He has no doctor-patient relationship with you so he can say whatever he wants in his report to the insurance. But the more he says that is beyond the medical facts, the less believable his whole report becomes. I would be very happy if I were a lawyer in a case where the IME doctor wrote all kinds of medically irrelevant BS in the report making personal judgments about the client. If he judges you based on your tattoos, it implies that he did not judge you based on your medical condition. That is good for you.
Can he do it? Yes. He is permitted, and even required, to state his conclusions in the case. However, the unprofessional things he did that you describe make it reasonably likely that his conclusions will not carry much weight with the trier of fact. A tattoo has no bearing whatsoever on whether the person needs pain medication.
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Dismissive conclusions from a 5 minute diagnosis mean little. I can see from my colleagues answers that perspectives on tatoos vary around the state. Tattoo artists in my county are not allowed to practice their craft while on probation. If you have a drug history, you should not of course take narcotics. But, if not, medications can be prescribed.
We do not have a client/attorney relationship until you make an appointment, we discuss your case face to face, I accept a retainer, and we explictly agree to enter into representation.