The deposition may reveal that the doctor never even looked at your old medical records and spent only minutes examining you. Get a free claim assessment from a local attorney. Sometimes they don't even perform a physical examination before rendering their opinion. As a practical matter, however, you may feel that it is necessary to do so. 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. This is a doctor that is different to your normal treating practitioner. Independent medical exams requested by disability insurance companies can be dangerous. In fact, most often, the insurance company is the one paying for the exam, so you should be aware that even a small discrepancy between what you say is a limitation and what youre showing in the way that you behave can cast doubt on your truthfulness. He has built a successful law practice by thoroughly educating, honestly helping, and successfully representing workers throughout Washington State. Don't guess about the value of your claim. In most cases, the adjuster working your claim chooses the IME doctor you will be required to see. Because of their financial interests, some doctors may order unnecessary or questionable tests or medical treatments hoping the insurance company will pay for them. What is the Workers Compensation Appeals Board and How Does it Work? After all, there are a lot of factors that can affect a workers comp claim. There might also be an arbitrator, who will decide whether the IME doctor or your doctor is more credible. The answer is the Independent Medical Examination or IMEalthough as you'll see, an IME is hardly "independent.". For additional information concerning the amended law, see. Florida Workers Comp Laws: A Quick Guide for Injured Workers. 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. It is generic information for informal purposes only. There is no such thing as a truly independent medical exam. Are you entitled to financial compensation for your work injury? In many cases, they will have a financial incentive to send an employee back to work because of their relationship with the employer. 12 MUST KNOW Facts about Filing for Workers Comp, Workers Compensation for Exposure to Viruses, Harmful Substances, and Dangerous Environments, Seeking Workers Compensation for a Concussion. During the IME examination the examining doctor makes an assessment of the injury victim, including: General Appearance. Its easier for the IME doctor to just side-step having to deal with your frustration or controversy with the insurance company. Questions are answered and no time is wasted. In cases like this, an experienced workers compensation lawyer like Victor Malca can help you. I am a restaurant manager for a very busy chain restaurant. The simple answer is that IME doctors arent always right. Our team of experienced attorneys are here to help, and your consultation is free. Also, IME doctors do not always have all the treatment records. If theres a discrepancy in the IME doctors report, you should gather evidence to disprove it. Why? You must complete a travel reimbursement form within one year of the exam and include your receipts. IME doctors understand that if they consistently side with the disabled claimant, they'll lose UNUM's business. Can I Get Disability After Getting Workers Comp Settlement? if (scrollToPosition < 0) { scrollToPosition = 0 } // make sure it is not negative Can Illegal Immigrants Claim Workers Compensation? If you are eligible for workers compensation benefits, the costs of diagnosing and treating your injury should be fully coveredat least until you reach maximum medical improvement (MMI). His law firm is helpful, honest,, What is an L&I Settlement? Take your choice: We usually reply to forms, texts, and emails within 1 business day. 250 (1964). It is NOT formal legal advice. RCW 51.32.110 (3), WAC 296-20-1103, and L&I Claim Adjudication Guidelines. Of course, the insurance company will refuse to pay for any treatment not recommended by the IME doctor. This website contains general information that may not reflect current legal developments, verdicts, and/or settlements. Chris has been helping injured Washington State workers for over 40 years. Your use of this site does NOT create an attorney-client relationship. Does that sound independent to you? Frequently, the IME doctor will talk to the insurance adjuster or the defense lawyer before conducting the IME exam and/or before writing his or her IME report, to make sure it helps out the insurance company position. I was walking past. No recipients of any content from this website, clients or otherwise, should act or refrain from acting on the basis of such content, without first seeking the appropriate legal and/or other professional advice on the particular facts and circumstances at issue, and from an attorney and/or professional who is licensed in the recipients state. Strictly speaking, you do not have to go back to work when an independent medical examiner disagrees with your doctor. A free phone consultation or email gets that figured out quickly. Insurance adjuster requesting IME 6 months after injury? We were told that it was because they determined my injury was a new injury and not related back to my original injury. You will need to work with an experienced lawyer who can dispute the IMEs report and file a claim with your states Workers Compensation Commission or Workers Compensation Appeals Board if necessary. I work in an industrial warehouse and was moving a large bin full of pipe chambers when I felt a pop and pain in my, I have a workers comp case where I have a herniated disc and it was discovered in the MRI and X-Rays that I have a. In this case, the "independent third party" refers to the IME doctor. Are you going to let them do this to you? } First of all, you should take accurate notes about how long youre there, when you arrive, and when you leave. Review exactly how the accident happened and be prepared to re-tell the details to the IME doctor. Here are the steps to take if you are wondering, What should I do when an IME doctor disagrees with my doctor?: When an independent medical examiner disagrees with your doctor, this is not the end of your workers compensation claim. Some states also require that the medical institutions they work for must be HIPAA compliant. Book a free consultation today. A lawyer can help mitigate that impact and perhaps improve chances of a favorable settlement. Who Are These Independent Medical Exam Doctors? You need to be careful when you leave the doctors office where your IME evaluation is done. He can help you contest your IME doctors opinion and