you listed the imaging studies. What’s very powerful in your opinion is if this person had multiple and we talked about objective medical evidence, here’s the chance to use it. So, if I’m a judge and I’m looking at the report and the opinion, and the opinion says, “I looked at the diagnostic test. This person had 13 different diagnostic tests for back problems or whatever.” Here’s the test, it was negative and the date. Here’s the test, it was negative. Here’s the test, it was negative. At the end of the list of 13 tests, what’s the only conclusions you can come to? That, most likely, the person doesn’t have that condition, or it’s not that serious.
So, that’s how you back up your opinion. So, instead of saying just the imaging studies were all negative, if you have a series of imaging studies, tweeze them out and put them in a little paragraph because the judge is not going to have time or inclination to go through your records or the report and try to figure out where this… You know, it’s very hard to do that. It takes a lot of time. You have to read through the whole thing and then make a chronological list and then try to figure it all out. They don’t really have time to do it. They’re involved in a volume practice with hundreds of people to see. And so, if you could have a little paragraph about diagnostic studies, that’s very helpful and if they’re positive or negative.
On page 233, that’s number six, the top, “This IME report contains some of my opinions.” Okay. So, it’s like waving a red flag in front of a bull. I mean, okay, it’s like an invitation for disaster. Okay. So, you put some of your opinions, then what happened? You ran out of ink? I mean, paper? I mean, why did you only put some of your opinions in here? And then go on and on…