For many in case management, they have difficult with what is often a _hunch._ They suspect that an injured worker is not being honest, often about their history, sometimes about their injury, many times about their care, and frequently about their limitations. They feel one way; someone else seeing the patient feels another way.
To get to the bottomline and help this patient, you have must provide to a neutral party all of the medical records including pharmacy records. That examiner must have access to the primary physician_s notes and often to the primary physician him/herself.
Patients often erroneously believe that there is no communication between offices. If they distort information in one way in one office, they think they can then change those data in the next office.
An ideal exam entails not only a complete history of development, work, injury and care, but it also feeds back to the patient the discrepancies noted and asks for an explanation.
Patients may become angered and defensive, but they are also aware that that the altering of information between offices is ineffective if they are to be helped.