Saturday, June 16, 2012

IMA Exams In New York

In New York, the Division of Disability Determinations of the New York State Office of Temporary and Disability Assistance (“OTDA”) decides if the medical evidence supports an application for Social Security Disability (“SSD”) benefits. If the OTDA believes that the claimant’s medical information is unavailable or insufficient, then the OTDA can pay for a consultative examination (“CE”). The Social Security rules and regulations clearly state that a claimant’s treating doctor is the preferred source for a CE, which Administrative Law Judges reluctantly admit.

Even though I submit medical tests, functionality opinions, and clinical records, when I file SSD applications, the OTDA almost without exception sends notices for my clients to go for a CE by IMA Disability Services. IMA Disability Services, which has also gone by the name Industrial Medicine Associates, is part of The IMA Group (collectively, ”IMA”).

Why are claimants always told to go to IMA when the rules and regulations clearly state that the treating physicians are the preferred sources for CEs? Why are claimants told they have to go to IMA CEs in virtually every case? I represent a 59 year old bricklayer whose SSD benefits were paid today two months after I filed his application, even though the OTDA sent two letters stating that it was “necessary” for him to be examined by an unnamed doctor from IMA. Obviously, the CE was not necessary.

The OTDA is supposed to issue three year contracts for performing CEs through a competitive bidding process. David Pulver, the President of IMA, gave a private cocktail party and fundraiser for Alan Hevesi while he was Comptroller. The Comptroller and Attorney General are supposed to review the CE contract process, and the fundraiser occurred when IMA’s contract was pending review at Hevesi’s office. Alan Hevesi plead guilty to unrelated corruption charges, and was sentenced to 1-4 years on April 15, 2011.

As of 2009, IMA held the contracts for performing CEs in 12 of the 13 regions in the State, and now apparently holds all 13, even though a State investigation revealed that IMA engaged in a practice of improperly altering and submitting documents to OTDA in connection with its bids for CE contracts, as well as other improprieties. How much does the OTDA pay IMA annually? Certainly, IMA has a great incentive to retain its monopoly.

The money that goes to IMA comes from our taxes. It would seem that anyone interested in preventing the wasting of tax revenues would want to ask a lot of questions about IMA CEs. Since the State found that there was no undue influence behind the OTDA issuing contracts to IMA, why, as noted above, are claimants reflexively sent for IMA CEs when they are in fact not necessary? Even if a CE is necessary, why does the OTDA insist that IMA perform the exam when many claimants’ doctors would conduct the CE without cost to the taxpayer? How much do we actually pay IMA in total each year for CEs? How much would we save if the OTDA only sent claimants for a CE when they were actually necessary, and then to treating doctors?

3 comments:

Ariel said...

IMA in Elmira, NY did not have an entry door that was wheel chair accessible. The door had a heavy closer @ no side room for a person in a wheel chair to accommodate opening it on their own. IMA practices are very questionable from my experience. I was called by IMA for an appointment and told that the purpose was "only" to review my records and that I would not need an exam. They refused to identify who I would see but said it was a specialist. It turned out to be a 75 year old Indian doctor who behaved like an angry bully. The nurse who worked with him didn't know how to say his name and also claimed he was a specialist. She wrote the name down at my request "Looknarine Persaud". He didn't wear a name tag, and there were no licenses anywhere. He mumbled something that was no where near the written name and I believe it was intentional to hide his identity. This explained why the nurse didn't how to say it after hearing him introduce himself all day). I was now told they did expect me to undress and be examined. When I told them I was informed otherwise, Persaud proceeded to threaten me and to falsely report that I refused the exam; which would have been untrue and dishonest. He made several other threats during the appointment to negatively misrepresent what actually occurred vs. what he would report; thus using his power over my SS information to belittle and bully me. He complained of the information I provided because it seemed he didn't want to have to document much of anything. For instance (and this was typical), one of the questions asked "do I make appointments". I claimed I did and clarified that I often had to reschedule due to my ongoing health issues. He openly ignored the rescheduling issue, as he similarly did with much of what I responded to questions, and instead documented that I made appointments without difficulty. He had the audacity to read back what little he chose to document, as it quickly became clear he had much animosity toward me and was working that into his report; even though he had never met or known me. It was a clear effort to change and slant what I had answered to what he wanted to document. It was dishonest and false. His approach totally changed the meaning of what I said in a major way. He wanted to limit what he needed to write down and his negative demeanor was set on limiting any disability supporting information that would justify my claim. He totally changed most of what I reported. These things are elements of malpractice according to NYS medical licensing. Doctors are identity is to be clear and posted. Bullying and reporting false information are other forms of malpractice. Speaking of which, he is not a specialist either (as per NYS websites). He only has the lowest level of medical licensing and no US medical training or certifications. In most other states he couldn't get a medical license, but NY requires the least in the country. In summary, I believe IMA purposely lies about the intent of a visit to their office to ensure you are prevented from asking to see your own doctor. Given what I experienced, I think IMA is a questionable company and if any competent unbiased review was conducted of their practices, that they would not have a NYS contract. If your primary purpose is disability medical reviews; you damn well should be REQUIRED to have wheel chair accessible entrances. Doctors should have US training, and be naturalized citizens under the age of 70. A 75 year old Indian from a culture known for the worst treatment of woman in the world should not have this job. A person of this background should not be given authority over SS disability claims for US woman. I am sure based upon the bullying that I was subjected to (in such a short visit) that this man is very negatively biased and has a deep hatred toward woman, misuses his authority and is not capable of performing a fair unbiased and competent medical review of any woman.

11 Phenomenon said...

I was ordered to go to IMA by Social Services without being asked for any medical opinions from my own doctor. How is that for taxpayer waste and an unbiased medical opinion?

11 Phenomenon said...

@Ariel It seems pretty clear that they are not interested in the truth and could care less about your or my condition(s). I saw someone in Schenectady NY. Was actually friendly, but the result indicated he had no interest in my conditions. It was scheduled to be a "comprehensive" exam. He basically had me walk to he corner of the room and do a half a squat. From that he declared me to be 100% fit, regardless of several documented conditions that stated otherwise, as well as some new concerns that were ignored. What a waste of taxpayer money and really an attack on the sick/disabled.Hitler would have likely approved of such a bogus process. IMA appears to me to be nothing more than a government shill.