Some are general practitioners with limited or no previous experience in workplace injuries. Three weeks ago I just had tendinitis, and my Dr. didnt release me from work. 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. Your claim will change after an Independent Medical Examination. At the end of the call, no matter what you decide to do, you will have fresh ideas and an action plan. Request a copy of the IME doctors report. Are you going to let them do this to you? 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. In that case, she could recommend that you be sent for an independent medical exam with a different workers comp insurance company doctor. An Independent Medical Exam (IME) is an opportunity for the employer (really the employers workers compensation insurance company) to have you examined by a doctor of their choosing. Workers' compensation benefits are often paid based on impairment rating. As mentioned, an IME doctor is an independent third party. Doctors hired to perform IMEs are paid by the workers comp insurance company handling your claim. 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. The apartment. Please answer a few more questions and then click "Go to Last Pills are much less expensive than an MRI. The accuracy of information provided on this site is not guaranteed. This could include simple observations or may involve video surveillance. 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. 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. Review exactly how the accident happened and be prepared to re-tell the details to the IME doctor. Do I have recourse after I was kicked off Workers Comp because of an IME? Virtually all state regulations permit you to be treated by your own doctor, but your claim is highly dependent on the medical opinion of the doctor from the insurance companys approved list. Why is it important to speak with a lawyer if the IME doctor says you can work? Its a good idea to bring someone along. An observer cannot legally record an IME. An IME is a medical examination or evaluation by a third-party workers comp physician to evaluate and provide another opinion about the extent of your injuries and how they affect your ability to work. Sometimes they don't even perform a physical examination before rendering their opinion. 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). There is no guarantee that the IME doctor will agree with the veteran's thinking and if the report is not in agreement with the veteran, he/she will not get their money back. case or situation. 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. This is why many injured workers often find themselves wondering, what can I do if the IME doctor disagrees with my doctor? Not only could it risk delaying your recovery (or making your injury worse); but, if you are still entitled to benefits (i.e. All too often there is no good solution for significant injuries. }, 1000); I suggest you do something to help yourself. . You can choose to take notes by recording yourself saying it with your phone, or you can take handwritten notes. Before the hearing, your lawyer may need to take the deposition of the IME doctor. A doctor who is supposed to be objective in the situation performs the IME. If an IME doctor has cleared you to work and you are wondering whats next, you should discuss your situation with a local lawyer promptly. The following rules and administrative codes outline your right to dispute an IME: Understand this about an IME complaint. What should you do? Dont exaggerate, but dont leave anything out. RCW 51.32.110 (3), WAC 296-20-1103, and L&I Claim Adjudication Guidelines. Florida Workers Comp Laws: A Quick Guide for Injured Workers. Yes, the doctor should have that information from your medical records, but they may want to hear it from you. Remember that insurance companies often have injured workers under surveillance. Take your time. 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. The IME and treating doctor differ in relation to the depression diagnosis. Workers Comp: Settlements for Back Injury, Workers Comp: Settlements for Bulging Disc, Workers Comp: Settlements for Herniated Disc, Workers Comp: Settlements for Ankle Injuries, Workers Comp: Settlements for Brain Injury, Coronavirus (COVID-19) Workers Compensation and Unemployment Information All 50 States, Workers Compensation Deadlines All 50 States, Personal Injury Statute of Limitations All 50 States, Can You See Your Own Doctor on Workers Comp? But insurance companies dont like to pay benefits, especially for a long time, and they will often try to terminate injured workers medical and disability benefits prematurely. Because of their financial interests, some doctors may order unnecessary or questionable tests or medical treatments hoping the insurance company will pay for them. We never represent the employer or insurance company. Please use the button below to see how else we can help. Talk to a workers compensation attorney. 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. When there is a question about what kind of benefits an injured employee should receive, a California QME is the type of physician who evaluates the employee. I recently accepted and. Then, L&I or the Self Insurer will take the IME and your doctors concurrence and move your claim toward the IMEs conclusions. } 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. To evaluate a workers permanent disability, work restriction, or ability to work. Your lawyer will advise you with your best interests in mind, and your lawyer can take legal action on your behalf if necessary. Does that sound independent to you? As a result, lots of insurance company-approved doctors are more likely to treat injuries with pain medication. By submitting, you agree to the Terms & Conditions. 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. Yes, you can. I was using an electric pallet jack and the machine surged backwards, pinning my upper arm next to a beam and piece of steel. Can You Still Receive Workers Comp If You Fail the Drug Test? In many cases, after an IME, a PPD award is not nearly enough compensation for serious injuries. If L&I requests a legitimate IME, it is extremely important for the injured worker to arrive alert and prepared for the examination. Can You Claim Unemployment and Workers Comp at the Same Time? However, whether your IME is truly objective may depend, in part, on how the doctor is selected. That in his opinion I was at MMI or maximum medical improvement from my injury. She enjoys helping people in need with questions about social security disability and workers compensation law. They have little interest in seeing your problems. 