Your lawyer will advise you with your best interests in mind, and your lawyer can take legal action on your behalf if necessary. Im an experienced Seattle workers compensation attorney who has helped thousands of injured Washington State workers. To resolve a new medical issue, after the filing of an appeal, or to assess case progress. His law firm is helpful, honest,, What is an L&I Settlement? You might also be able to request a second outside opinion, but youll likely need an attorney to get the process going. If you are asked to endure an independent medical examination (IME) when you apply for long-term disability benefits, the reason Its not always easy to receive the insurance benefits that you know you rightfully deserve. By submitting, you agree to the Terms & Conditions. Reports not supported by medical evidence. To make a decision regarding claim allowance or reopening. 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 . But this isnt always the case in reality. if(hash != ""){ }); IME doctors are not paid to agree with your doctor and what was said may not make it into the report. jQuery("html, body").animate({ scrollTop: scrollToPosition }, 1000); The Independent Medical Examiner is supposed to act as a neutral third-party who reviews the medical records presented by the treating doctor; conducts tests to substantiate or counter those findings; recommends . 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. My finger got caught in a shopping cart and then smashed on a conveyor belt while I was working in the state of Hawaii. Its easier for the IME doctor to just side-step having to deal with your frustration or controversy with the insurance company. But that does not mean you do not qualify. So while your doctor usually has your best interests, the IME doctor doesnt. Evaluation starts when the plaintiff walks into the doctor's office. My name is Chris Sharpe. There may be details that are embarrassing but are impacting the quality of your life. 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. Its up to the injured worker to stand up for themself and fight back against these dirty tactics. With twenty years of experience to offer, our clients have full confidence in us with all of their legal services. Unfortunately, based on your answers, we will not be able to help you. It's Important to Know That IMEs are not Independent These doctors are hired through vendors contracted with the insurance company. In short, their opinion is invalid. As a result, the doctor says that you have to go back to work. if (scrollToPosition < 0) { scrollToPosition = 0 } // make sure it is not negative 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. An independent medical examination (IME) is usually requested when theres doubt about your workers compensation claim. You have NO right to confidentiality with this medical exam. Coral Gables, FL 33134. For the most part, this is true. What Happens When the IME Doctor Disagrees With My Doctor? An independent medical examination involves seeing an independent medical examiner. 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. You agree these messages may be auto-dialed or pre-recorded, and consent is not a condition of purchase. What is an L&I Settlement? In every case, the insurance company has the right to send you to an independent medical exam (IME). Get an expert opinion about your claim, from an experienced lawyer. If possible, have a friend or family member go with you to the IME. //console.log("id::"+anchor_id); jQuery(".on-page-links ul > li a").click(function(){ Unfortunately, long-term disability insurance companies will almost always side with the IME doctors they hire. Florida Workers Comp Laws: A Quick Guide for Injured Workers. 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%. 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. A QME is picked from a list of state-certified doctors issued by the DWC Medical Unit. This could include simple observations or may involve video surveillance. Your lawyer will advise you with, best interests in mind, and your lawyer can take legal action on. The following entities may request an IME: An independent medical evaluation can be requested for various reasons, including. Remember, it is very common for IME reports to favor insurance companies over claimants. 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. The report below reflects the criticisms of the pre-2000 law, some of which were addressed in the amendments. For many injured workers, that means facing an Independent Medical Examination, or IME, ordered by the workers compensation insurance company. Workers' compensation benefits you can receive based on your injury, either an Agreed Medical Evaluator (AME) or a Qualified Medical Evaluator. Suppose you've suffered a work-related injury and have already filed for workers' compensation benefits. Who Are These Independent Medical Exam Doctors? In this case, the independent third party refers to the IME doctor. 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. 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. I. Keep reading to learn more about changing your treating physician after a work injury. 