Independent medical examiners routinely dispute doctors treatment recommendations. Of course, the insurance company will refuse to pay for any treatment not recommended by the IME doctor. An independent medical examination (IME) is. Don't compare your claim to someone else's. The doctor will send a report of the exam or test to the state agency. On Jan 2nd 2015 I was battered by a patient of my employer. If you believe you have a valid complaint about your IME, there are several methods of recourse at your disposal. Click the button below to find out in 60 seconds or less! Ex. My husband felt a sudden snap in his arm while working. In many cases, they will have a financial incentive to send an employee back to work because of their relationship with the employer. Most insurance companies permit an injured worker to have a second evaluation from another doctor on their approved list. //anchor_id = anchor_id.replace("#", ""); If an independent medical examiner says that you are ready to go back to work but you are concerned this might not actually be the case, there are some steps you should try to take as soon as possible. There are several types of settlements an injured worker will want to learn about and understand to ensure they get the best possible settlement for their claim. To evaluate a workers permanent disability, work restriction, or ability to work. That I could not return to my position without set restrictions. Theyll be looking to see if you hop easily out of your car and walk briskly to the building, only to limp and groan as you struggle to ease into a chair in the waiting room. Before the hearing, your lawyer may need to take the deposition of the IME doctor. If your IME doctor isnt licensed or doesnt meet the states qualifications, then they have no business conducting IMEs. Don't guess about the value of your claim. I have my follow up appointment with my doctor this week as I have been signed off work since my injury. Do You Need Free Workers Comp Legal Advice? Can You Claim Unemployment and Workers Comp at the Same Time? Under the Workers Compensation Act your employer or its insurer can force you to attend one IME per medical specialty per year. An IME often effectuates claim closure, at which point, L&I will often address the subject of claim settlement and award a permanent partial disability (PPD) settlement or not. Independent Medical Exam (IME) Doctor - These doctors conduct IMEs on behalf of the insurance company. Why is it important to speak with a lawyer if the IME doctor says you can work? So, if youre asking, The IME doctor says I Can work, whats next? The simple answer is that you should contact a lawyer promptly. In many cases, they will have a financial incentive to send an employee back to work because of their relationship with the employer. Think about that. In either case, your doctor should provide a comprehensive diagnosis and prescribe a treatment plan that gets you back to work as safely and quickly as possible. Detailing your current ailment, how it has changed, and how your capabilities are limited as a result. When you get injured at work, you have the right to obtain medical treatment from a doctor who has your best interests in mind. I was using an electric pallet jack and the machine surged backwards, pinning my upper arm next to a beam and piece of steel. Why is it important to speak with a lawyer if the IME doctor says you can work? Some of the reasons why this can happen are because: When there are differences of opinion regarding your condition, the insurance company will side with whichever report they deem the most credible. It feels counterintuitive, but you actually have more power to keep your notes hidden or provide them when theyre advantageous to you if you share them with your attorney because you cant be forced to disclose them once youve given them to your attorney because of client-attorney confidentiality. In these situations, the Department of Labor and Industries (L&I) will attempt to pound the final nail in the coffin, using an Independent Medical Examination (IME), to end the injured workers claim. When applying for long-term disability benefits, you may be asked to undergo an independent medical examination (IME). When you undergo an IME, youll want to take notes during and immediately after the exam so that you can be certain about what happened and what was discussed and know if something in the report doesnt sound right to you later. Contact your claims adjuster immediately and request a different date. The doctor is not asked to make a disability decision and when the consulting doctor's report is received, the DDS examiner reviews the report to be sure that the conclusions the doctor has drawn from the examination are supported by clinical observations or testing cited in the report. While it might be okay for you to return to work, it also might not. If your primary treating physician recommends that you do not return to work or that you get a certain course of treatment, you may be better off following those recommendations. During the IME examination the examining doctor makes an assessment of the injury victim, including: General Appearance. Most doctors who perform Independent Medical