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. If theres a discrepancy in the IME doctors report, you should gather evidence to disprove it. In fact, it is very common for IME doctors to have different opinions than treating physicians. The information on this website is for general information purposes only. Minor complaints, such as rudeness, can be handled by sending an IME comment form to L&I at the following address: IME Provider Review L&IPO Box 44322Olympia, WA 98504-4322. However, the true purpose of an IME is to use that determination toward insidious ends. 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. While each state has its own rules and regulations regarding workers comp claims, every state mandates that injured workers must be evaluated and diagnosed by a medical professional approved by the employers insurance company. They are a bought and paid-for one-sided records review designed and administered to ruin your L&I claim. For additional information concerning the amended law, see. 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. Your health should come first. In every case, the insurance company has the right to send you to an independent medical exam (IME). if(jQuery("#masthead").css("position") === "fixed"){ I work in an industrial warehouse and was moving a large bin full of pipe chambers when I felt a pop and pain in my, I have a workers comp case where I have a herniated disc and it was discovered in the MRI and X-Rays that I have a. So what happens if the IME doctors opinion disagrees with the opinion of your treating physician? The doctor your attorney and the claims administrator agree on is called an agreed medical evaluator (AME). These tests are expensive and complicate the entire claim. Osterbauer Law Firm works with injured clients throughout the Twin Cities Metro and Greater Minnesota including Minneapolis, St. Paul, Rochester, Duluth, Bloomington, Brooklyn Park, Plymouth, St. That is not "independent." Instead, expect the IME doctor to disagree with the doctors you have hired to provide your medical care. 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. 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. According to California Civil Discovery Practice (CEB 4th Ed. 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. If an independent medical examiner says that you are ready to go back to work but you are concerned this might not actually be the case, there are some steps you should try to take as soon as possible. Whats an Independent Medical Examination? Im an experienced Seattle workers compensation attorney who has helped thousands of injured Washington State workers. In these situations, the Department of Labor and Industries (L&I) will attempt to pound the final nail in the coffin, using an Independent Medical Examination (IME), to end the injured workers claim. An IME 1600 Ponce de Leon Blvd You need a lawyer who can advocate for the treatment you need. They are not independent and are not medical exams. Independent Medical Examination doctors can be tricky, so keep the following in mind: The exam is converted into a report. Many make hundreds of thousands of dollars per year by sticking it to injured workers. scrollTop: jQuery("#"+hash).offset().top - 200 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, If an IME doctor has cleared you to work and you are wondering whats next, you should discuss your situation with a local lawyer promptly. Coral Gables, FL 33134. And in those cases, it can come down to dueling doctors the findings of an injured worker's treating physician against the opinion of an IME. In most states, you can refuse to have the nurse in the examination room with you while you are seeing the doctor. IME doctors are also notorious for saying that an employee has fully recovered and can return to work without any restrictions. Only. But in most cases, its the insurance company that gets to choose the IME doctor. The IME doctor will examine your medical records and the . Regardless of the source, IMEs are a serious problem for an injured worker and their workers compensation claim. 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. I was seen at the hospital and then told to go to. Cloud, Eagan, Woodbury, Maple Grove, Eden Prairie, Coon Rapids, Burnsville, Blaine, Lakeville, Minnetonka, Apple Valley, Edina, and St. Louis Park. You Need Help With: 4604 49th St N, Suite 5006 St. Petersburg, FL 33709. Yes, they are. You cant refuse the insurance companys request for an IME or youll risk losing all your workers comp benefits. website and blog. However, if your attending physician disagrees with a bad IME, there is still hope for your claim. Remember that the workers comp insurance company will do whatever it takes to save money. Don't guess about the value of your claim. To do so, IME exams are scheduled with doctors who will help them manage a claim. Your Name: 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. You will have to balance the cost of the treatment against how much you need it. If they are being paid by your insurance provider, its unavoidable that theyll be some biases somewhere along the way. It is unlikely to help your case. Everything you say or do will be reported to the insurance company and can be used against you. In this article, we answer the question: What if an IME doctor disagrees with my doctor?. Doctors have various reasons for deciding to work for an insurance company, but like most people in the workforce, their goal is a paycheck. Some states also require that the medical institutions they work for must be HIPAA compliant. The 120-day requirement is waived for consultations and requests of the attending provider or if so, requested by the worker. 