There might also be an arbitrator, who will decide whether the IME doctor or your doctor is more credible. The IME doctor will look for any inconsistencies in your behavior. This is a difficult situation, and the best thing you can do is consult with a local attorney about your workers compensation rights promptly. Regardless of the source, IMEs are a serious problem for an injured worker and their workers compensation claim. Dont volunteer your opinions, just relate the facts. 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. Do it or lose it! Joe Osterbauer, Esq. Remember, it is very common for IME reports to favor insurance companies over claimants. What should you do? 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. Your Phone Number: IME doctors are also notorious for saying that an employee has fully recovered and can return to work without any restrictions. In that case, she could recommend that you be sent for an independent medical exam with a different workers comp insurance company doctor. At Osterbauer Law Firm, we have a strong belief in the relationship between our lawyers and our clients. This medical opinion is sometimes based upon surveillance video obtained by the insurance company through private investigators. Get started with a free case assessment online 24/7. What happens when the IME disagrees with my doctor? //console.log("id::"+anchor_id); L&I and Self-Insured claims managers schedule IMEs so they can move a claim toward the conclusion they desire. 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. if(hash != ""){ Medical treatment is stopped immediately. The IME doctor will be looking for inconsistencies in your story, so dont let anyone rush you. The information on this website is for general information purposes only. At Chisholm Chisholm & Kilpatrick LTD, our team of experienced attorneys and professionals has assisted clients throughout the long-term disability claim process. You have 60 days from receipt of this order to protest or appeal the L&I Decision. Make sure to include evidence to prove your claim. TALK WITH YOUR DOCTOR BEFORE THEY AGREE WITH A BAD IME! Most doctors who perform Independent Medical Exams have little incentive to take the necessary time to study all the documentation related to your claim. They are not independent and are not medical exams. An IME is an examination scheduled by the Indiana Work Comp Board, and this report will be very important to your case. 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. Some states give that prerogative to the injured worker. But in most cases, its the insurance company that gets to choose the IME doctor. In some states, that should be taken into account when calculating your workers comp benefits. He then said that if Dr. Demeter does not exam her, then her benefits will be denied. If youve suffered a tragic workplace injury and youre tired of fighting for the compensation you deserve, schedule a free case evaluation today to learn how we can help you fight these injustices. 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. scrollTop: jQuery("#"+anchor_id).offset().top - 200 IME doctors may review a case file, conduct an IME, and write a report all in the same day or two days. Are you entitled to financial compensation for your work injury? 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. Approval takes < 24 hours with no credit checks and no obligation you only pay it back if you win your claim. When an injury is severe enough, the injured person may never recover from the unrelenting pain and permanent disability. Their opinions are heavily biased, and many already believe you arent injured before they even begin your examination. 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. jQuery(window).load(function() { Do I need to ask for a work release note from my doctor? The insurance company nurse may demand to be in the room when your doctor is examining or treating you and wont hesitate to challenge your doctors opinion. If your doctor says you need a surgery and the IME doc says you don't then you'll have a battle on your hands . They may also do a functional capacity evaluation. Some are general practitioners with limited or no previous experience in workplace injuries. An L&I settlement is money paid at claim closure. Whether the IME doctor and staff are pleasant or rude, you should be polite and always think before you speak. Nothing on this site should be taken as legal advice for any individual Keep reading to learn more about changing your treating physician after a work injury. In fact, it is very common for IME doctors to have different opinions than treating physicians. In this case, the "independent third party" refers to the IME doctor. The IME is a type of medical examination where an independent third party evaluates the condition of an injured worker. 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. There are 4 different ways you can get a free initial consultation. Reasonable requests should be accommodated. When Can Independent Medical Exams be Requested? But its not unheard of for employers and insurance companies to use it to discredit your claim. 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. Cloud, Eagan, Woodbury, Maple Grove, Eden Prairie, Coon Rapids, Burnsville, Blaine, Lakeville, Minnetonka, Apple Valley, Edina, and St. Louis Park. 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. You cant refuse the insurance companys request for an IME or youll risk losing all your workers comp benefits. 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. The IME doctor could also order more tests to determine your health status. Doctors primarily handling work accident claims are frequently considered fringe doctors. In Hoover, the employer required employees get medical evaluations from its doctor. More than likely, the doctor and other staff members will be watching the way that you act as you leave. Because of their financial interests, some doctors may order unnecessary or questionable tests or medical treatments hoping the insurance company will pay for them. 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. When you click the button you will be redirected to LawsuitInfoCenter.com. Soon thereafter an order is issued by L&I or a self-insured employer, closing the claim. 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. As a result, lots of insurance company-approved doctors are more likely to treat injuries with pain medication. 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. Independent medical examiners routinely dispute doctors treatment recommendations. Come see why fellow attorneys and past clients have voted me one of the Best Workers Compensation Lawyers in Virginia. Doctors have various reasons for deciding to work for an insurance company, but like most people in the workforce, their goal is a paycheck. 