get the benefits you deserve too. They are doctors are engaged by the WorkCover . Suite 1202, Even if you brought a witness to take notes during the IME, make your own notes about the exam while its all fresh in your mind. Remember that insurance companies often have injured workers under surveillance. You wont often find doctors certified in surgery, orthopedics, or other specialties performing medical evaluations for workers comp insurance companies. To remain on the list for workers comp referrals, some doctors may classify patients as malingerers, rather than diagnosing real pain issues and injuries with implications for disability claims. At the same time, however, going back to work too soon could be dangerous. Even when doctors would normally recommend those diagnostic or therapeutic services, in workers comp cases, they wont mention it to the injured worker. This doctor may try and trick or confuse you with his tests - Give genuine effort and honestly communicate your pain levels and limits. Because both you and the attorney want to know if your case is any good. Minor complaints, such as rudeness, can be handled by sending an IME comment form to L&I at the following address: IME Provider Review L&IPO Box 44322Olympia, WA 98504-4322. How Long Does It Take To Get Disability Check After Approval? Get started with a free case assessment online 24/7. To do so, IME exams are scheduled with doctors who will help them manage a claim. He then said that if Dr. Demeter does not exam her, then her benefits will be denied. Self-Insured employers. Try to get a copy of that letter. In fact, it is very common for IME doctors to have different opinions than treating physicians. If IME doctors tell you differently, they are wrong. Before the hearing, your lawyer may need to take the deposition of the IME doctor. The accuracy of information provided on this site is not guaranteed. Can You Claim Unemployment and Workers Comp at the Same Time? Nothing personal for them you are just a claim number. Call Dabdoub Law Firmtoday at (800) 969-0488 to speak with an attorney about your case. Depending on where you live, this may be a doctor of your own choosing, or it may be a doctor who has been pre-selected by your employer. You need to know if the insurance company has incorrect information about you, so you can correct mistakes. If the IME doctor agrees with your doctor in terms of the treatment that you're 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. Workers comp independent medical examiners know that if they verify the severity of your injuries, the insurance company will have to pay your benefits accordingly. If your IME doctor isnt licensed or doesnt meet the states qualifications, then they have no business conducting IMEs. But, the workers compensation laws in most states place limits on when insurance companies can require independent medical exams. Judy Ponio is a writer and editor for the Victor Malca Law P.A. Contact us today to schedule a complimentary and free case evaluation and learn how we can help you. If your IME doctor neglected to include such detail in their report, you should write to your insurance company and inform them about it. (You can read more in our guide to handling an IME.). The doctor will then use this information to determine whether they agree with your personal doctor or not. Virginia Beach, VA 23462 (757) 455-8889 (888) 694-1671 (757) 455-6757 Elizabeth City Office (by appointment only) 507 E Main St #K There are three types: PERMANENT PARTIAL, Who is Christopher Sharpe? Suite 1202 This article was reviewed by Victor Malca a licensed workers compensation and social security disability attorney at law for over 27 years. But if you feel that the IME doctors recommendation is detrimental to your health, you should tell them so. Its up to the injured worker to stand up for themself and fight back against these dirty tactics. If you havent been able to dress yourself since the accident, or sometimes have trouble making it to the bathroom in time, you must speak up. An Independent Medical Exam (IME) is an opportunity for the employer (really the employers workers compensation insurance company) to have you examined by a doctor of their choosing. if(hash != ""){ The workers comp doctor isnt there to treat you or help you deal with your work-related injuries. If you dont like what L&I is doing to you, you must do something about it. The carrier often has an investigator record video of you the day before the exam, the day of the exam, and the day after the exam to try to find inconsistencies. They told me it was just a bad ankle sprain. To reduce the perception of bias, a random selection of IME doctors . console.log("hash::"+hash); What will the state agency do? When there is a question about what kind of benefits an injured employee should receive, a California QME is the type of physician who evaluates the employee. Virtually all state regulations permit you to be treated by your own doctor, but your claim is highly dependent on the medical opinion of the doctor from the insurance companys approved list. Its a good idea to bring someone along. An observer cannot legally record an IME. 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. Said that I had not returned to my pre-injury levels. . Some injured workers do not realize the negative impact that the IME report can have on the insurance companies valuation of their cases. scrollTop: jQuery("#"+anchor_id).offset().top - 200 There are several things that you should take note of. Like the doctor who orders custom braces or orthotic shoe inserts that can only be made by a company owned by the doctor. Given all of these issues, you might be wondering if you have to go to an independent medical exam. An IME 1600 Ponce de Leon Blvd Do not let the insurance company push you back to work before you are ready you could get injured again. 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. Incorrect information about you, so you can read more in our Guide to handling an IME )... All the treatment records know if your case law P.A before the hearing, your lawyer may need be... Your pain levels and limits 800 ) 969-0488 to speak with an about. Reflect current legal developments, verdicts, and/or settlements the perception of bias, random! An independent medical exams requested by disability insurance companies can require independent medical exam Board and how Does it to... Claim assessment from a local attorney new injury and not related back to work too could... Them you are just a bad ankle sprain time, however, you gather. 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