The simple answer is that IME doctors arent always right. Get your doctor to write a helpful report outlining their disagreement with the incorrect IME findings and conclusions, including their own findings and conclusions. Because of their financial interests, some doctors may order unnecessary or questionable tests or medical treatments hoping the insurance company will pay for them. Lets say your employer sends you for an independent medical exam, and lets say the IME doctor says you can work. If the IME says that you are ready to go back to work, the insurance company will terminate your benefits, and you might need to work in order to cover your medical bills and other expenses. 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. L&I has a plan for you and they will use the IME to make it happen. Independent medical examination. He can help you contest your IME doctors opinion and get the benefits you deserve too. Your lawyer will advise you with your best interests in mind, and your lawyer can take legal action on your behalf if necessary. 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). 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. Get started with a free case assessment online 24/7. He then said that if Dr. Demeter does not exam her, then her benefits will be denied. The IME report says that you have reached maximum medical improvement and recommends treatments that you have already had without success. Even when doctors would normally recommend those diagnostic or therapeutic services, in workers comp cases, they wont mention it to the injured worker. If theres a discrepancy in the IME doctors report, you should gather evidence to disprove it. if(hash != ""){ 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. As a practical matter, however, you may feel that it is necessary to do so. At the other end of the spectrum, the employee will be entitled to 6 weeks of benefits for every percentage of impairment that is more than 21%. That I could not return to my position without set restrictions. Your Name: 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. With the nurse case manager in the room, anything you say or do during the examination can be used against you. You might choose to take notes on a few important issues when you get to your car, or you might choose to wait until youre home if you live near the doctors office. Learn about Permanent Partial Disability Settlements. If you dont help yourself, who will do it for you? Remember, its you against the insurance company, and the nurse case manager is just another of their employees. Given all of these issues, you might be wondering if you have to go to an independent medical exam. Joe Osterbauer, Esq. Just because the IME doctor does not agree with the diagnosis your treating physician provided, that does not mean your case is over. IMEs review medical records and in some cases examine the injured worker. 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. An IME doctor is not your doctor - The evaluation does not create a doctor patient-relationship. But in most cases, its the insurance company that gets to choose the IME doctor. What is the Workers Compensation Appeals Board and How Does it Work? Your Phone Number: 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. Independent Medical Exam (IME) Doctor - These doctors conduct IMEs on behalf of the insurance company. The IME is a type of medical examination where an independent third party evaluates the condition of an injured worker. 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. For instance, if you came in with a limp and suddenly dont have it when you walk out the front door to the clinic, theres a good chance that the doctors are taking note of that, especially if this information affects your claim. Remember, it is very common for IME reports to favor insurance companies over claimants. First and foremost. You will have to balance the cost of the treatment against how much you need it. 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. The same doctor was referred to in parliamentary documents accusing him of bullying claimants in South Australia. In Hoover, the employer required employees get medical evaluations from its doctor. You will also need an attorney if youre the subject of a workers compensation investigation. The responsibility of an IME doctor is only to ascertain your medical condition. 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. By submitting, you agree to the Terms & Conditions. But that doesnt mean you cant challenge their opinion. It is unlikely to help your case. Like the doctor who orders custom braces or orthotic shoe inserts that can only be made by a company owned by the doctor. Also, you dont have to speak with the nurse. Independent medical examiners routinely dispute doctors treatment recommendations. Unfortunately, based on your answers, we will not be able to help you. An IME 1600 Ponce de Leon Blvd To report a doctor who has been improper you can complain. As the. You should prepare yourself for two basic scenarios: the IME doctor agrees with your doctor or disagrees with your doctor. She enjoys helping people in need with questions about social security disability and workers compensation law. Is It Time to Speak with a Work-Related Injury Lawyer? When an injury is severe enough, the injured person may never recover from the unrelenting pain and permanent disability. The IME doctor could also order more tests to determine your health status. console.log("fxiedd"); I never consider a an IME exam to be independent because you are required pursuant to the terms of your disability . Talk to your claims manager to make this happen.In certain situations, there is reimbursement for meals, hotel expenses, taxi fare, parking costs, and ferry and bridge tolls. The claim is moving too slowly or getting too expensive, and the insurance adjuster wants to close it down. 