Independent psychiatric examination (IME psychiatry): don’t get fooled

When can workcover send you to an Independent Psychiatric medical examinations (IME)

According to the Claims Manual, (under the ‘claims Management Segments) an s112 examination,aka an independent medical examination (IME) conducted by an IME psychiatrist may be appropriate only in the following circumstances:

  • the case manager, in consultation with the technical manager is not confident that the advice (from the IMA or Medical Advisor provides sufficient evidence (from the treating practitioner, worker and employer) to establish the diagnosis and/or casual relationship or
  •  the information (from the treating practitioner, worker and employer) is conflicting or inconsistent.

Whilst the Act clearly states that workcover (your case manager) should seek answers to her/his questions first via discussion with your treating GP, psychologist or psychiatrist, they will inevitably try to send you to an IME psychiatry as often as possible (i.e. every 6 months) in the hope to find a loophole.

Before sending you to an IME Psychiatry,your case manager should provide you with a clear and valid reason for the need to be (re)assessed by an IME Psychiatry.

Your case manager will most often provide you with a bulls**t reason, such as “it has been 6 months since your last IME”; “the previous IME you saw states in his/her report that you should be reviewed in 6 months”; or they may occasionally provide you with a more reasonable reason such as ” we need to assess your ability to engage in rehabilitation/return to work, and assess whether your psychology services are of benefit and whether they should continue”.

Why does workcover send you to independent psychiatric examinations/assessments

But don’t get fooled for basically what workcover is after is to:

  • have you certified fit and/or
  • cut off your benefits and entitlements (such as your psychology treatment)

Over the past 2 years I have been sent to 4 IME psychiatry (basically every 6 months). I have noted that when my case manager is unhappy with an IME report (which is my favour), she will send me to yet a different IME 6 months later.

For example IME Psychiatrist A stated in his report that I was unfit for all work and that I should be reviewed in 6 months. My case manager, clearly unhappy with the IME’s opinion, decided to send me to IME Psychiatrist B six months later. Whilst this report was reasonably in my favour (unfit for work), it also contained some nonsense comments about “other matters affecting my psychological recovery” detailing that “I was upset that my mother had not visited me since the accident” (hey my mom lives overseas and is too unwell to fly this distance!). The report also stated that I should be reviewed 6 months later.

Six month later my case manager sends me again to Psychiatrist B, explaining that Psychiatrist B had recommended in her report that I should be reviewed 6 months later as an explanation for the reason for the IME.

Note: here is the catch already: my case manager does obviously NOT send me to Psychiatrist A, who also requested I be reviewed in 6 months. See where this is going?

I obviously requested my solicitor to have me sent to another IME instead of IME Psychiatrist B, stating that I had a very traumatic experience with Psychiatrist B (which is  true anyway) and that I refused to see that psychiatrist ever again.

We were successful and my case manager had no option but to sent me to IME Psychiatrist C for an assessment, instead of IME Psychiatrist B.

I had the assessment and a couple of weeks later I obtained a copy of IME Psychiatrist C’s report. Well, this was an eye-opener! The report by the way was  in my favour stating (shall I say an honest report)  that the IME agreed with Psychiatrist A and I was deemed unfit for all work for a long time.  The report also stated that any “other matters affecting my psychological recovery were merely after-effects stemming from the injury and subsequent surgeries”, which is really true. For example, if I had not been injured and had not have to endure 10 major surgeries, I would not have been ‘upset’ that my mom could not visit me, right – cos I could have gone to visit her overseas.

Useful guide on how best to prepare yourself for a dreaded independent independent psychiatric examination

Questions workcover will ask the independent psychiatrist

The eye-opener of the IME report was that I had a look at the questions which were asked by my case manager.Please read through these real questions, so you know what workcover is after and how they will try to catch you.