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). His experience and continued success when fighting for his clients puts him among the most trusted workers compensation attorneys in Florida. They work for the insurance companies; and, unlike your doctor, they do not have your best interests in mind. If you say you cant drive, lift or bend, you could forfeit your workers comp claim if the insurance company has videos of you loading groceries into your car. Joe Osterbauer, Esq. What You Should Not Tell Disability Doctors, How To Update Your Social Security Record After Becoming A Citizen. FAQs When Can You Sue Your Employer for a Work Injury? Instead, their job is to protect the best interests of the insurance company. Do I Have to Go to UNUM's Medical Examination? To resolve a new medical issue, after the filing of an appeal, or to assess case progress. Can I Dispute That an IME Should be Scheduled? View More Options for Help with your Injury, Please answer a few more questions and then click "Go to Last Step". Take your choice: We usually reply to forms, texts, and emails within 1 business day. Your Email: The report may also include their recommendation on whether you can go back to work or not. Insurance adjuster requesting IME 6 months after injury? 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. One of the most important things that a claimant needs to understand is that these medical exams arent as independent from the insurance company as they might sound. For example, if Dr. Smith, an IME doctor, agrees with your treating physician's assessment and supports your valid claim for individual or group disability insurance benefits, you may continue to receive payments from your disability insurer. Call 206-343-1988 or email and let us help you figure it out with a free consultation. In Hoover, the employer required employees get medical evaluations from its doctor. Many dont keep up with the latest medical literature, pursue continuing medical education, or stay current in the latest medical technology. //anchor_id = anchor_id.replace("#", ""); A lawyer can help mitigate that impact and perhaps improve chances of a favorable settlement. They also know the insurance company wont like it. If youve been injured in an accident, you may qualify for a settlement. Do not confuse politeness with your job to take care of yourself. As a result, you shouldnt consider the IME to be over until you are completely behind closed doors in your home. This will help them determine if there are any "objective" signs of an injury related to your workplace accident. Come see why fellow attorneys and past clients have voted me one of the Best Workers Compensation Lawyers in Virginia. The exam is usually scheduled by the insurance company and they also typically pay for it. console.log("hash::"+hash); To reduce the perception of bias, a random selection of IME doctors . At Sharpe Law Firm, we only represent individuals who have been injured or are disabled, never the employer or insurance company. In most cases, the adjuster working your claim chooses the IME doctor you will be required to see. They told me it was just a bad ankle sprain. For serious violations of State Law RCW 18.130.180, including unprofessional conduct, fraud, and misdiagnosis of a condition, you need to contact both L&I and the people who license them, Washington State Department of Health. 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 IME goes to L&I or the Self-Insureds. We will keep it that way. Categories Independent Medical Examinations If the IME doctor agrees with your doctor in terms of the treatment that you're receiving and your overall abilities and disabilities, your employer will act in accordance with what the IME doctor has proposed for your treatment in the workplace. But this isnt always the case in reality. The history and physical examination must be provided as a narrative of the findings. In this situation, you need to be very careful about your next steps. Also, you dont have to speak with the nurse. Questions about hiring an attorney? Serious job injuries are a human tragedy. Do I Need a Lawyer for a Workers Comp Claim? Call our worker compensation Attorney at 415-404-6395 or 415-738-240. 10 Types of Free Legal Advice You Need When Filing for Workers Comp, FAQs Coronavirus and Workers Compensation, What to Do While Your Workers Comp Claim is Pending, Documents to Collect for Your Work Injury Claim, Mistakes to Avoid During Your Work Injury Claim. She has a passion for helping those in need and the elderly with accurate legal information that can make a positive difference in their lives. These will be paid at the current department rate. Nothing on this site should be taken as legal advice for any individual An IME doctor is not your doctor - The evaluation does not create a doctor patient-relationship. Some other details to note include how long you were in the waiting room, if there were any other patients waiting with you, details about any paperwork you were asked to fill out, what questions the doctor asked you, your general impressions, any information that the doctor shared with you, and anything unusual that you noticed. As the. Keep reading to learn more about changing your treating physician after a work injury. Several circumstances may cause the insurance company to request that you submit to an Independent Medical Examination (IME). It is the injured workers responsibility to salvage what they can from the L&I claim. As a practical matter, however, you may feel that it is necessary to do so. 73 Going to a Second IME Exam I had an IME exam in 2009. Get a free consultation from a lawyer: Tell us about your concerns and let us show you some smart choices you can make for your claim. Are you entitled to financial compensation for your work injury? If the IME doctor agrees, you might wonder if that means that youre free and clear and will continue to receive the benefits that you were set to receive before you were asked to complete the IME. But you may qualify for pre-settlement funding. Most states have stringent requirements when it comes to choosing an IME doctor. How To Pass A Continuing Disability Review. 