Saturday, February 7, 2009

Work Comp. Independent Medical Examination (IME)

If you've sustained an injury at work, and your employer or the insurance company has scheduled you for an Independent Medical Examination (IME), there are a few things you should know.

First, you are generally required to attend this examination. To find out if you have to go, contact your attorney. If you don't have an attorney, give us a call at 877-746-5680 for a free consultation.

If your employer and their insurance company are requesting that you attend an Independent Medical Examination (IME), generally, it means that they are looking for a basis to discontinue some or all of your workers' compensation benefits.

You should also be aware that the doctor who conducts the "Independent" Medical Examination (IME) is paid by the insurance company. While in theory, doctors conducting IME's are supposed to be objective, in reality, the opinion issued by the IME doctor is generally not favorable to the injured worker.

Unlike when you visit your regular doctor, no doctor-patient relationship is created when you are examined by the IME doctor. Therefore, nothing you tell the doctor is privileged or confidential. You should also be aware that the doctor will not provide any treatment for your injury, nor will they recommend treatment or refer you for additional medical care or treatment.
The only purpose of an Independent Medical Examination (IME) is to get an expert opinion regarding the cause, nature, and extent of your injuries.

You should be aware that a scheduled IME can generally only be canceled for emergencies. You should also plan on being there about 20 minutes before the exam is scheduled to begin. If you are late, or if you miss the exam, the insurance company may try to charge you for the missed appointment.

Typically, the doctor will ask you regarding your past medical history, and will generally conduct a physical examination. Just be honest about your medical history, and be honest about your current injuries and symptoms. It is a good idea to make note of the type of examination the doctor conducts. Did he have you touch your toes? Did he touch your back? Did he rotate your shoulder? Did he lift your legs up? How long did he spend examining you?

After your examination, the doctor will issue an opinion. You and your attorney should be provided with a copy of this opinion.

What the doctor says in his or her opinion can have a serious impact on your right to benefits. For example, the doctor may conclude that your injury is not related to your work, which gives the insurance company a basis to deny both wage loss benefits and medical benefits. The doctor may also determine that you have reached Maximum Medical Improvement (MMI), which means that the doctor believes that no further significant recovery from or lasting improvement to your injury can be reasonably anticipated, regardless of your subjective complaints. Your entitlement to Total Temporary Disability (TTD) benefits ceases 90 days after you are served with notice of Maximum Medical Improvement (MMI). Finally, the doctor may conclude that medical treatment you have received in the past was not reasonable or necessary, which gives the insurance company a basis to refuse to pay for your medical bills.

While you shouldn't get upset if the IME report is not favorable to you, it is important that you contact an attorney if you do not already have one. Your attorney can challenge the doctor's opinion by a variety of means, including obtaining a report from one of your treating physicians. While an IME opinion can provide an insurance company with a basis to deny your workers' compensation benefits, there are many ways to challenge their denial.

If you've been scheduled for an IME, often the insurance company is looking for a basis to deny your work comp benefits. If you do not already have an attorney, you should contact one as soon as possible. Call Meuser & Associates at 877-746-5680 to schedule a free consultation. Click here to send us an e-mail. We can help you get the benefits you are entitled to, and we can help you keep the benefits you are currently receiving.

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