  1. In your clinical opinion, is the worker’s current treatment appropriate? Please include your comment on the appropriateness of the type, frequency and duration of any treatment and in the case of medication, the dosage. >>Now, here you can already see what your case manager is after, namely an attempt to cease your psychology treatments (frequency/duration), and perhaps cease certain medications
  2. If ,in your clinical opinion, the worker’s current treatment is appropriate, how long should the currently precribed treatment continue? Please explain your opinion. >> Again, it’s about whether they can find a way to wind down your psychology sessions or cease them
  3. Would the worker be able to undertake the activities of daily living and/or return to work or stay at work or would the worker’s capacity to do so be reduced if the current treatment was ceased? >> this is an obvious question, again to try to cut off your psychology entitlements whilst of course keeping you at work.
  4. Do you recommend any changes in the worker’s current treatment? For example, should there be any change to the frequency of treatment. >> Needless to say how crafty workcover is in writing their questions to try and please cease either your psychology treatment or at the very least reduce your entitlements.
  5. What medical condition/injury does the worker have? >> this is also a tricky question, get not fooled! They want to see whether your employment injury is still a significant contributing factor to your current emotional state!
  6. In your pinion, what has caused the worker’s injury/medical condition? If there are multiple causes, please list all of these. Please give specific consideration whether the worker’s employment is still a cause. >> See what they’re doing and heading for? They are hoping to find OTHER causes (not your work injury) to your current emotional state of course!
  7. Can the worker return to work in their pre-injury duties and hours?
  8. If the worker cannot return to their pre-injury duties and hours, does the worker have a current work capacity?
  9. Can the worker return to work in modified pre-injury duties and/or hours; alternative duties
  10. If the worker can return to work in modified pre-injury duties what do you recommend? Modified pre-injury duties, modified pre injury hours, length of time for the modifications to remain in place, review time? >> O boy, now they are really getting desperate!
  11. If the worker can return to work in alternative duties, do you recommend alternative duties,alternative hours, length of time for the alternative duties, review time frame?
  12. When can the worker return to work whether is pre-injury duties, modified pre-injury duties or alternative duties?
  13. If the worker has no current work capacity, please provide your detailed opinion about why that is the case.>> WTF
  14. When should the worker’s capacity for work be reviewed?
  15. If there is ANYTHING other than the worker’s injury that is affecting their recovery including their return to work (i.e. DOMESTIC ISSUES, RELATIONSHIP PROBLEMS, RELATIONSHIP PROBLEMS AT WORK, SOCIAL FACTORS) >> This is where you need to be VERY careful on what you say!!!! In fact it is nobody’s business!!! How your sex life is, how your marriage is, who your friend are, etc HAS GOT NOTHING TO DO WITH YOUR INJURY. DON’T DISCUSS IT OR EMPHASIZE THAT YOUR INJURY IS AFFECTING YOUR SEX LIFE, YOUR MARRIAGE ETC.
  16. Does the worker have no work capacity for suitable employment arising from the secondary psychiatric condition related to “your injury” for this claim? Please don’t take into consideration any other injuries or conditions the worker suffers from. >> note the last bit!
  17. Is the worker fit to participate in a vocational assessment; vocational re-education assessment; retraining; a functional capacity evaluation; a work hardening program
  18. Does the worker’s psychiatric condition allow the worker to travel by public transport or car? >> Again, a very tricky question in my case because they were trying everything not to grant me taxi transport based on my physical injury and requested my specialist surgeon!!!!
  19. Any other comments?

In my case workcover was desperate to have me certified fit (although why remains a mystery as I am currently totally unfit from a physical perspective -however they would rely on an OLD physical IME by a general surgeon who stated in his report over 1 year ago that I MAY be able to work provided I was given no less than 22 ergonomic tools). That’s why they purused the IME Psychiatry in the first place and REFUSED to send me to a physical IME after being notified of the catastrophic deterioration of my phsyical injury. They are pretty clever and DESPERATE.

Workcover was also threathening me repeatedly that my psychology entitlements would be ceased – they tried very hard but  I successfully appealed it at the ACCS. Mind you after the conciliation, they tried to disregard the legal ruling by not paying my psychologist (and sending me a bill for $800)!!!

So, obviously workcover was also desperate to cease or cut off my psychology treatment by requesting the 4th IME psychiatry in 2 years (one very 6 months).

When you look back at question 15, this is where the IME psychiatrist twisted things to state that “I was upset that my mom did not visit” and that “this contributed to my recovery”. Yeah- nice try!). So, again, don’t talk about your PRIVATE life, or simply make it clear that your injury IS AFFECTING this and that. You should not have to discuss anything that is NOT RELATED to your injury because those workcover morons will try and make a case against you and, in my example, may have tried to say that “being upset about my mom not visiting” is the CAUSE of my depression/whatever and therefore they would NOT PAY for psychological treatment.

Always remember that workcover (Allianz/ Xchanging / Whatever) is NOT YOUR FRIEND. Their priority is to their shareholders! They are a very greedy insurance company and don’t give a sh*t about you – it’s about MONEY. Don’t get fooled!