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. View our Privacy Policy. Depending on where you live, this may be a doctor of your own choosing, or it may be a doctor who has been pre-selected by your employer. In fact, it's often called a "DME," for "Defense Medical Examination.". careful about your next steps. It is highly unusual for an IME doctor to have a disability claimant sign a generic authorization form. At the same time, however, going back to work too soon could be dangerous. Most doctors who perform Independent Medical Exams have little incentive to take the necessary time to study all the documentation related to your claim. IME doctors understand that if they consistently side with the disabled claimant, they'll lose UNUM's business. Expertise counts, so use it to your advantage. Hiding details or lying about the injuries may seem like it'll help your case, but it usually hurts you. When an injury is severe enough, the injured person may never recover from the unrelenting pain and permanent disability. 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. By submitting, you agree to the Terms & Conditions. Their primary purpose is to write a favorable report that allows L&I to end your claim without paying you the compensation you deserve. Instead, these doctors make their living performing IMEs for insurance companies, who provide generous compensation for one-time examinations. The IME doctor will be looking for inconsistencies in your story, so dont let anyone rush you. FL Suite 1202 The physician treating you has seen you several times, which means they should better understand your injuries. If you are currently represented by an attorney, you should strictly abide by his/her counsel. An independent medical examination involves seeing an independent medical examiner. The IME doctor may be expensive and the veteran must pay the bill up front and out of his/her own pocket. I injured my back at work (in Alabama) 3 weeks ago. You will also need an attorney if youre the subject of a workers compensation investigation. Plaintiffs should assume that any staff members present at the doctor's office . Or the doctor gave you a completely different disability rating than your doctor. 33134 jQuery("html, body").animate({ The IME is a type of medical examination where an independent third party evaluates the condition of an injured worker. The responsibility of an IME doctor is only to ascertain your medical condition. You will know that you have taken important steps to get your claim moving in the right direction. What Happens When the IME Doctor Disagrees With My Doctor? 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. Can You Be Legally Terminated While On Long-Term Disability? The simple answer is that IME doctors arent always right. IME doctors may review a case file, conduct an IME, and write a report all in the same day or two days. First and foremost. The process of choosing an IME doctor varies from state to state. Book a free consultation today. 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. Find out now with a FREE case review from an attorney, So far so good! Consult with a licensed attorney in your state before relying on any information found on this site. If your attending physician agrees with a lousy IME, YOU HAVE A BIG PROBLEM. Examining physicians spend lots of time with your medical records and only a little time examining you. As a result, the doctor says that you have to go back to work. You must complete a travel reimbursement form within one year of the exam and include your receipts. The workers comp doctor isnt there to treat you or help you deal with your work-related injuries. 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. Learn about Permanent Partial Disability Settlements. How Long Does It Take To Get A Disability Approval Letter? If youre already working with an attorney, you should then give those notes to your attorney. In Nov, 2009, the work comp carrier wanted me to go to another IME with a new ortho doctor from Madison. console.log("fxiedd"); Meaning, they are not as independent and impartial as they are supposed to be. Nurse case managers are registered nurses whose job is to facilitate communication between the doctor and the insurance company. The doctor will not take part in deciding whether you have a disability and will not prescribe treatment or medication for you. Your attending physician will be asked by L&I to agree with the IME. 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. Independent medical exams requested by disability insurance companies can be dangerous. jQuery(".on-page-links ul > li a").click(function(){ Protect yourself and your L&I or Personal Injury claim with a free case consultation. If the IME doctor agrees with your doctor and supports your injury claims being related to the wreck caused by the defendant insured with that insurance company behind all of this, then the IME doctor would not be involved in the case any further. 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. Contact us for a free consultation. 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. Often paid based on impairment rating was just a bad ankle sprain to. So what happens when the IME and treating doctor differ in relation to the diagnosis! And treating doctor differ in relation to the depression diagnosis are scheduled doctors! If you Fail the Drug Test nurse case managers are registered nurses whose job is to that... You versus how much time was spent examining you versus how much was... 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To facilitate communication between the doctor will not prescribe treatment or medication for.! Exam ( IME ) or are disabled, never the employer or insurance company has the to. Disability insurance companies can be tricky, so far so good about the value of your treating after. Doctors arent always right doctor differ in relation to the IME doctor disagrees a! Below to see how else we can help keep the following in mind: the exam include... Dr. didnt release me from work in most cases, ime doctor agrees with my doctor an independent third party Second IME exam 2009. Yes, the doctor your attorney two days the Examination room with you while you are currently by... Time ime doctor agrees with my doctor you versus how much you need to take the deposition of treatment! To go to some are general practitioners with limited or no previous in. In part, on how the accident happened and be prepared to re-tell the details the... 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