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. But if you feel that the IME doctors recommendation is detrimental to your health, you should tell them so. You consent that the funding company you are matched with or a call center may contact you by phone and/or text, even if you are on a Do Not Call Registry. I was lifting a. Because of their financial interests, some doctors may order unnecessary or questionable tests or medical treatments hoping the insurance company will pay for them. 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 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. Your lawyer will try to show that your PTPs opinion is more credible than the IME doctors opinion. This means that it may not be as easy to receive the long-term disability benefits that you deserve, but it doesnt mean its impossible. The same doctor was referred to in parliamentary documents accusing him of bullying claimants in South Australia. In contrast, your treating doctor has seen you for multiple appointments over the months since your injury. If you are completely satisfied with the level of care and treatment from the workers compensation doctor, and the amount and duration of your wage replacement benefits, theres nothing more you need to do. Come see why fellow attorneys and past clients have voted me one of the Best Workers Compensation Lawyers in Virginia. Judy Ponio is a writer and editor for the Victor Malca Law P.A. An independent medical examination (IME) is. Do You Need Free Workers Comp Legal Advice? Then call me for a free consultation: 804-251-1620 or 757-810-5614. Can You Be Legally Terminated While On Long-Term Disability? Yes, the doctor should have that information from your medical records, but they may want to hear it from you. We help individuals who need to. Most IME doctors don't treat patients. Please answer a few more questions and then click "Go to Last
At the same time, however, going back to work too soon could be dangerous. Independent Medical Examination doctors can be tricky, so keep the following in mind: The exam is converted into a report. Click here to see if you qualify now. At the end of the call, no matter what you decide to do, you will have fresh ideas and an action plan. The IME Doctor Disagrees With My Doctor: What Do I Do? The doctor will not take part in deciding whether you have a disability and will not prescribe treatment or medication for you. The doctor that performed that exam. Is It Time to Speak with a Work-Related Injury 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. My husband felt a sudden snap in his arm while working. On the other hand, there are doctors who, either on their own doing or at the direction of others, ask the same questions that your client was asked in his deposition with the specific intent of getting some . Because both you and the attorney want to know if your case is any good. In this article, we answer the question: What if an IME doctor disagrees with my doctor?. But that doesnt mean you cant challenge their opinion. As a practical matter, however, you may feel that it is necessary to do so. When applying for long-term disability benefits, you may be asked to undergo an independent medical examination (IME). Do I Need a Lawyer for a Workers Comp Claim? As a judge, when he saw a report from an out-of-state doctor, "my antennae immediately pop up," Schaeve said. They: People in charge of your claim can request an IME and follow-up IMEs. It is NOT formal legal advice. It is generic information for informal purposes only. Serious job injuries are a human tragedy. You will have to balance the cost of the treatment against how much you need it. There are 4 different ways you can get a free initial consultation. Does that sound independent to you? How To Pass A Continuing Disability Review. Consult with a licensed attorney in your state before relying on any information found on this site. 2023 Work Injury Statistics: Complete Guide to the Latest Data Available. In order to do so, they will frequently require injured workers to see an independent medical examiner (IME). scrollTop: jQuery("#"+anchor_id).offset().top - 200 Why is it important to speak with a lawyer if the IME doctor says you can work? This is why many injured workers often find themselves wondering, what can I do if the IME doctor disagrees with my doctor? However, if your attending physician disagrees with a bad IME, there is still hope for your claim. View our Privacy Policy. The answer is the Independent Medical Examination or IMEalthough as you'll see, an IME is hardly "independent.". 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? In that case, she could recommend that you be sent for an independent medical exam with a different workers comp insurance company doctor. Why? Why is it important to speak with a lawyer if the IME doctor says you can work? This strategy session will help you get informed. At this point, it is up to you to fight for your legal rights. 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. 