To resolve a new medical issue, after the filing of an appeal, or to assess case progress. It is unlikely to help your case. Examining physicians spend lots of time with your medical records and only a little time examining you. With that said, if you dont do anything, your workers compensation claim will be over. jQuery("html, body").animate({ Note: This page was last updated on February 21, 2023. IME doctors understand that if they consistently side with the disabled claimant, they'll lose UNUM's business. Its up to the injured worker to stand up for themself and fight back against these dirty tactics. They wont be allowed to speak but ask them to take notes. 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. Do I have recourse after I was kicked off Workers Comp because of an IME? Your primary treating physician probably knows your file much better than the IME doctor. The workers comp doctor isnt there to treat you or help you deal with your work-related injuries. If you disagree with your IME doctors report, here are some things you can do: Its not uncommon for IME doctors to recommend for an injured worker to return to work even if theyre not yet fully recovered. 250 (1964). That is not "independent." Instead, expect the IME doctor to disagree with the doctors you have hired to provide your medical care. Protect yourself and your L&I or Personal Injury claim with a free case consultation. You have NO right to confidentiality with this medical exam. Independent Medical Examination doctors can be tricky, so keep the following in mind: The exam is converted into a report. In some states, that should be taken into account when calculating your workers comp benefits. Who was involved, did you require medical treatment, how can we help you? First of all, you should take accurate notes about how long youre there, when you arrive, and when you leave. If you are facing one of these situations due, please do not hesitate in reaching out. The. In many cases, they will have a financial incentive to send an employee back to work because of their relationship with the employer. Independent medical exams requested by disability insurance companies can be dangerous. We help individuals who need to. This medical opinion is sometimes based upon surveillance video obtained by the insurance company through private investigators. Nothing personal for them you are just a claim number. The insurance company will send copies of your medical records to the IME doctor well before the scheduled exam date, usually along with a cover letter telling the doctor what they want to know about your condition. //anchor_id = anchor_id.replace("#", ""); The good news is your claim wont end just because of two doctors differing opinions. jQuery("html, body").animate({ scrollTop: scrollToPosition }, 1000); Copyright 2005-2022 | All Rights Reserved Worldwide. His experience and continued success when fighting for his clients puts him among the most trusted workers compensation attorneys in Florida. Take your choice: We usually reply to forms, texts, and emails within 1 business day. Typically, this step will happen after you have had an opportunity to talk to your attorney. They usually send a copy to your doctor with a cover letter asking them to agree or disagree with the IME report: Doctor, if you disagree, write a lengthy report. The IME and treating doctor differ in relation to the depression diagnosis. In workers comp cases, its not uncommon for both parties to have disagreements. Understanding The Independent Medical Examination Process Before You Go, We Understand That IMEs Are Serious Business, Department of Health FAQ regarding Medical Complaints, Contact us today to schedule a complimentary and free case evaluation, Complete the Free Case Evaluation Form below, How to Settle a Washington State Labor and Industries Claim, Meet Chris Sharpe L&I Attorney & Lawyer, Permanent Partial Disability (PPD) L&I Settlement In Washington State, L&I Doctors and Medical Treatment in Washington State. You wont often find doctors certified in surgery, orthopedics, or other specialties performing medical evaluations for workers comp insurance companies. Please be sure to indicate the best answer. You consent that the law firm you are matched with or a call center may contact you by phone and/or text, even if you are on a Do Not Call Registry. Coral Gables, FL 33134. If you are experiencing this dilemma, heres what you need to know. 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. The process of choosing an IME doctor varies from state to state. Back injury preventing me from working. In this case, the "independent third party" refers to the IME doctor. }); They are not independent and are not medical exams. How can I get my doctor to put me on full work restriction? Its a good idea to bring someone along. An observer cannot legally record an IME. } Some states also require that the medical institutions they work for must be HIPAA compliant. Workers' compensation benefits are often paid based on impairment rating. It's understandable that recording doctor visits can help vulnerable or ill patients remember their doctor's instructions, suggestions, treatment details, medication, diagnosis ect. 73 Going to a Second IME Exam I had an IME exam in 2009. 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. How Long Does It Take To Get Disability Check After Approval? Get your doctor to write a helpful report outlining their disagreement with the incorrect IME findings and conclusions, including their own findings and conclusions. The Law in All 50 States. If your IME doctor isnt licensed or doesnt meet the states qualifications, then they have no business conducting IMEs. 