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. However, if the deficit in both ranges of motion are moderate or higher, and the measures are within 10 degrees of each other, up to 10% may be added to the overall schedule loss of use, not to exceed ankylosis." In the 2018 Guidelines, note Table 5.4 (a), p. 31. Come see why fellow attorneys and past clients have voted me one of the Best Workers Compensation Lawyers in Virginia. The IME doctor will observe the plaintiff from the moment they first meet. Should the insurance company consider those tests or devices medically unnecessary, you may be personally responsible for the costs of the tests or other extended treatment. Chris has been helping injured Washington State workers for over 40 years. 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 you cant help yourself, contact a lawyer to see if they will help you. Reasonable requests should be accommodated. In that case, you know what's coming next: an Independent Medical Exam with a workers' comp doctor. 5-Step Disability Evaluation Under Social Security On rare occasions, an arbitrator will need to get involved to enforce a decision because either the employer or the insurance company is not willing to go along with what the IME doctor and your doctor both agree on. Workers comp refuses to order MRI for elbow injury? When you click the button you will be redirected to LawsuitInfoCenter.com. Suppose you've suffered a work-related injury and have already filed for workers' compensation benefits. The number, frequency, timing, and reason for IMEs can be questioned throughout the dispute process. Call 206-343-1988 or email and let us help you figure it out with a free consultation. I recently accepted and. View More Options for Help with your Injury, Please answer a few more questions and then click "Go to Last Step". Whats next? Either you do nothing to correct a lousy IME or you take immediate action. After a specified time from your claim filing, youll be permitted to have an evaluation and treatment from a physician you choose, whether on the insurance companys approved list or not. Whats an Independent Medical Examination? The IME goes to L&I or the Self-Insureds. Briefly Describe Your Case: document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Learn more about Social Security Disability and Long Term Disability Insurance, as well as appealing denials and how an attorney can help. Some injured workers do not realize the negative impact that the IME report can have on the insurance companies valuation of their cases. There is no such thing as a truly independent medical exam. Please be sure to indicate the best answer. Sometimes they don't even perform a physical examination before rendering their opinion. How To Write A Disability Appeal Letter (With Sample). I. Unfortunately, long-term disability insurance companies will almost always side with the IME doctors they hire. In that case, she could recommend that you be sent for an independent medical exam with a different workers comp insurance company doctor. 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. Then call me for a free consultation: 804-251-1620 or 757-810-5614. Theoretically, they should be. Workers comp doctor fees are based on the number of patients, not on the time spent on each case. This is why many injured workers often find themselves wondering, what can I do if the IME doctor disagrees with my doctor? According to California Civil Discovery Practice (CEB 4th Ed. You agree these messages may be auto-dialed or pre-recorded, and consent is not a condition of purchase. careful about your next steps. This could include simple observations or may involve video surveillance. Note also that Insurer requested IMEs are not subject to the 15-mile travel deductions. This strategy session will help you get informed. Some are general practitioners with limited or no previous experience in workplace injuries. Read: How to Find a Work Injury Lawyer Near Me. Several circumstances may cause the insurance company to request that you submit to an Independent Medical Examination (IME). The Court began its analysis with an evaluation of an IME Doctor's Duty: Even absent a formal doctor-patient relationship, a doctor conducting an Independent Medical Examination ('IME') owes a duty of reasonable care to his or her patient.It can arise from a relationship between the parties, a contractual relationship, or any number of . Legal authority for this exists in Section 12 of the Illinois Worker Compensation Act: "An employee entitled to receive disability payments shall be required, if . With this, its inevitable that