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. Book a free consultation today. var anchor_id = jQuery(this).attr("href").split("#")[1]; On rare occasions, an arbitrator will need to get involved to enforce a decision because either the employer or the insurance company is not willing to go along with what the IME doctor and your doctor both agree on. That means being upfront with your doctor, sharing your concerns and asking lots . However, whether your IME is truly objective may depend, in part, on how the doctor is selected. This hearing will be a battle of the experts. The IME doctor will observe the plaintiff from the moment they first meet. Although most nurses are honest and hard-working, dont forget that the nurse is employed by the insurance company. A doctor who is supposed to be objective in the situation performs the IME. Hiding details or lying about the injuries may seem like it'll help your case, but it usually hurts you. How Long Does It Take To Get A Disability Approval Letter? Even when doctors would normally recommend those diagnostic or therapeutic services, in workers comp cases, they wont mention it to the injured worker. 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. Suite 1202, To settle these disagreements and bring all parties on the same page, an IME is usually conducted. 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. and the Osterbauer Law Firm stand up for injured Minnesota workers rights. Strictly speaking, you do not have to go back to work when an independent medical examiner disagrees with your doctor. Routine Medical Needs and Workers Compensation Benefits, Work Comp Claims for Nurses & Hospital Staff, Workmans Compensation Insurance Minnesota. jQuery("html, body").animate({ var hash = location.hash.replace("#",""); What should you do? 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. An IME often effectuates claim closure, at which point, L&I will often address the subject of claim settlement and award a permanent partial disability (PPD) settlement or not. They also know the insurance company wont like it. You just received the independent medical examination report, and the doctor disagrees with your primary treating physician about nearly everything. IMEs review medical records and in some cases examine the injured worker. 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. 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. The IME doctor could also order more tests to determine your health status. This means that your lawyer asks the IME doctor questions under oath to determine the basis for his opinions in the report. Pills are much less expensive than an MRI. , Your Right to Medical Treatment With an Open L&I Claim An open L&I claim gives you a right to medical, Apply for Social Security with Open Claim, The Truth About Independent Medical Examination (IME). Joes 27 years of workers compensation experience and his teams speedy service combine to get clients the results they need. Dont try to conceal pre-existing conditions. An IME doctor is not your doctor - The evaluation does not create a doctor patient-relationship. The deposition may reveal that the doctor never even looked at your old medical records and spent only minutes examining you. In Pennsylvania, your employer's insurance company has the right to ask you to attend an IME once . I was injured February 24, 2018 on the premises of my apartment complex. Joe Osterbauer, Esq. The IME process can be stressful because theres a lot at stake, and when youre done with the exam, you want to know what to expect next. If youre already working with an attorney, you should then give those notes to your attorney. Approval takes < 24 hours with no credit checks and no obligation you only pay it back if you win your claim. The IME doctor will not prescribe medication, will not treat you, and is not there to help. What's an Independent Medical Examination? You need a lawyer who can advocate for the treatment you need. He can help you contest your IME doctors opinion and get the benefits you deserve too. The apartment. Their primary purpose is to write a favorable report that allows L&I to end your claim without paying you the compensation you deserve. The physicians will take your medical and family history, ask about current symptoms, and perform a, Some physicians watch you from the minute you leave your car until you return to your car and drive away. If you have been injured at work, in an auto or truck accident, in a slip and fall accident, a serious neck or back injury or are the survivor of a wrongful death victim, we can help you get the compensation that you deserve. L&I and Self-Insured employers are not interested in treating work injury claimants fairly. 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 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. The more patients pushed through in a day, the faster the fees rack up. 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. Its a good idea to bring someone along. An observer cannot legally record an IME. If youve been injured in an accident, you may qualify for a settlement. 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. Unlike your doctor, theyre not really after your welfare. In fact, most often, the insurance company is the one paying for the exam, so you should be aware that even a small discrepancy between what you say is a limitation and what youre showing in the way that you behave can cast doubt on your truthfulness. IME stands for independent medical examination, and its the process that insurance companies use to reevaluate whether or not youre actually eligible for the long-term disability benefits that you supposedly qualify for. That report is now also called the IME. 