Academy of Independent Medical Examiners, Hawaii
Aiming to Advance the Specialty and Quality of Independent Medical Examinations in Hawaii

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10 Ways to get a better IME by Dr. Nierenberg November 20. 2001
February 22, 2002 Course for claims Personnel
Want to know about Psychological aspects of IME's and Disability? (a PDF handout of AIMEHI presentation courtesy of Dr. Brigham)
13 Red Flags to alert Personnel to problems in Impairment Reports (August 18, 2004)
DLIR Hearing Officer Training (June 17, 2005)
NEW! Standards for IME's


(How to get the most Bang for your Buck)
Presented to Hawaii Claims November 20, 2001, Pagoda Hotel, Marie Weite Presiding

By Chet Nierenberg, M.D.

1) Decide exactly what you need and why you need it, i.e. PPD, general IME. ? Something cheaper like case merit analysis might suffice.
2) What is true agenda? Is something contentious? Disability issues, apportionment, suspect symptom magnification, inappropriate treatment, etc.
3) Pick the right doctor. Old way of just picking doctors in specialty not the best. Doctor familiar with current concepts. Special training or experience in IME. Are special issues involved? Remember better is cheaper. Cheaper is not better.
4) Establish a good relationship with user friendly office. Gets better service. Maybe all you need is phone call. Maybe another Dr. is better suited.
5) Communicate exactly what you need and when you need it. Supplement your cover letter with phone call. You can save lots by telling what you DON’T need.
6) Record preparation and delivery. Complete and timely. Don’t expect doctor to delay report pending delivery of records. Expect an addendum (costs more)
7) Notify all parties (attorneys, claimant, doctors, etc.) and find out if any special issues involved.
8) Do you need PPD? If so, is injury contested?
9) Don’t expect IME doctor to order diagnostic tests.
10) Attend course Feb. 22, 2002 "How to Get Most Out of an IME".
*Use and abuse of 5th Edition Guides
*Topics will include, Return to work issues, NCS, difficult diagnosis like Fibromyalgia, and a Panel discussion with Attorney and MD participation.
Course brought to you by:
AIMEHI (Academy of Independent Medical Examiners Hawaii) and
ABIME (American Board of Independent Medical Examiners)


In association with Academy of Independent Medical Examiners Hawaii, (AIMEHI)


Now past history, those that attended thought it was high quality.
Honolulu, Hawaii February 22, 2002
How to Identify Quality Independent Medical Examinations and
Use Them to Your Advantage

You asked for it!, Hawaii told us you wanted a course covering these topics. Well here it is. The main presenter, Dr. Ranavaya from the mainland ABIME is the international expert in these subjects and literally is one of those who "wrote the book". Don’t miss one of the true "high Maka Makas" coming just for us.

8:30am-8:45am Welcome and Introduction
8:45am-10:00am Use and Misuse of AMA Guides (5th Edition) .
How to Identify the Abuse of the Guides.
10:00am-10:15am Coffee Break (Coffee and Pastries Included in Registration)
10:15am-12:00pm Emperor has no Clothes On!!
Controversial Diagnosis Update.
Fibromyalgia, Myofascial Pain, Multiple Chemical Sensitivity
12:00pm-1:15pm Lunch (cost of Lunch is included in registration)
1:15pm-2:15pm Return to Work Issues in Disability Claims.
How to Meet the Challenges.
2:15pm-2:30pm Break
2:30pm Door prizes awarded
2:35pm-3:30pm Panel discussion

The Panel format is audience questions and panel discussion of the answers. Just to get things started, it will begin with the provocative question of "In Hawaii, When is an Independent Examination not truly "independent" and what do you do about it?"

Panel Members:
Mohammed Ranavaya MD, President-Elect of American Board of Independent Medical Examiners.World-renowned expert in Disability and Independent Medical Examinations. Dr Ranavaya is also the main presenter of the lecture material. He is truly a superstar in his field. Primary contributor to the AMA Guides to Evaluation of Permanent Impairment. Also primary contributor to Official Disability Guidelines.

Mark Stitham MD, Prominent local forensic Psychiatrist, and member of AIMEHI.

Chet Nierenberg MD, Director of Honolulu Sports Medical Clinic and president

Attorney Randy Chung, of Matsui, Chung ,Sumida, and Tsuchiyama. Prominent and Experienced Defense Attorney.

Attorney Dan Colon, Prominent Plaintiff Attorney, previously a Defense Attorney.

Where? Pagoda Hotel
Who? Both ABIME and AIMEHI are cosponsors. Both are non-profit organizations.

13 Red Flags in Impairment Reports

Presented to the Hawaii Claim Association, August 18, 2004
by Dr. Chet Nierenberg, Ala Moana Hotel, Jim Araki Presiding.
Content courtesy of Dr. Cristopher Brigham.

1. AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition not correctly referenced.
2. Evaluation performed by the treating physician, especially if treating chiropractor.
3. Report fails to delineate clearly the steps of medical evaluation, medical analysis, and comparison to criteria.
4. Maximal medical improvement or permanency not defined, or defined before one year from date of injury.
5. The term "disability" used, when should be referencing "impairment".
6. Specific Figures, Tables and page numbers in the Guides not referenced.
7. Report is "too brief', "disorganized", or "sloppy".
8. Subjective complaints, without specific objective findings, are rated.
9. For the spine, Range Of Motion Method, without clear explanation of why required.
10. For the spine, Diagnosis Related Estimate higher than Category 111 (unless a single level fusion).
11. For the upper extremity, ratings of the hand, carpal tunnel syndrome, or other disorders.
12. For the lower extremity, use of more than one method.
13. Ratings for Mental / Behavioral Disorders or for pain.


AIMEHI assisted the DLIR (Hawaii Department of Labor and Industrial Relations) in training hearing officers on June 17, 2005. Although AIMEHI did not conduct the training, it assisted the DLIR obtaining quality instruction. AIMEHI suggested Dr. Chris Brigham put on the instructional seminar and he did a superb job as usual. Dr. Brigham, a Master Fellow of AIMEHI, also had 3 other AIMEHI Physicians (Dr. Nierenberg, Dr. Brewer and Dr. Direnfeld) on a panel to explain clinical aspects. Key points included that the ODG were to be used as guidelines and there use was explained.


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