Good luck with your Psychiatric IME’s ;)

 

Shortlink of this post: http://workcovervictimsdiary.com/?p=450

About WorkcoverVictim

I was assaulted by a large patient whilst working as a nurse . I underwent numerous major shoulder reconstructions and suffered near fatal complications. I am left with an extremely painful and irreparable dominant arm. This site was born out of my sheer frustration, anger and grief regarding the workcover system where all is not made clear, where the waters are very murky, and when the chips are down, the very people who are responsible for duty of care and support simply choose to ignore you, the injured worker. I dedicate this site to all injured workers who have been abused by the adversarial workcover compensation system. May they never give up, may they fight like warriors for their legitimate rights, and -most importantly- may they hold onto their dignity, self-respect, self-esteem and sanity; and may they WIN!

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24 Responses to Independent psychiatric examination (IME psychiatry): don’t get fooled

  1. Doctor Watch August 30, 2011 at 12:25 PM #

    There are a number of psychiatrists used regularly by the insurance companies for “too hard” cases. These doctors are flown around the country, into hired local offices or other doctor’s room, so they can do their dirty work against you.

    If referred to a doctor, apart from seeking union or legal advice, you should also check with the relevant medical board to examine the doctor’s registration details. You may be able to glean some information from this e.g. that your insurance company’s chosen doctor is actually based in another state. Check Google and the White Pages for any references to the doctor.

    The other thing to be careful of is every insurance company arranged appointment will come with an escort – though you won’t know about this. That’s right: they’ll be arranging surveillance on these days as they know where you will be.

    If possible, leave hours earlier than required and use an entrance (to the building where the doctor is located) that one wouldn’t normally use e.g. a side entrance and so on. Also, if there is a waiting room, you can expect that one of those people will be a private investigator.

    • WorkcoverVictim August 30, 2011 at 1:00 PM #

      Wow, that bit about the surveillance is really freaky – thanks for the tip! Also your information about flown in doctors is amazing – it’s actually unbelievable to what length workcover insurance companies go to ‘catch you’ and obviously at any cost. It is no wonder many of us, genuine injured workers, are developing serious secondary mental problems such as depression, paranoia even suicidal ideation. I strongly feel that if workcover insurance companies would adopt an open, transparent and human relationship with injured workers, many more of us would recover faster and at a much cheaper price too. Thanks again for commenting, much appreciated.

      • Doctor Watch August 30, 2011 at 1:18 PM #

        Use your State’s privacy legislation to get access to your complete file, or to specific aspects of your file. Or, simply write and as the insurance company to detail its use of surveillance on you.

        You can expect your insurance company to fight any access request – you must be very persistent and push this through – using all legal avenues.

        Regarding Independent Medical Examiners, you can be sure that a call has been made to them – so that nothing is in writing – so that the case manager has been able to put across their views on how the injured worker can be caught out.

        Case managers are truly evil – getting team bonuses for closing claim files.

  2. Psych January 11, 2012 at 8:48 PM #

    @grathom – I followed the discussion between you and aworkcovervictim on twitter and I hope you have read this (and the other) articles. I have a “stress’(mental) work injury and am going through hell with workcover. I have been sent from one IME to the next and it’s not stopping, they are desperate to shall I say close my file. Over the years I have become much worse, my depression has significantly worsened because of the workcover system and the way I am being treated. I even have recurring nightmares about my case managers and even some IMEs. On top of that I have the PTSD from being bullied and harrassed at work, and feel really hopeless but also very very angry. Because I have had to go to all those IMEs of which quite a few were real hired guns, I have had to learn the “tricks of the trade” real quick. This is not to say that I am committing fraud or exaggerating my illness, but I know what to say in those 10 minute assessments and how to behave. The fact is those IMEs don’t know you from a bar of soap. So I will share some tips too: when you speak, at time make sure you raise your voice inappropriately loud. Then speak very quietly again. Swear at times, just one word. Then go quiet again. Loose eye contact and let your eyes wander off… you are lacking concentration. Now and then tell the IME ” sorry I forgot what I was saying”, you have poor memory. When they make you talk about the traumatic event, look frightened and say that you c-c-c-can’t t-t-talk ab-a-bout it, you are too traumatised right. Make your leg jitter often, drum your fingers, don’t sit still, hey you get easily startled. Don’t shower for 2 days before ur appointment and make sure u look tired and not well “groomed”, hey you are depressed so why bother making an effort for that dude. See what I am saying?