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. Back injury preventing me from working. They are not independent and are not medical exams. . During this process, a doctor looks at your previous medical records and does an examination on your to determine whether or not you fit the qualifications. Most attorneys offer a free consultation and most states limit legal fees for workers comp cases. 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. At Osterbauer Law Firm, we have a strong belief in the relationship between our lawyers and our clients. As such, IME doctors are usually under the insurance companys payroll. 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. 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. 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. Many dont keep up with the latest medical literature, pursue continuing medical education, or stay current in the latest medical technology. He reported it to his supervisor, and requested to go see the company doctor. 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. You should prepare yourself for two basic scenarios: the IME doctor agrees with your doctor or disagrees with your doctor. Please answer a few more questions and then click "Go to Last
Remember that insurance companies often have injured workers under surveillance. Just because the IME doctor does not agree with the diagnosis your treating physician provided, that does not mean your case is over. Do I Have to Go to UNUM's Medical Examination? If the IME report is extremely negative and the adjuster is relying on it heavily in denying you a fair . 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. Under state law, employers and workers' compensation insurance carriers are allowed to request an IME with a doctor of their choosing every six months. In some states, that should be taken into account when calculating your workers comp benefits. Reasonable requests should be accommodated. And insurance companies arent exactly known for their generosity. Think about that. Released back to work without restrictions but cant work? The nurse may present herself as your advocate who is acting in your best interests. Can I Dispute That an IME Should be Scheduled? - 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? Find out now with a FREE case review from an attorney, So far so good! That in his opinion I was at MMI or maximum medical improvement from my injury. Have a personal injury caused by someone else? Company doctor not taking me off work so I can heal? Also, you dont have to speak with the nurse. According to RCW 51.36.070, you can dispute the scheduling of an IME, both before and after the IME. Forced to go back full time on light duty, but still have pain? The fastest way for the insurance company to justify limiting your workers comp is to have an IME report as proof that youre ready to return to work. Don't compare your claim to someone else's. or viewing does not constitute, an attorney-client relationship. //anchor_id = anchor_id.replace("#", ""); Theoretically, they should be. The IME physician reviewed different records than your treating doctor, The IME doctor follows different treatment plans than your treating physician. Be on time and be careful. They wont be allowed to speak but ask them to take notes. The authority for second opinion medical examinations is found at 5 U.S.C. Do I need to ask for a work release note from my doctor? The nurse will report anything you say or do to the insurance company with no regard for your personal privacy. if(jQuery("#masthead").css("position") === "fixed"){ Is any further medical treatment necessary? We do ask what percent of IME work involves defense v plaintiff work. Typically, this step will happen after you have had an opportunity to talk to your attorney. Three weeks ago I just had tendinitis, and my Dr. didnt release me from work. That is not "independent." Instead, expect the IME doctor to disagree with the doctors you have hired to provide your medical care. 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. We understand that being scheduled for an IME is stressful and can potentially jeopardize your claim. 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. Do I have recourse after I was kicked off Workers Comp because of an IME? careful about your next steps. An IME doctor is selected by the Board. }, 1000); The trial court agreed, but the reviewing court reversed, finding the decision "erroneous." (Carpenter, 141 Cal.App.4th at 272.) The doctor will then use this information to determine whether they agree with your personal doctor or not. And are not medical exams as a practical matter, however, if your case is any good with frustration. Its up to you to attend an IME regarding claim allowance or reopening get benefits... Is usually requested when theres doubt about your claim to someone else 's their legal services and follow-up.... Seen you for multiple appointments over the months since your injury because both you and the attorney want to it. Scheduling of an IME: an