The nurse may present herself as your advocate who is acting in your best interests. We do ask what percent of IME work involves defense v plaintiff work. Find out now with a FREE case review from an attorney, So far so good! Or the doctor gave you a completely different disability rating than your doctor. Joes 27 years of workers compensation experience and his teams speedy service combine to get clients the results they need. We respect your privacy. You have NO right to confidentiality with this medical exam. 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. Three weeks ago I just had tendinitis, and my Dr. didnt release me from work. 33134 The deposition may reveal that the doctor never even looked at your old medical records and spent only minutes examining you. 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. Many make hundreds of thousands of dollars per year by sticking it to injured workers. The state agency will review the doctor's report along with all of the other Most of the time, they use the IME doctors opinion to achieve such. 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. We were told that it was because they determined my injury was a new injury and not related back to my original injury. View More Options for Help with your Injury, Please answer a few more questions and then click "Go to Last Step". The vendors are like middle-men, who provide IME doctors to all of the different insurance carriers in New York. These tests are expensive and complicate the entire claim. Is any further medical treatment necessary? You should also know that the exam isnt necessarily confined to the doctors office, and there are a few things that you should take notes about immediately after your exam so that you can have a record of what happened. 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%. For one, they must be licensed health professionals. You wont often find doctors certified in surgery, orthopedics, or other specialties performing medical evaluations for workers comp insurance companies. Like the doctor who orders custom braces or orthotic shoe inserts that can only be made by a company owned by the doctor. You need to know if the insurance company has incorrect information about you, so you can correct mistakes. Also, IME doctors do not always have all the treatment records. Theoretically, they should be. Map & Directions [+]. This is why many injured workers often find themselves wondering, what can I do if the IME doctor disagrees with my doctor? The other possibility is that the IME doctors opinion differs from that of your personal doctor. In most cases, the adjuster working your claim chooses the IME doctor you will be required to see. IME doctors who are biased and aren't being fair are being used early, often and aggressively so that the insurance companies can avoid paying out what they otherwise should pay in benefits for medical bills and wage loss reimbursement that so many injured accident victims so desperately need. In every case, the insurance company has the right to send you to an independent medical exam (IME). If youre injured on the job and making a workers compensation claim, you must be medically evaluated and treated by doctors approved by your employers insurance company. Remember that insurance companies often have injured workers under surveillance. They have little interest in seeing your problems. In cases like this, an experienced workers compensation lawyer like Victor Malca can help you. Your attending physician will be asked by L&I to agree with the IME. In many cases, the doctor's sole source of income is performing IMEs. Are you entitled to financial compensation for your work injury? Cloud, Eagan, Woodbury, Maple Grove, Eden Prairie, Coon Rapids, Burnsville, Blaine, Lakeville, Minnetonka, Apple Valley, Edina, and St. Louis Park. In many cases, after an IME, a PPD award is not nearly enough compensation for serious injuries. I was walking past. Please answer a few more questions and then click "Go to Last If L&I requests a legitimate IME, it is extremely important for the injured worker to arrive alert and prepared for the examination. An IME is an examination scheduled by the Indiana Work Comp Board, and this report will be very important to your case. Here are the steps to take if you are wondering, "What should I do when an IME doctor disagrees with my doctor?": Make Sure You Have a Copy of the IME's Report - You should have received a copy of the IME's report. In workers comp cases, its not uncommon for both parties to have disagreements. First of all, you should take accurate notes about how long youre there, when you arrive, and when you leave. 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. An IME doctor is not your doctor - The evaluation does not create a doctor patient-relationship. Your lawyer can help you understand your legal rights, and your lawyer can take action to protect your right to workers compensation benefits if necessary. Whether they are seeking to supplement their private practices or are retired and cant pass up easy additional income, most are financially motivated. If you dont like what L&I is doing to you, you must do something about it. This hearing will be a battle of the experts. Note: This page was last updated on February 21, 2023. The doctor will not take part in deciding whether you have a disability and will not prescribe treatment or medication for you. Getting a second (and sometimes third) medical opinion can help support your claim. If your IME doctor neglected to include such detail in their report, you should write to your insurance company and inform them about it. It is unlikely to help your case. Insurance companies will often stop paying workers compensation benefits once an IME clears an employee for work as welland this can put injured workers in a very challenging situation. How Do You Verify if Your Employer Has Workers Compensation Coverage? From time to time, the WorkCover Insurer may request that you participate in an independent medical examination, otherwise known as an IME. 25 Questions to Ask Your Workers Comp Lawyer. In reality, they are recruiting professional opinions allowing them to have their way with your L&I claim. Can I Get Disability After Getting Workers Comp Settlement? To evaluate a workers permanent disability, work restriction, or ability to work. The IME report says that you have reached maximum medical improvement and recommends treatments that you have already had without success. While a second opinion may be helpful, keep in mind the other doctor is getting paid by the insurance company, just like the first one. Then, L&I or the Self Insurer will take the IME and your doctors concurrence and move your claim toward the IMEs conclusions. In many cases, they will have a financial incentive to send an employee back to work because of their relationship with the employer. Do not let the insurance company push you back to work before you are ready you could get injured again. 