    Good luck, power to you!

    • None January 11, 2012 at 9:17 PM #

      My advice would be to simply be as natural as you can be. There is no need for training for an IME though it is important to know that these IMEs are not really independent.

      Each state has its own rules, but if in NSW, the insurer cannot send you to an IME unless your own treating doctors are unable to supply them with the requesite information.

      Anyone attending an IME should also bring a support person (family member, but preferably union official).

      Also, you are entitled to surreptitiously record the examination as you are protecting your own legal interests. You are not, however, allowed to broadcast that (or post it to the net for that matter).

      So, my advice is to be yourself but be aware that the insurer-selected IME has one job and one job alone — to close your claim.

      Who is the doctor involved in the IME? Have yo searched for his or her name online? You may get some clues about them. Also try searching http://www.austlii.edu.au for where s/he may have been mentioned in other cases.

    • You know... January 12, 2012 at 10:30 AM #

      It’s almost as if Psych is setting someone up here! I am incredibly suspicious of that post.

  3. "Insurers" Medical Examiners September 24, 2012 at 12:33 PM #

    Lets not get paranoid, although hypervigilance is a symptom of PTSD, I do not think there are any setups here. I agree just be yourself at IME but be careful not to disclose any personal information that can be used by CM teams to cut your entitlements. Make sure that you make sure that you stress that your CM team is making you more stressed by their constant harassment and bullying. Of course, this will probably be written as “your perception”, but one IME didn’t, and of course I was not sent to him again.
    Check http://www.ratemds.com and make sure you are not being sent to a hired gun. If you discover you are, discuss with your treater or lawyer if you have one and have one of them request the IME be changed. You cannot refuse an IME appointment, however the choice of IME can be changed.

    Having been in the system for some time and having had over 7 CMs, in my experience, most CMs are not evil, just misguided, inexperienced and some clueless. They are the shit kickers and scapegoats and the Team Leader and Team Manager are the ones behind the scenes that plan all the tactical moves to try to terminate you. My last CM was very young & in their first office job by all appearances. This person twittered to her former supermarket employees about her new job as a CM, which she also stated on her Facebook page. Her Facebook friends were all my other CMs and team leaders etc. It is amazing how much info you can learn from social networks. Just as these are used against injured workers.

  4. Injured SA Worker February 3, 2013 at 11:43 PM #

    I have been the victim of psych shopping but by a self-insurer so there is no difference between the insurers.  I found that it was better to be proactive and ask for an appointment with the claims manager so that some sort of relationship is established.  I felt that more of what I wanted to say was heard and getting a lot of things off your chest to the person that matters is very therapeutic.  Of course, you definitely do not go on your own.  I attended 4 x IMEs at which l said the same things as I put to the claims manager so no need to remember anything new and I could feel some degree of confidence in being able to cope with the process.  I found IME interviews very much like a court process, very much one way and you find yourself second guessing but what doesn’t kill you makes you stronger.  I guess that I was lucky in having a great support network and eventually I was able to return to work at my own pace.  My biggest tip is to be prepared for the huge amounts of emotional energy these IME’s suck out of your body.  Be kind to yourself for a few days afterwards.  Good luck to you all in future.

  5. Jo August 20, 2013 at 2:46 PM #

    Wow! I am for the first time am being sent to a IME Psychiatrist after ALL the Insurer’s (Surgery etc) IME’s have written me off over the years.

    I did look up this IME Psychiatrist who seems to have an office on level 2 of 12 Collins St Melbourne, but couldn’t find any really bad reviews on him? I’ll call him Dr Peter K****n for arguments sake :-) is that vague enough!

    I don’t know if he is a dodgy IME or not? If you know who I might be talking about please let me know?

    I have also noticed in documents obtained for the Insurer my Permanent Injury has been changed to “Temporary” Injury? Why would the Insurer do this?

    • FU_CGU August 20, 2013 at 3:27 PM #

      Hi Jo, if your insurer may be classing your status as “temporary” hang on to your seat. Depending at what stage your case is at, they might be getting ready to have a report written that you have a “pre-existing psychiatric disorder” which opens the door to doubt everything you have ever said to other insurers IMEs. I assume that you have a lawyer, depending on the insurer’s psychiatrist’s report (I don’t think one has ever been written that favours the injured worker), your lawyer would need to seek an opinion of an expert witness psychiatrist to give a more balance view. And so on and so forth.

