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Shaw Chiropractic
A Medical-Legal Newsletter for Personal Injury Attorneys
by Dr. Steven W. Shaw

Direct Examination of the IME Orthopedic Surgeon

A chiropractic friend of mine, Dr. Jeffrey Silber of Trumbull, recently sent me some deposition questions he had written for an attorney. The attorney was unclear regarding several key issues with regard to the direct examination of the IME orthopedist. The attorney felt these questions were the primary cause for favorable settlement which took place immediately after deposition. After reviewing the questions Dr. Silber gave me permission to reprint them in our monthly newsletter. I hope you find them as enlightening and helpful as the attorney who used them during his examination of the orthopod.

-Doctor, what is your medical specialty?
-How many years have you practiced orthopedics?
-In the past two years what percentage of your practice has been devoted to IME and case review?
-In the past two years what percentage of your practice has been devoted to private patients?
-What percentage of your income is derived from IME and case reviews?
-What special training or certification do you have in impairment rating, disability rating, utilization review, case management or quality assessment
-How many times per year are you asked to testify on IME patients?
-On average, how long is the examination you perform on an IME patient?
-Is this the usual amount of time for an IME?
-During your IME what tests are customarily performed?
-Can you describe the importance of each and their significance?
-Please describe you protocol when performing an IME?
-How many times did the attending chiropractic physician see the patient? How long is each visit?
-Given this information, would you or the chiropractic physician have a better understanding of this patient’s condition from onset to present day?
-In what medical capacity do you believe you hold the most expertise?
-Are you an expert in psychiatry, gynecology, urology, obstetrics, opthamology, osteopathy, chiropractic, dermatology, dentistry, podiatry, neurology etc?
-(If yes) What specific training have you had in this field?
-When did you take these courses? Are you certified in any of these areas?
-Specifically, what training do you have in chiropractic medicine?
-How much education does it take for a chiropractor to obtain a state issued license to practice in Connecticut?
-Do you know what courses a chiropractic student must take to earn the degree, Doctor of Chiropractic?
-Are you aware that the treating physician was a Doctor of Chiropractic?
-You indicate that chiropractic care was not necessary?
-Are you licensed as a chiropractor?
-Do you hold any degrees in chiropractic?
-Have you received any chiropractic certifications?
-Do you consider yourself an expert in chiropractic medicine?
-On what do you base your opinion when you state the care was excessive?
-What are the recommended treatment parameters for chiropractic?
-On what basis are you qualified to make a determination with regard to chiropractic evaluation, management or assessment of this patient?
-Doctor, please define disability.
-Have you ever rated a person for disability?
-Have you had any additional training in disability rating?
-What parameters do you use to rate for disability?
-Doctor, Please define impairment.
-Have you had any additional training in impairment rating?
-What parameters do you use to rate for impairment?
-Doctor are you familiar with the AMA’s Guide to the Evaluation of Permanent Impairment.?
-Can you describe how the guide is used?
-Is the AMA Guide an authoritative reference?
-Would you agree that 10 equally trained physicians would arrive at a very similar rating using the guides?
-Can you describe the models used by the AMA Guides for impairment (injury and range of motion models)?
-Why would one model be used rather than the other?
-Why do the guides recommend whole body impairments rather than other methods?
-Would you agree that disability may be defined as an alteration of an individuals capacity to meet personal, social or occupational demands because of an impairment?
-Would you agree that disability may also be defined as the gap between what a person can do and what he needs or wants to do?
-Please describe in detail what steps you used to make a medical assessment of impairment and disability?
-Do you use the Guides (if not why?)