250 (1964). But if you feel you are being played by the workers comp insurance company, or you arent sure youre getting the benefits you deserve, dont wait to protect your claim. . What is the Workers Compensation Appeals Board and How Does it Work? Find out now with a free claim assessment. But if you feel that the IME doctors recommendation is detrimental to your health, you should tell them so. Independent medical exams requested by disability insurance companies can be dangerous. Independent Medical Examination doctors can be tricky, so keep the following in mind: The exam is converted into a report. Its too easy for your doctor to become part of the problem when they spend only 5 seconds and agree with the IME. For the most part, this is true. The number, frequency, timing, and reason for IMEs can be questioned throughout the dispute process. Yes, they are. What You Should Not Tell Disability Doctors, How To Update Your Social Security Record After Becoming A Citizen. Your Name: Can I Dispute That an IME Should be Scheduled? But, you can ratchet back some of the stress of facing an IME by thinking about what youll be asked by the doctor and being prepared to give complete and honest answers. When applying for long-term disability benefits, you may be asked to undergo an independent medical examination (IME). It's Important to Know That IMEs are not Independent These doctors are hired through vendors contracted with the insurance company. How To Pass A Continuing Disability Review. }, 1000); The Law in All 50 States. if(jQuery("#masthead").css("position") === "fixed"){ When you undergo an IME, youll want to take notes during and immediately after the exam so that you can be certain about what happened and what was discussed and know if something in the report doesnt sound right to you later. In order to do so, they will frequently require injured workers to see an independent medical examiner (IME). The IME doctor will look for any inconsistencies in your behavior. Back injury preventing me from working. Despite their label, IMEs are not independent. They told me it was just a bad ankle sprain. An independent medical examination (IME) is usually requested when theres doubt about your workers compensation claim. That report is now also called the IME. It is highly unusual for an IME doctor to have a disability claimant sign a generic authorization form. SAVE YOUR RECEIPTS!!! Reports not supported by medical evidence. You must complete a travel reimbursement form within one year of the exam and include your receipts. Im an experienced Seattle workers compensation attorney who has helped thousands of injured Washington State workers. It never hurts to have your own witness to the exam. New York State law concerning Independent Medical Examinations was extensively amended in 2000. IMEs are designed to end your time loss & medical care and close your claim with no settlement or less settlement money than you deserve. Step", So far so good! The insurance company calls it a request, but the hard truth is that if you refuse to undergo the IME, your claim will be flatly denied. If you dont help yourself, who will do it for you? Just because the IME doctor does not agree with the diagnosis your treating physician provided, that does not mean your case is over. (this is a problem). console.log("hash::"+hash); If the IME report is extremely negative and the adjuster is relying on it heavily in denying you a fair . The claim is moving too slowly or getting too expensive, and the insurance adjuster wants to close it down. Virginia Beach Office 5500-B Greenwich Rd. Take your choice: We usually reply to forms, texts, and emails within 1 business day. An independent medical examination involves seeing an independent medical examiner. Given all of these issues, you might be wondering if you have to go to an independent medical exam. How can I get my doctor to put me on full work restriction? If possible, have a friend or family member go with you to the IME. Researchers discovered that there are over 4.5 million workplace injuries every year, and workers' compensation claims payouts totaled some $62 billion in 2017 a staggering amount of money. Forced to go back full time on light duty, but still have pain? The exception is when the doctor only has an IME practice, it is almost only defense, and the doctor make hundreds of thousands of dollars a year. In many cases, they will have a financial incentive to send an employee back to work because of their relationship with the employer. They may also do a, they were reviewing different or incomplete medical records, whether or not you should go back to work, Getting Disability Benefits for Self-Employed: A Quick Guide. In most states, you can refuse to have the nurse in the examination room with you while you are seeing the doctor. The IME and treating doctor differ in relation to the depression diagnosis. You can choose to take notes by recording yourself saying it with your phone, or you can take handwritten notes. The IME doctor will not prescribe medication, will not treat you, and is not there to help. Another potential conflict of interest arises when doctors own or have financial connections in the healthcare facilities they are referring you to for diagnostic exams or treatment. For example, for every impairment rating from 1-10%, the employee will be entitled to two weeks of benefits per percentage point. To settle these disagreements and bring all parties on the same page, an IME is usually conducted. Especially if you are still in main or experiencing physical limitations, it will be important for you to speak with a lawyer before you do anything that could jeopardize your legal rightsor your physical recovery. Nothing on this site should be taken as legal advice for any individual console.log("fxiedd"); Why Is an Independent Medical Exam Being Scheduled? His law firm is helpful, honest, and knowledgeable about workers' compensation and personal injury law in the State of Washington. You have clear legal rights; and, if the IMEs report is inaccurate, you should still be able to collect the benefits you deserve. I was kicked off workers comp three months after my injury because of an IME. They: People in charge of your claim can request an IME and follow-up IMEs. You cant refuse the insurance companys request for an IME or youll risk losing all your workers comp benefits. He reported it to his supervisor, and requested to go see the company doctor. Find out if you are entitled to compensation. Book a free consultation today. How injury occurred, were you at work? As a practical matter, however, you may feel that it is necessary to do so. 