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. Contact your claims adjuster immediately and request a different date. Then, L&I or the Self Insurer will take the IME and your doctors concurrence and move your claim toward the IMEs conclusions. careful about your next steps. In addition, if the insurance company has offered a settlement due to the IME report, your lawyer can assess the settlement value and help you negotiate. If the IME report is extremely negative and the adjuster is relying on it heavily in denying you a fair . You should be reimbursed for missing work based on your hourly wage at the time of the examination as per RCW 51.32.110 (4). 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. To help your case reread What Can I Do About a Bad IME above. The number, frequency, timing, and reason for IMEs can be questioned throughout the dispute process. 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). Hiding details or lying about the injuries may seem like it'll help your case, but it usually hurts you. Step". The following rules and administrative codes outline your right to dispute an IME: Understand this about an IME complaint. Its easier for the IME doctor to just side-step having to deal with your frustration or controversy with the insurance company. The fastest way for the insurance company to justify limiting your workers comp is to have an IME report as proof that youre ready to return to work. Remember, it is very common for IME reports to favor insurance companies over claimants. The accuracy of information provided on this site is not guaranteed. The insurance company can also authorize your employer to accommodate work restrictions so that you can continue to work with modified arrangements, or they can also say that you need to have additional treatments before you can be considered for benefits again. You just received the independent medical examination report, and the doctor disagrees with your primary treating physician about nearly everything. The information on this website is for general information purposes only. But that doesnt mean you cant challenge their opinion. 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. They are a bought and paid-for one-sided records review designed and administered to ruin your L&I claim. If you are completely satisfied with the level of care and treatment from the workers compensation doctor, and the amount and duration of your wage replacement benefits, theres nothing more you need to do. What happens when the IME disagrees with my doctor? Has the workers claim-related medical condition reached maximum medical improvement? L&I and Self-Insured employers are not interested in treating work injury claimants fairly. Unfortunately, based on your answers, we will not be able to help you. An IME doctor is not your doctor - The evaluation does not create a doctor patient-relationship. And as such, the WorkCover insurer refuses to pay for any medical treatment related to the depression. 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. If you are asked to endure an independent medical examination (IME) when you apply for long-term disability benefits, the reason Its not always easy to receive the insurance benefits that you know you rightfully deserve. If L&I requests a legitimate IME, it is extremely important for the injured worker to arrive alert and prepared for the examination. How do I get a doctor to take me off work for severe pain? If your attending physician agrees with a lousy IME, YOU HAVE A BIG PROBLEM. Before the hearing, your lawyer may need to take the deposition of the IME doctor. 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. 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. And insurance companies arent exactly known for their generosity. To do so, IME exams are scheduled with doctors who will help them manage a claim. Their primary purpose is to write a favorable report that allows L&I to end your claim without paying you the compensation you deserve. Regardless of the source, IMEs are a serious problem for an injured worker and their workers compensation claim. Their opinions are heavily biased, and many already believe you arent injured before they even begin your examination. It is not uncommon to see IME reports saying, . Therein lies the problem. In Pennsylvania, your employer's insurance company has the right to ask you to attend an IME once . It is generic information for informal purposes only. 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. 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. You only get a short period of time to salvage what you can from your L&I claim. For one, they must be licensed health professionals. 25 Questions to Ask Your Workers Comp Lawyer. 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. What is the Workers Compensation Appeals Board and How Does it Work? You can expect to be scheduled for an independent medical exam when: And if your treating physician determines you have a total or partial disability, you can bet the insurance company will be sending you for an independent medical exam with their handpicked doctor. In cases like this, an experienced workers compensation lawyer like Victor Malca can help you. If you dont like what shows up in your IME report, there are steps you can take to counteract that bad IME. 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