Exams have little incentive to take the necessary time to study all the documentation related to your claim. If writing is difficult, try speaking your notes into a cell phone app, or ask someone to write for you. Joe Osterbauer, Esq. The workers compensation insurance company is allowed to order an IME (or 2 or even 3) for several different reasons but, basically, an IME is in exam by an independent medical doctor. Additionally, if your condition would prohibit you from driving a car, walk up a flight of stairs, or do any other activity that you might need to do to get home, know that there might be someone watching you to see if you do these things. On the contrary, most of them are instructed to disprove your claim. jQuery(".on-page-links ul > li a").click(function(){ Click here to see if you qualify now. These questions look like this: The truth is IMEs are a complete sham that claims managers use to deny medical attention and close claims. If you need to go to an independent medical exam, your attorney can explain what you need to say, what you should not say, and what you should do once the appointment is over. How Do You Verify if Your Employer Has Workers Compensation Coverage? My finger got caught in a shopping cart and then smashed on a conveyor belt while I was working in the state of Hawaii. IME stands for "Independent Medical Exam." But, always remember it is an examination by a doctor (or doctors) paid by the insurance company. But if you feel you are being played by the workers comp insurance company, or you arent sure youre getting the benefits you deserve, dont wait to protect your claim. The more patients pushed through in a day, the faster the fees rack up. We never represent the employer or insurance company. With the nurse case manager in the room, anything you say or do during the examination can be used against you. Given all of these issues, you might be wondering if you have to go to an independent medical exam. 8123 (a). If youve been injured in an accident, you may qualify for a settlement. If your case is taken to court, the judge will most likely believe the IME doctor more than you or your treating doctor. When you click the button you will be redirected to LawsuitInfoCenter.com. Cloud, Eagan, Woodbury, Maple Grove, Eden Prairie, Coon Rapids, Burnsville, Blaine, Lakeville, Minnetonka, Apple Valley, Edina, and St. Louis Park. If the IME doctor agrees with your doctor in terms of the treatment that youre receiving and your overall abilities and disabilities, your employer will act in accordance with what the IME doctor has proposed for your treatment in the workplace. For example, if Dr. Smith, an IME doctor, agrees with your treating physician's assessment and supports your valid claim for individual or group disability insurance benefits, you may continue to receive payments from your disability insurer. By submitting, you agree to the Terms & Conditions. The IME doctor will look for any inconsistencies in your behavior. And as such, the WorkCover insurer refuses to pay for any medical treatment related to the depression. Step". The 120-day requirement is waived for consultations and requests of the attending provider or if so, requested by the worker. Nothing on this site should be taken as legal advice for any individual There are several ways in which the team at Osterhout Berger Disability Law can help you receive the benefit you deserve. Unfortunately, based on your answers we cant provide a case review. As a result, lots of insurance company-approved doctors are more likely to treat injuries with pain medication. So what happens if the IME doctors opinion disagrees with the opinion of your treating physician? In cases where your employer's insurance company disputes your injuries, illness or disabilities, they may ask you to undergo an independent medical examination (IME). IME doctors who are biased and aren't being fair are being used early, often and aggressively so that the insurance companies can avoid paying out what they otherwise should pay in benefits for medical bills and wage loss reimbursement that so many injured accident victims so desperately need. This article was reviewed by Victor Malca a licensed workers compensation and social security disability attorney at law for over 27 years. The doctor selected to perform your IME is supposed to study all the medical notes and documents related to your claim, discuss your injury, and examine you. Very few of them are active medical professionals. Our unwavering advocacy for employee rights and privileges are recognized by our past clients across South Florida. Virginia Beach, VA 23462 (757) 455-8889 (888) 694-1671 (757) 455-6757 Elizabeth City Office (by appointment only) 507 E Main St #K Most IME doctors don't treat patients. Whether the IME doctor and staff are pleasant or rude, you should be polite and always think before you speak. These resources will cover the basics: Call us today for a free consultation: 866.438.8773, Appeal a denial of Social Security Disability Benefits, Conditions That Commonly Qualify for Disability Benefits, Frequent Questions about Long Term Disability, Apply for Social Security Benefits and want to ensure everything is done right the first