      • workcovervictim3 August 20, 2013 at 5:14 PM #

        @Jo – if it is the IME I think it is, Dr KO..AN, he is the most decent guy I ever saw out of many many.

         

  6. sidewinder August 20, 2013 at 3:18 PM #

    Because that’s how they roll ,anything to downgrade your injury so they can get your medical certificate changed and then get you back to work doing any old shit job and if you refuse they will cut your payments off

  7. Richmond August 20, 2013 at 9:04 PM #

    It is stunning that this “”adversarial System”” has existed for so long. And the same 5 insurance companies are selected over and over again, when will the politicians step in and save the tax paid dollars which is peoples money wasted in billions. Before we all lose faith in humanity and belief in progress.

    Richmond

  8. Pauline Pope August 20, 2013 at 9:30 PM #

    We can’t rely on the Politicians to stop this nonsense off their own bat. Their comfort relies on their ability to consciously ignore our pain when we take it to them individually. It will take a huge grass roots style people’s campaign  to ignite the political will to deal with the “Masters of the Workover Universe” those mammoth, inhuman, hotbeds of “risk management” culture and the fear and stigma it spreads, the big Insurance Corporations.

  9. johnny rotten August 20, 2013 at 9:51 PM #

    The politician step they got their noses that far up the insurers arses they don’t know weather their Arthur or Martha have a look at Boof our premier his mate caught with hand in the cookie jar and then sacked months later we politicians with big balls and a big ticker

  10. Jo August 21, 2013 at 1:59 PM #

    Thank you for all of your feed back, I will try to reply without giving to much personally identifiable information about myself.

    FU_CGU I have been in the system for a few years and had common law pain and suffering settlement several years ago so I am quite far along and don’t actively use a Solicitor any more but I am still on their Books (low hanging Fruit?) I can’t really see them saying I had some pre-existing condition now due to the time frame? but who knows??  As you will also understand I get a little nervous when being referred to a new of different type of IME after some of the experiences I have had in the past, A question I often think of when I hear from the Insurer is “What are they up to this time”

    Thank you Workcovervictum3, I had read a little here about him being fair and online about his fairness being at 50% I just hope he is genuine like the last couple of IME’s I’ve seen.

    When I found they had changed my Injury to “Temporary” Alarm Bells started ringing! After going through the Medical Panel and common law stuff I was classed/certified as having a Permanent Serious Injury section 32? I think.  The way things are going the Insurers seem to have power over Worksafe and make up their own rules and decisions, I suppose they have Worksafe by the short and curly’s in a way because who else is going to want to provide Insurance at such a level.

    The only way I can see any Politicians or Worksafe making the system Honest and truly fair is to start administering severe Fines for any and all misconduct committed by the Insurer! The ACCS needs the power to do this and stop the Bullshit going on to try and wear people down and intimidate them.  The way the ACCS is now is like a Toothless Tiger against these Insurers.

    It seems more and more common now the Insurer doesn’t care or sometimes doesn’t even turn up at Conciliation meetings, I think they know the Injured person just can’t fund taking them to Court to sort the problem out? Maybe the system should change in that if the Insurer doesn’t care about the ACCS outcome the Injured person is awarded funded Legal representation? argh I don’t know!

  11. Pauline Pope August 21, 2013 at 2:54 PM #

    Jo, it seems to me the Claims Management just totally abuse the Conciliation process and the Injured Workers who take them there. I found I’ve become more and more unbalanced as my Conciliations have stretched out over 9 months, with no real progress made. Same old story, lost documents, no rational responses from Insurer to correspondence from the Injured Worker, a different CM rep every time so it’s like starting all over from the beginning. the Conciliators in my case have done their best to move my matters along in the face of all this. I’ve requested Genuine Dispute Certificates to be issued so I can go to Court and get it over with.

    The system is rotten to the core. Even the legal system shows a parasitic and biased face in the Workover. No win, No fee lawyers judged my case (They never even sounded like they’d read it!}, and manipulated  me to accept an unsustainable pittances for compensation. I never get anywhere near the Courts! It’s all done behind closed doors in back rooms. Then the Workover refused to retrain me or support my return to a working life. Then I had another major breakdown and ended up homeless when the money ran out because the Disability Pension won’t pay for private rental that suits my impairments, and Public Housing is in crisis. It’s a wicked and corrupt system from my experience.