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. Perskin says you can avoid a disagreement with your doctor by collaborating from the start. FAQs When Can You Sue Your Employer for a Work Injury? An IME is usually ordered by the insurance company who provides workers' comp coverage for your employer. You will have to balance the cost of the treatment against how much you need it. Your use of this site does NOT create an attorney-client relationship. 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. There are ways you can reduce the amount of weight an IME report will have on your case, such as: An IME report will lose credibility if the physician simply had one short visit with you or didnt do much to examine your condition or ask you pertinent questions. Unfortunately, in most cases, you do. } The IME goes to L&I or the Self-Insureds. She enjoys helping people in need with questions about social security disability and workers compensation law. 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. With twenty years of experience to offer, our clients have full confidence in us with all of their legal services. Victor Malca P.A. It never hurts to have your own witness to the exam. This is because the faster an injured worker returns to work, the lesser compensation the insurance provider will have to pay. 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. If you dont like what shows up in your IME report, there are steps you can take to counteract that bad IME. The process of choosing an IME doctor varies from state to state. He specializes in representing injured workers on compensation benefit cases and disabled individuals claiming lost social security disability benefits. Is it still workers comp when two doctors disagree? What will the state agency do? 4604 49th St N, Suite 5006 St. Petersburg, FL 33709. Your Name: I was kicked off workers comp three months after my injury because of an IME. When all this is done, they will then prepare a medical report containing their findings. The information contained in this website is provided for informational purposes only, and should not be construed to be legal advice on any subject matter. Do You Need Free Workers Comp Legal Advice? How do I get a doctor to take me off work for severe pain? 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. 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. Questions are answered and no time is wasted. Have a personal injury caused by someone else? 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. These will be paid at the current department rate. 33134 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). Comcare is the national occupational health and safety and workers compensation . The Law in All 50 States. Yes, they are. Can You Still Receive Workers Comp If You Fail the Drug Test? Whats an Independent Medical Examination? Your attorney can also start preparing to dispute the IMEs report (as this will most likely be necessary); and, after the appointment, your attorney can deal with the insurance company on your behalf. 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. case or situation. Our Confidentiality Pledge The information you give us is private and confidential. In many cases, the doctor's sole source of income is performing IMEs. The IME physician reviewed different records than your treating doctor, The IME doctor follows different treatment plans than your treating physician. Has the workers claim-related medical condition reached maximum medical improvement? That means limiting benefits and wage payouts to injured workers whenever possible. You may have a nurse case manager assigned to help you with your claim. Contact us for a free consultation. The apartment. The workers compensation insurance company is allowed to order an IME (or 2 or even 3) for several different reasons but, basically, an IME is in exam by an independent medical doctor. They are a bought and paid-for one-sided records review designed and administered to ruin your L&I claim. Given all of these issues, you might be wondering if you have to go to an independent medical exam. Getting a second (and sometimes third) medical opinion can help support your claim. Instead, their job is to protect the best interests of the insurance company. SAVE YOUR RECEIPTS!!! What Are Your Chances of Getting Disability for Arthritis. Released back to work without restrictions but cant work? The. Frequently, the IME doctor will talk to the insurance adjuster or the defense lawyer before conducting the IME exam and/or before writing his or her IME report, to make sure it helps out the insurance company position. As a result, the doctor says that you have to go back to work. 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. They are doctors are engaged by the WorkCover . Recalling the length of your visit with the IME doctor as well as what they said and did during the examination. Also, you dont have to speak with the nurse. If youve been injured in an accident, you may qualify for a settlement. 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. This is why having a skilled long-term disability attorney on your side can make all the difference in the outcome of your case. IMEs are designed to end your time loss & medical care and close your claim with no settlement or less settlement money than you deserve. 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. To make a decision regarding claim allowance or reopening. Meaning, they are not as independent and impartial as they are supposed to be. Unfortunately, based on your answers we cant provide a case review. Get started with a free case assessment online 24/7. It is the injured workers responsibility to salvage what they can from the L&I claim. There are three types: PERMANENT PARTIAL, Who is Christopher Sharpe? 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. Learn about Permanent Partial Disability Settlements. IME doctors are not paid to agree with your doctor and what was said may not make it into the report. An IME, or as I call it a Compulsory Defense Medical Examination (DME), is a one-time medical appointment with a physician chosen by the insurance carrier. Suite 1202, This website contains general information that may not reflect current legal developments, verdicts, and/or settlements. Before the hearing, your lawyer may need to take the deposition of the IME doctor. 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. 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