(Kiosk 8) Is There Deception in Medical Examinations Performed by Doctors Hired by the Defense?

Case Diagnosis: This study will evaluate the validity of defense medical examinations by comparing reported findings to video recordings of these examinations.

Case Description or Program Description: I analyzed 20 consecutive defense medical examinations over a 6-month period (May-Oct 2019.) Exam reports were compared to videos of the examinations. (All parties consented to video recordings.) Review components included assessment of: a. Spine & limb ROM. b. Strength. c. Muscle bulk. d. Sensation. e. Reflexes. f. Gait. g. Cranial nerves. h. Medical exam gown use.

Setting: Forensic medical examinations results as reported by defense doctors are used by insurance companies to deny claims of injury. Physicians perform these exams in medical offices or conference rooms, and typically the examinations are performed without transparency. In the cases reviewed, a non-obtrusive video recording was made of the examination to allow for doctors' final reports to be evaluated for validity and accuracy.

Assessment/Results: Analysis of the data found that 100% of doctors' reports significantly misrepresented what took place during physical exams, including: a. Reporting tests not actually performed. b. Claiming results were normal when they were not. c. Omission of abnormal exam findings. d. Performance of examination in non-standard and unscientific manner. The average hands-on physical exam took approximately 10 minutes, with some exams as brief as 2.5 minutes. Exams were performed by orthopedists, neurologists, physiatrists, a psychiatrist, and a neurosurgeon.

Discussion (relevance): Defense medical examiners consistently failed to follow generally accepted standard scientific testing methods and misrepresenting exam results in their final reports. For example, one doctor reported normal vascular findings, but did not remove the patient's shoes and socks for the exam, and did not check the pulses of the limbs.

Conclusions: This research shows significant problems with accuracy and validity of reports provided by defense medical examiners, supporting the necessity of video recording these exams to ensure integrity and transparency.