A free phone consultation or email gets that figured out quickly. Contact us today to schedule a complimentary and free case evaluation and learn how we can help you. 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. In most states, you can refuse to have the nurse in the examination room with you while you are seeing the doctor. Independent Medical Exam (IME) Doctor - These doctors conduct IMEs on behalf of the insurance company. My name is Chris Sharpe. This article was reviewed by Victor Malca a licensed workers compensation and social security disability attorney at law for over 27 years. In this case, the independent third party refers to the IME doctor. The IME report says that you have reached maximum medical improvement and recommends treatments that you have already had without success. He specializes in representing injured workers on compensation benefit cases and disabled individuals claiming lost social security disability benefits. If the doctor failed to take a medical history from you, your attorney can point this out to the adjuster or use it in court and negotiations with the defendant's lawyer. ---Filing for Social Security DisabilityAppealing a SSD DenialShort/Long Term Disability Claim When your injuries are serious enough to keep you out of work for an extended period, or your treating doctor says youll never go back to the same type of work, the insurance company may question your diagnosis. Get started with a free case assessment online 24/7. 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. The state agency will review the doctor's report along with all of the other Additionally, if you dont agree with the IME doctor, you might be able to challenge their decision if they made it based on incomplete, incorrect, or outdated information. Workers comp refuses to order MRI for elbow injury? I injured my back at work (in Alabama) 3 weeks ago. Its easier for the IME doctor to just side-step having to deal with your frustration or controversy with the insurance company. Stephen Scott, the Aetna Claims Analyst called our office today and said that our client must sign the form or Dr. Demeter won't exam her. 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. View our Privacy Policy. But this isnt always the case in reality. For many injured workers, that means facing an Independent Medical Examination, or IME, ordered by the workers compensation insurance company. How long can I stay home to recover from a work injury? 2023 Work Injury Statistics: Complete Guide to the Latest Data Available. We were told that it was because they determined my injury was a new injury and not related back to my original injury. These tests are expensive and complicate the entire claim. Unfortunately, based on your answers, we will not be able to help you. 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. jQuery("html, body").animate({ You can choose to take notes by recording yourself saying it with your phone, or you can take handwritten notes. The IME Doctor Disagrees With My Doctor: What Do I Do? L&I has a plan for you and they will use the IME to make it happen. Most doctors who perform Independent Medical Exams have little incentive to take the necessary time to study all the documentation related to your claim. var scrollToPosition = parseInt(jQuery("#" + anchor_id).offset().top) - parseInt(jQuery("#masthead").outerHeight()); 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. If L&I requests a legitimate IME, it is extremely important for the injured worker to arrive alert and prepared for the examination. 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. Victor Malca P.A. That is not "independent." Instead, expect the IME doctor to disagree with the doctors you have hired to provide your medical care. This is an exam by a doctor of their choosing who often is not so "independent" and can mess up or at least delay your case. Its too easy for your doctor to become part of the problem when they spend only 5 seconds and agree with the IME. 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. Coral Gables, Plaintiffs should assume that any staff members present at the doctor's office . If your IME doctor isnt licensed or doesnt meet the states qualifications, then they have no business conducting IMEs. He reported it to his supervisor, and requested to go see the company doctor. Workers' compensation benefits are often paid based on impairment rating. var anchor_id = jQuery(this).attr("href").split("#")[1]; IME stands for "Independent Medical Exam." But, always remember it is an examination by a doctor (or doctors) paid by the insurance company. Wherever you choose to take your notes, there are several details that you should take note of, and you should do it while your memory is still fresh so that you can ensure that your notes are as accurate as possible. I. She enjoys helping people in need with questions about social security disability and workers compensation law. 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. Joe Osterbauer, Esq. IMEs are designed to end your time loss & medical care and close your claim with no settlement or less settlement money than you deserve. Hed been helping injured workers in Florida for the past three decades. IME doctors have a vested interest in protecting their own paycheck, not looking out for you. His law firm is helpful, honest,, What is an L&I Settlement? An L&I settlement is money paid at claim closure for a work related job injury. You have clear legal rights; and, if the IMEs report is inaccurate, you should still be able to collect the benefits you deserve. How To Write A Disability Appeal Letter (With Sample). This will help them determine if there are any "objective" signs of an injury related to your workplace accident. Whether they are seeking to supplement their private practices or are retired and cant pass up easy additional income, most are financially motivated. Why Is an Independent Medical Exam Being Scheduled? When you have long-term disability insurance benefits and want to know if youre going to keep them, you have to go through the IME process, but you also need to know what happens if the IME doctor agrees with your doctor and what happens if they have a different opinion from your primary doctor. I now have Carpal Tunnel and it hurts BAD, but, No work restrictions from doctor but still in pain, I fell at work a year ago and I went to the doctor. I was seen at the hospital and then told to go to. If a nurse threatens to stop your workers comp benefits if you wont let her come to your doctor appointments, immediately contact a personal injury attorney for advice. The process of choosing an IME doctor varies from state to state. As a practical matter, however, you may feel that it is necessary to do so. If this answer was helpful, please mark as helpful below. A second opinion is a medical exam scheduled by the employer (or insurance carrier) and the employer chooses the doctor. Self-Insured employers. There are several ways in which the team at Osterhout Berger Disability Law can help you receive the benefit you deserve. Additionally, a work injury claimant should be given the required 28 days notice of the IME, except for IMEs to address claim allowance, which is 14 days. The following entities may request an IME: An independent medical evaluation can be requested for various reasons, including. If youve been injured in an accident, you may qualify for a settlement. In this situation, you need to be very careful about your next steps. Can You Claim Unemployment and Workers Comp at the Same Time? Some states give that prerogative to the injured worker. An L&I settlement is money paid at claim closure. You only get a short period of time to salvage what you can from your L&I claim. The IME physician reviewed different records than your treating doctor, The IME doctor follows different treatment plans than your treating physician. Your attending physician will be asked by L&I to agree with the IME. Questions about hiring an attorney? The IME doctor could also order more tests to determine your health status. They may also do a functional capacity evaluation. Do You Need Free Workers Comp Legal Advice? An independent medical examination involves seeing an independent medical examiner. Suite 1202 My husband felt a sudden snap in his arm while working. 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. This same insurance company pays them, so it is common for an IME doctor to disagree with your doctor or the doctor providing care for your workers' comp injury. Three weeks ago I just had tendinitis, and my Dr. didnt release me from work. Do not let the insurance company push you back to work before you are ready you could get injured again. So, if youre asking, The IME doctor says I Can work, whats next? The simple answer is that you should contact a lawyer promptly. With this, its inevitable that the IME doctor will disagree with your treating doctor. 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).