the IME doctor will disagree with your treating doctor. Call our worker compensation Attorney at 415-404-6395 or 415-738-240. Dabdoub Law Firm is a highly specialized disability insurance law firm based in South Florida offering representation to disability claimants across the country. If you force yourself to work when your body is not yet up to it, your injury may only get worse. How Do You Verify if Your Employer Has Workers Compensation Coverage? Doctors hired to perform IMEs are paid by the workers comp insurance company handling your claim. I am still in a lot of pain because my. At Chisholm Chisholm & Kilpatrick LTD, our team of experienced attorneys and professionals has assisted clients throughout the long-term disability claim process. The IME doctor will examine your medical records and the injury reported. . Do not let the insurance company push you back to work before you are ready you could get injured again. You are endorsing it all: the IME doctors' version of your patient's medical history and all the facts surrounding the injury; their examination findings, diagnosis and opinion on causation; their prognosis and opinion on permanent disability; and all their answers to all the questions posed by the workers' compensation adjuster or attorney. They are a bought and paid-for one-sided records review designed and administered to ruin your L&I claim. In fact, it's often called a "DME," for "Defense Medical Examination.". In fact, there might even be people from the insurance company surveilling you at your home, watching you as you walk inside your house. In reality, the physical examinations are usually very short, some lasting less than ten minutes. Our experience is the jury knows the doctor is charging and it is a waste of time to impeach on money charged to do forensic work. Independent medical exams requested by disability insurance companies can be dangerous. 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. Instead, these doctors make their living performing IMEs for insurance companies, who provide generous compensation for one-time examinations. Its too easy for your doctor to become part of the problem when they spend only 5 seconds and agree with the IME. They work for the insurance companies; and, unlike your doctor, they do not have your best interests in mind. We will keep it that way. Because both you and the attorney want to know if your case is any good. The vendors are like middle-men, who provide IME doctors to all of the different insurance carriers in New York. We help individuals who need to. 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. Consultations are free. Don't compare your claim to someone else's. or viewing does not constitute, an attorney-client relationship. jQuery(window).load(function() { You can use this to contest the IME report at court. It is highly unusual for an IME doctor to have a disability claimant sign a generic authorization form. There are two common reasons why the IME doctor may disagree with your doctor: Some of the most common things they disagree on are: Unfortunately, an IME doctors opinion tends to hold a lot of weight even if theyre a little biased. The stated purpose of an Independent Medical Examination (IME) is a medical evaluation ordered by L&I to determine the status of a workers medical condition. Said that I had not returned to my pre-injury levels. }, 1000); Detailing your current ailment, how it has changed, and how your capabilities are limited as a result. In short, their opinion is invalid. Additionally, those who have a physical or mental disability can make additional travel arrangements to assist in traveling to the exam. If you have been injured at work, in an auto or truck accident, in a slip and fall accident, a serious neck or back injury or are the survivor of a wrongful death victim, we can help you get the compensation that you deserve. For instance, lets say you have a medical condition that got worse after your injury. } Get started with a free case assessment online 24/7. Unfortunately, based on your answers we cant provide a case review. The nurse will report anything you say or do to the insurance company with no regard for your personal privacy. It is not uncommon to see IME reports saying, . You have clear legal rights; and, if the IMEs report is inaccurate, you should still be able to collect the benefits you deserve. Can You Still Receive Workers Comp If You Fail the Drug Test? Read: Workers Comp Settlements for Ankle Injury, Workers Comp Settlements for Brain Injury, Workers Comp Settlements for Bulging Disc, Workers Comp Settlements for Carpal Tunnel, Workers Comp Settlements for Cervical Spine Injury, Workers Comp Settlements for Electrocution Injury, Workers Comp Settlements for Herniated Disc, Workers Comp Settlements for Injuries Requiring Surgery, Workers Comp Settlements for Permanent Partial Disability, Workers Comp Settlements for Secondary Injury, Workers Comp Settlements for Shoulder Injury. When all this is done, they will then prepare a medical report containing their findings. 1600 Ponce de Leon Blvd, This article was reviewed by Victor Malca a licensed workers compensation and social security disability attorney at law for over 27 years. 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