If you have suffered an injury on the job, you may be asked to attend an examination with a doctor who may not be your primary care physician or treating physician. These exams are known as independent medical exams and could have a significant impact on the outcome of your case.
For this reason, it is crucial that you prepare for this examination, know and understand what to expect and follow some guidelines with regard to how you conduct yourself during the exam.
What is an Independent Medical Examination (IME)?
An Independent Medical Examination is conducted by a physician who will provide an expert opinion about any disputes with regard to your workers' compensation case. In many cases, your employer's insurer may request an IME especially when there is a dispute with your treating physician about whether or not your injury is work-related.
The insurance company may also call for an IME to determine whether a particular medical treatment such as surgery is truly necessary or to determine when you can go back to work. They may also require an IME to evaluate if you have a permanent disability. You may have to attend several IMEs during the course of your claim.
How is a Doctor Selected for an IME?
An independent medical examination, as the name suggests, is meant to be an objective assessment of your medical condition. It determines a number of important details that could affect your work injury case including the type of treatment you need, whether you have a permanent injury that could affect your ability to work and your ability to work in the future. However, whether or not your IME is impartial may depend on how the doctor who will conduct the examination is selected.
Typically, when the insurance company requests an IME, it also chooses the doctor who will perform this evaluation. In these types of situations, there is validity behind the suspicion that the doctors who receive their payment from the insurance companies and depend on them for referrals would take the side of the insurance company rather than the injured worker.
So, essentially, these doctors may be motivated to lower the insurance company's costs, which means your benefits will take a hit. More importantly, you may not have access to the medical treatment you need. This is why it is important that you consider retaining the services of a work injury attorney to make sure your legal rights and best interests are protected.
What Happens During an IME?
You will need to send your medical records and any other documents that are relevant to your work injury case to the IME doctor. The doctor will them decide whether to review the documents before or after the exam. If there is a disputed issue in your case, then the insurer may write a letter to the doctor detailing your injury, course of treatment to date and asking specific questions about your medical condition, which are often meant to frame the issue for the doctor.
Here are some of the issues that are frequently explored in an Independent Medical Examination:
- Your condition and whether it has been properly diagnosed.
- Whether your current injury and symptoms were caused by a work-related accident. Were your injuries caused by activities outside of work?
- Do you need additional diagnostic tests or medical treatment for your injury? If so, what type of treatment or therapy do you need?
- If your treating doctor has recommended surgery, is it necessary and appropriate, given your condition?
- When will you be able to return to work?
- Do you have any restrictions with regard to the type of work you can perform such as standing for long periods of time or carrying heavy weights?
- Do you have permanent injuries or disabilities? If so, how does that affect your ability to work?
It is important to remember that anything you tell the examining doctor during this exam is not privileged or protected in any way. So, your statements to the doctor can be used against you in a workers' comp hearing. This is also true for any observations the doctor makes.
During the exam, the doctor will likely begin by asking about the circumstances of your accident and injury. He or she may then go into your medical history and the treatment you've received so far for your injuries. The doctor may then conduct physical exams and tests related to your injury.
How an IME Can Affect Your Case
Once the IME has concluded, the examining doctor will write a report with his or her conclusions and opinions. The doctor will also provide his or her opinion on any disputed issues raised by the insurer. It is important to make sure that you and your lawyer receive a copy of this report.
The results of an IME can have a significant impact on your work injury case because workers' comp judges and hearing officers attach a lot of importance to these reports. Even though it may not be the case, IME doctors are viewed as "objective third parties" and therefore, it may be challenging to discredit their opinion.
There are certain times when you may be able to challenge an IME report. For example, if the doctor based his or her opinion on incorrect information, you can challenge the report. In order to do so, you will need to write a letter to the insurance company and the doctor explaining the inaccuracies in the report and supporting your case with documentation. Sometimes, you may also be able to request a second medical examination done by a doctor you choose.
Protecting Your Rights
If you have been injured in a workplace accident, the experienced Los Angeles work injury lawyers at Greenberg and Ruby Injury Attorneys can help protect your legal rights and options. The work injury claim process is riddled with potential pitfalls that could eventually end up jeopardizing your case and affecting your work injury settlement. We will fight for your rights every step of the way and help put you in a position to receive maximum compensation for your losses. Call us at (323) 782-0535 to find out how we can help you.
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