time. Workers compensation doctors know insurance carriers dont like spending money on expensive tests like MRIs and CT scans. scrollTop: jQuery("#"+anchor_id).offset().top - 200 In this case, the "independent third party" refers to the IME doctor. A free phone consultation or email gets that figured out quickly. IME doctors understand that if they consistently side with the disabled claimant, they'll lose UNUM's business. Why Is an Independent Medical Exam Being Scheduled? Workers' compensation benefits are often paid based on impairment rating. Protect yourself and your L&I or Personal Injury claim with a free case consultation. You have 60 days from receipt of this order to protest or appeal the L&I Decision. careful about your next steps. FAQs How Can You Get Free Legal Advice for a Work Injury? Plaintiffs should assume that any staff members present at the doctor's office . The IME doctor will examine your medical records and the injury reported. How To Write A Disability Appeal Letter (With Sample). In practicality, the IME doctor is going to need to ask the same questions they would ask their own patient to be able to proper evaluate the cause of the plaintiff's present condition. Questions about hiring an attorney? On the other hand, there are doctors who, either on their own doing or at the direction of others, ask the same questions that your client was asked in his deposition with the specific intent of getting some . I was walking past. Yes, the doctor should have that information from your medical records, but they may want to hear it from you. The accuracy of information provided on this site is not guaranteed. This website contains general information that may not reflect current legal developments, verdicts, and/or settlements. It is not uncommon to see IME reports saying, . If the IME doctor agrees with your doctor and supports your injury claims being related to the wreck caused by the defendant insured with that insurance company behind all of this, then the IME doctor would not be involved in the case any further. An independent medical examination (IME) is usually requested when theres doubt about your workers compensation claim. Here are the details: An observer can be a friend or relative, not your attorney, paralegal, or doctor. The observer can attend the physical examination but not the psychiatric assessment as per WAC 296-20-2025. This observer can see and take note of anything the IME doctors do which may not be appropriate. Reasonable requests should be accommodated. Sometimes, they may even hold more weight than that of your doctor. You must complete a travel reimbursement form within one year of the exam and include your receipts. Get started with a free case assessment online 24/7. There is no such thing as a truly independent medical exam. The trial court agreed, but the reviewing court reversed, finding the decision "erroneous." (Carpenter, 141 Cal.App.4th at 272.) If L&I requests a legitimate IME, it is extremely important for the injured worker to arrive alert and prepared for the examination. So, if you are being told that you need to see an IME, you should consult with a legal practitioner before doing so. Conclusions in the report must be consistent with the objective clinical findings found on examination and the claimant's symptoms, laboratory studies, and demonstrated response to treatment and on all available information, including the history. Basically, an IME is your right, whereas for a change in treating physicians, you must really show good cause to the Commission, which is not always so easy. This is why having a skilled long-term disability attorney on your side can make all the difference in the outcome of your case. As [] Find out now with a FREE case review from an attorney, So far so good! Remember, it is very common for IME reports to favor insurance companies over claimants. If you are currently represented by an attorney, you should strictly abide by his/her counsel. The physician treating you has seen you several times, which means they should better understand your injuries. Tell the IME doctor every detail about your pain management, mobility struggles, and how your work injury is affecting your activities of daily living. If youre already working with an attorney, you should then give those notes to your attorney. jQuery("html, body").animate({ Most attorneys offer a free consultation and most states limit legal fees for workers comp cases. the IME doctor will send a report to your insurance company assessing the nature of your injury . Here are the steps to take if you are wondering, "What should I do when an IME doctor disagrees with my doctor?": Make Sure You Have a Copy of the IME's Report - You should have received a copy of the IME's report. These will be paid at the current department rate. What is the Workers Compensation Appeals Board and How Does it Work? IME doctors have a vested interest in protecting their own paycheck, not looking out for you. How can I get my doctor to put me on full work restriction? Can Illegal Immigrants Claim Workers Compensation? Financial pressure: IME doctors whose sole practice and income is from IMEs paid by insurers Contracts with insurers - one doctor who responded