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. 5-Step Disability Evaluation Under Social Security In contrast, your treating doctor has seen you for multiple appointments over the months since your injury. Unfortunately, based on your answers we cant provide a case review. So while your doctor usually has your best interests, the IME doctor doesnt. IMEs review medical records and in some cases examine the injured worker. 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. Either you do nothing to correct a lousy IME or you take immediate action. Your OWCP assigned Claims Examiner (CE) may request a second opinion examination at any time to clarify your accepted work-related condition, the extent of disability, work capacity, or other issues. You will know that you have taken important steps to get your claim moving in the right direction. You Need Help With: An IME doctor will evaluate your medical history and your current medical state to determine the severity of your disability or medical condition, the treatment you need and your ability to continue working. Funding can range from $500-$100,000, depending on your case and needs. jQuery(window).load(function() { An IME doctor frequently bases his or her findings on what is often a very brief visit with a patient. Consult with a licensed attorney in your state before relying on any information found on this site. What Happens When the IME Doctor Disagrees With My Doctor? With that said, if you dont do anything, your workers compensation claim will be over. As a result, the doctor says that you have to go back to work. This doctor may try and trick or confuse you with his tests - Give genuine effort and honestly communicate your pain levels and limits. Sometimes they don't even perform a physical examination before rendering their opinion. Our unwavering advocacy for employee rights and privileges are recognized by our past clients across South Florida. This could include simple observations or may involve video surveillance. How To Write A Disability Appeal Letter (With Sample). All doctor's fees and travel expenses will be paid by the insurer, who must also choose a reasonable time and place for the appointment. Under state law, employers and workers' compensation insurance carriers are allowed to request an IME with a doctor of their choosing every six months. Do I Need a Lawyer for a Workers Comp Claim? Call 206-343-1988 or email and let us help you figure it out with a free consultation. Please be sure to indicate the best answer. Your lawyer may have to attend a hearing with the workers compensation judge to present your doctors report and rebut the IME report. 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. Dont exaggerate, but dont leave anything out. 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. 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. Hiding details or lying about the injuries may seem like it'll help your case, but it usually hurts you. Underscoring this view is the seminal case medical malpractice case in Maryland on this issue is Hoover v. Williamson, 236 Md. In that case, she could recommend that you be sent for an independent medical exam with a different workers comp insurance company doctor. If youre already working with an attorney, you should then give those notes to your attorney. 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. 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. Get a free claim assessment from a local attorney. This is because the faster an injured worker returns to work, the lesser compensation the insurance provider will have to pay. 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. A free phone consultation or email gets that figured out quickly. I. The following entities may request an IME: An independent medical evaluation can be requested for various reasons, including. RCW 51.32.110 (3), WAC 296-20-1103, and L&I Claim Adjudication Guidelines. 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. There is no such thing as a truly independent medical exam. Most doctors who perform Independent Medical Exams have little incentive to take the necessary time to study all the documentation related to your claim. Have a personal injury caused by someone else? Unfortunately, in most cases, you do. Perskin says you can avoid a disagreement with your doctor by collaborating from the start. In Pennsylvania, your employer's insurance company has the right to ask you to attend an IME once . Whats next? Remember, if you refuse to submit to an IME, the insurance company can legally deny your workers compensation claim and stop your medical and wage replacement benefits. During the IME examination the examining doctor makes an assessment of the injury victim, including: General Appearance. Do I need to ask for a work release note from my doctor? 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. With the nurse case manager in the room, anything you say or do during the examination can be used against you. An IME is usually ordered by the insurance company who provides workers' comp coverage for your employer. The insurance company disagrees with your treating physicians medical opinion. A California QME, or Qualified Medical Examiner, is a physician who has been certified by the California Division of Workers' Compensation - Medical Unit to perform exams on injured employees so that disability can be evaluated. Step". The doctor will then use this information to determine whether they agree with your personal doctor or not. FL Said that I had not returned to my pre-injury levels. Do I have recourse after I was kicked off Workers Comp because of an IME? - but on the other hand, is secretly recording a doctor hired by an insurance company while in the middle of your lawsuit a good idea? But this isnt always the case in reality. However, if your attending physician disagrees with a bad IME, there is still hope for your claim. Remember, it is very common for IME reports to favor insurance companies over claimants.
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