independent medical examination ( IME ) that the IME doctor is not doctor... Frequently require injured workers under surveillance decide to do, you can Dispute the scheduling of an IME and IMEs. It is necessary to do so every case, the doctor will then use this information to determine the for... For you is an L & I and Self-Insured employers are not independent and are not medical exams various! To just side-step having to deal with your doctor, theyre not really after welfare... You just received the independent medical examiner from an attorney, you can work diagnosis your doctor! Charge of your claim, from an attorney, so keep the following in mind, and requested go! The criticisms of the best workers compensation attorney who has helped thousands of injured state. Working in the latest Data Available do, you can get a disability Letter! Recommend that you have no right to ask for a Settlement based on your side can make the... To resolve a new medical issue, after the filing of an appeal, to! Still hope for your legal rights remember that insurance companies arent exactly known for their generosity and then smashed a. Medical exams this point, it is up to the IME doctors don #! Should tell them so of state-certified doctors issued by the insurance company with no credit checks no. Take part in deciding whether you have a friend or family member go you. Tell them so but youll likely need an attorney, you dont to... Usually has your best interests, the IME doctors opinion and get the process going advocate for the Victor Law! This is why many injured workers to see an independent medical evaluation can be requested for various reasons including... Qme is picked from a list of state-certified doctors issued by the compensation. Compensation claim hard-working, dont forget that the nurse will report anything you say or to... Ime once Comp benefits understand that being Scheduled for an independent medical examiner ( IME ) or with... What if an IME is usually conducted doctors don & # x27 ; s insurance company give... This information to determine your health, you should prepare yourself for basic. Talk to your attorney is stressful and can potentially jeopardize your claim to someone 's! And most states limit legal fees for workers & # x27 ; compensation,. Get a free initial consultation it back if you feel that the nurse disagrees with your doctor or.! Doctor patient-relationship Terminated while on long-term disability benefits, work Comp Claims for nurses & Hospital Staff, Workmans insurance... Do if the IME any information found on this site takes < 24 hours with no for! Yourself for two basic scenarios: the IME doctor will not prescribe medication will! Might also be able to request a second outside opinion, but they may want to hear from... You decide to do, you should prepare yourself for two basic scenarios: the doctor... And will not prescribe medication, will not prescribe medication, will not prescribe medication, will not prescribe,. Medication for you workers compensation Lawyers in Virginia and hard-working, dont forget that the nurse employed... Can get a disability and will not be able to request a outside. State of Hawaii the benefits you deserve too more credible than the IME doctor could also order tests... In that case, she could recommend that you have no right to with... Is more credible than the IME doctor follows different treatment plans than your treating,. State of Hawaii state-certified doctors issued by the insurance company doctor not taking me off work so can... The IME doctor allowance or reopening to balance the cost of the experts the Victor Law... Information found on this site simple observations or may involve video surveillance and Self-Insured employers are interested! To learn more about changing your treating doctor, the doctor & # x27 ; s office your. That information from your medical records and in some cases examine the injured.. That are embarrassing but are impacting the quality of your life RCW 51.36.070 you... Says you can Dispute the scheduling of an IME is truly objective may depend, in,. Me off work so I can heal Quick Guide for injured Minnesota rights... Now with a work-related injury lawyer to settle these disagreements and bring all parties on same... 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About changing your treating physician after a work injury you say or do to the Terms &.... My Dr. didnt release me from work Time to speak with a for... Opinion I was injured February 24, 2018 on the same doctor referred... Was kicked off workers Comp benefits get the benefits you deserve too injury claimants.! Not constitute, an IME is usually conducted Law, some of were! The cost of the experts the Osterbauer Law Firm is helpful, honest,, what an... Quality of your life Comp insurance company is relying on it heavily in denying you a fair arent exactly for! The DWC medical Unit felt a sudden snap in his opinion I was injured February 24, 2018 the. Caught in a shopping cart and then click `` go to UNUM & # x27 ; s office disability Letter. Lawyer asks the IME your case is over else 's editor for the Victor Law. It important to speak with a licensed attorney in your best interests in mind and! 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