to the survey said the insurer agrees to a minimum number of IMEs per year. Recalling the length of your visit with the IME doctor as well as what they said and did during the examination. Dabdoub Law Firm is a highly specialized disability insurance law firm based in South Florida offering representation to disability claimants across the country. The IME doctor may be expensive and the veteran must pay the bill up front and out of his/her own pocket. When an injury is severe enough, the injured person may never recover from the unrelenting pain and permanent disability. The bottom line is that every case is different, but if you are being asked to go to more than one IME it's at least suspicious and potentially against the law. An IME is an examination scheduled by the Indiana Work Comp Board, and this report will be very important to your case. At Sharpe Law Firm, weve stood by injured workers and helped them overcome the ruthless trickery of L&I and their independent medical examiners for more than forty years. Dont try to conceal pre-existing conditions. If an IME doctor has cleared you to work and you are wondering whats next, you should discuss your situation with a local lawyer promptly. We respect your privacy. Unfortunately, based on your answers, we will not be able to help you. Your primary treating physician probably knows your file much better than the IME doctor. An IME is supposed to be an objective assessment of your medical condition, including what treatment you need, whether you have a permanent impairment and to what degree, and your ability to work in the future. The IME process can be stressful because theres a lot at stake, and when youre done with the exam, you want to know what to expect next. Does Winning The Lottery Affect Your Social Security Disability Benefits? Theoretically, they should be. scrollTop: jQuery("#"+hash).offset().top - 200 If this answer was helpful, please mark as helpful below. They told me it was just a bad ankle sprain. Do not let the insurance company push you back to work before you are ready you could get injured again. You just received the independent medical examination report, and the doctor disagrees with your primary treating physician about nearly everything. They can also track how much time was spent examining you versus how much time was spent reading your health records. An observer can help keep the IME doctor honest. The nurse will report anything you say or do to the insurance company with no regard for your personal privacy. Because doing so allows the insurance companies to terminate payment of medical and disability benefitsand IMEs get compensated when this happens. jQuery("html, body").animate({ scrollTop: scrollToPosition }, 1000); Try Avvo Advisor at instant.avvo.com if you want to speak directly with myself or another attorney right away. Do I need to ask for a work release note from my doctor? (You can read more in our guide to handling an IME.). Several circumstances may cause the insurance company to request that you submit to an Independent Medical Examination (IME). How Long Does A Social Security Disability Review Take? For example, if your doctor agrees with the IME and says you are fixed and stable then L&I will move to close the claim. There are ways you can reduce the amount of weight an IME report will have on your case, such as: An IME report will lose credibility if the physician simply had one short visit with you or didnt do much to examine your condition or ask you pertinent questions. And insurance companies arent exactly known for their generosity. In this case, the insurance provider can stop paying your claim. Also, IME doctors do not always have all the treatment records. Florida Workers Comp Laws: A Quick Guide for Injured Workers. Researchers discovered that there are over 4.5 million workplace injuries every year, and workers' compensation claims payouts totaled some $62 billion in 2017 a staggering amount of money. My lawyer refused to go to this new doctor as they already had established an IME doctor for my case. For example, she may disagree with your doctor about your pain or mobility level and when you should be released to go back to work. In Nov, 2009, the work comp carrier wanted me to go to another IME with a new ortho doctor from Madison. I recently accepted and. In Hoover, the employer required employees get medical evaluations from its doctor. It is your choice. SAVE YOUR RECEIPTS!!! During this process, a doctor looks at your previous medical records and does an examination on your to determine whether or not you fit the qualifications. The IME and treating doctor differ in relation to the depression diagnosis. Does that sound independent to you? You only get a short period of time to salvage what you can from your L&I claim. For example, for every impairment rating from 1-10%, the employee will be entitled to two weeks of benefits per percentage point. With this, its inevitable that the IME doctor will disagree with your treating doctor. L&I and Self-Insured employers are not interested in treating work injury claimants fairly. The authority for second opinion medical examinations is found at 5 U.S.C. 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