    As injured workers, many of us fight and record our individual battles and complaints with the system. One voice in the void is inaudible. One voice in a crowd is magnified many times. It’s time for Injured workers to get together and work out ways they can campaign effectively against the Workover.

    • Jo August 22, 2013 at 12:37 PM #

      Pauline, In an ideal system you should not have to take the matter to a Court! This needs to be settled through the ACCS; if the Insurer has been proven to have done something wrong or has not paid proper attention to the Person they need to be financially fined so they eventually learn mistreating an injured vulnerable person is not tolerated.

      The way the system seems to be now is we the injured are treated like some sort of criminal, and the Insurer in a hell of a lot of cases is doing harm to people instead of treating them with respect and some compassion.

      My Doctor has suggested I ditch Worksafe and go on a Centrelink pension to reduce stress! but I shouldn’t have to do this.  Here’s another idea how about Centrelink handle the administration of permanently Injured people and they just invoice the Insurer??

      What ever happens there needs to be BIG changes to the Worksafe system!!

      • Pauline Pope August 22, 2013 at 2:28 PM #

        I’m with you on that Jo! We are treated worse than accused criminals, guilty till proven innocent, and guilty ever after in the Workover. Adversarial law has only destructive effect in the workover, and most of it is worn by the Injured Worker and the rest by the Public Purse. Legal pursuit of an injured and traumatised person is a form of torture, and ultimately always health reducing.

  12. Jo August 22, 2013 at 1:57 PM #

    This was taken from ABC Victoria and was 2 years ago so not much has changed:

    SHAUN MARCUS: There is just nearly no accountability for the WorkCover agent or for an injured worker to get that money out of the WorkCover agent more importantly and the appeal mechanisms or the resolution mechanisms are just timely and cumbersome.

    http://www.abc.net.au/pm/content/2011/s3228087.htm

  13. Pauline Pope August 22, 2013 at 2:37 PM #

    Getting money out of the Workover? I’d rather try for blood from a stone. I once had CGU withhold a $500+ refund from me for two years as I lumbered up and round and about through the right channels to trying to get my refund paid! Then they found out they had paid me $200+ that was meant for my Psychiatrist. I had been ringing them, writing them for two years trying to find out what this unexpected and unaccounted for payment was. They just kept ignoring me, till one day (long before my big refund was paid) they sent me a letter saying I owed them this money and if I didn’t pay it back in a fortnight they would take me to Court! How nasty and one-sided is this System? I won the complaints battle on that one and got a written apology, a reasonable request to repay the money – which I promptly did, and the promise that the partiicular form letter they’d sent me would be re-written so as not to carry or imply any threat to or judgement of the Injured Worker.

    We have to enjoy our little victories. My Case Manager at the time rang me to tell me that she and the other workers were well pleased to see the end of that particular letter, as they hated sending them out to Injured Workers!

  14. Jo August 29, 2013 at 3:40 PM #

    The way things are Pauline I would not trust or believe anything a case Manager said now, they say one thing and do another.

    They will put on a great act to appear they are on your side, its in their best interest to stay in contact with you; for example one of my previous case Managers that I thought was OK rang me to ask how I was and if he could help me with anything, then while he had me check my details were up to date (I was in the process of moving) about an hour later a Car stopped in front of the new place and later an unknown Man came onto the property and tried to look into a window frightening my Daughter. Silly naive me just thought it was something to do with the last resident.

    Years later I pieced it together when I finally got a covert surveillance log describing the surveillance people couldn’t see any activity at the residence I was moving from so one of them went onto the property and peeked through a partially open Blind to find hardly any Furniture.

    If they tell you they were pleased to see the end of a letter they are just trying to patronise you! NEVER NEVER NEVER NEVER have any trust in what they say please.

  15. Pauline Pope August 29, 2013 at 4:20 PM #

    Definitely don’t trust any I’ve had lately, Jo. They turn over more often than me on a sleepless night. I’ve taken to making it all my fault (something they’ve been trying to convince me of for oh, ten years), that way I can give myself points everytime the latest one leaves.

  16. Jo September 5, 2013 at 4:19 PM #

    Thats a good way to think about it Pauline, I manage to keep mine for a couple of years at a time now, but a few years back they’d only seem to last 3 months before I got another. Maybe this is why we now get senior case Managers to handle the file and the junior one’s do the leg work? sort of a probation to see if they’re going to stay.