An IME doctor is selected by the Board. My finger got caught in a shopping cart and then smashed on a conveyor belt while I was working in the state of Hawaii. Note: This page was last updated on February 21, 2023. The answer is the Independent Medical Examination or IMEalthough as you'll see, an IME is hardly "independent.". Your lawyer may have to attend a hearing with the workers compensation judge to present your doctors report and rebut the IME report. Coral Gables, View our Privacy Policy. It is highly unusual for an IME doctor to have a disability claimant sign a generic authorization form. This will help them determine if there are any "objective" signs of an injury related to your workplace accident. Back injury preventing me from working. Finding a Compromise. 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. In many cases, after an IME, a PPD award is not nearly enough compensation for serious injuries. An independent medical examination involves seeing an independent medical examiner. 4604 49th St N, Suite 5006 St. Petersburg, FL 33709. 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. These questions look like this: The truth is IMEs are a complete sham that claims managers use to deny medical attention and close claims. . 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%. How Do You Verify if Your Employer Has Workers Compensation Coverage? Unfortunately, based on your answers we cant provide a case review. 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. Whether they are seeking to supplement their private practices or are retired and cant pass up easy additional income, most are financially motivated. And insurance companies arent exactly known for their generosity. 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. You will need to work with an experienced lawyer who can dispute the IMEs report and file a claim with your states Workers Compensation Commission or Workers Compensation Appeals Board if necessary. Many dont keep up with the latest medical literature, pursue continuing medical education, or stay current in the latest medical technology. If youve been injured in an accident, you may qualify for a settlement. I am a restaurant manager for a very busy chain restaurant. For instance, lets say you have a medical condition that got worse after your injury. On the contrary, most of them are instructed to disprove your claim. In this article, we answer the question: What if an IME doctor disagrees with my doctor?. 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. }); Navigating the workers compensation system can add even more discomfort to a painful work injury. Workers comp refuses to order MRI for elbow injury? And as such, the WorkCover insurer refuses to pay for any medical treatment related to the depression. Before the hearing, your lawyer may need to take the deposition of the IME doctor. //console.log("id::"+anchor_id); Remember, it is very common for IME reports to favor insurance companies over claimants. But that doesnt mean you cant challenge their opinion. IMEs review medical records and in some cases examine the injured worker. Yes, they are. For many injured workers, that means facing an Independent Medical Examination, or IME, ordered by the workers compensation insurance company. Ex. For example, if your doctor agrees with the IME and says you are fixed and stable then L&I will move to close the claim. Although most nurses are honest and hard-working, dont forget that the nurse is employed by the insurance company. They are a bought and paid-for one-sided records review designed and administered to ruin your L&I claim. Some states also require that the medical institutions they work for must be HIPAA compliant. 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. Can You Be Legally Terminated While On Long-Term Disability? Saying or doing the wrong thing in front of the workers' comp doctor could cause your claim to be denied. We cover all of Illinois. 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. An independent medical examination (IME) is usually requested when theres doubt about your workers compensation claim. 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. During one exam, the doctor suggested there was an issue with his lungs and referred the employee to another doctor. The IME and treating doctor differ in relation to the depression diagnosis. *By requesting a free consultation, you confirm that you are 18 or older and do not have an attorney. The IME is a type of medical examination where an independent third party evaluates the condition of an injured worker. Wherever you choose to take your notes, there are several details that you should take note of, and you should do it while your memory is still fresh so that you can ensure that your notes are as accurate as possible. This website contains general information that may not reflect current legal developments, verdicts, and/or settlements. 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. Is it still workers comp when two doctors disagree? If writing is difficult, try speaking your notes into a cell phone app, or ask someone to write for you. 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. 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. Just because the IME doctor does not agree with the diagnosis your treating physician provided, that does not mean your case is over. var hash = location.hash.replace("#",""); It is not uncommon to see IME reports saying, . If you cant help yourself, contact a lawyer to see if they will help you. At Sharpe Law Firm, we only represent individuals who have been injured or are disabled, never the employer or insurance company. These IME opinions may cost from $600.00 to $1500.00 or more. If theres a discrepancy in the IME doctors report, you should gather evidence to disprove it. 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. Your doctor can initial in 5 seconds and be done with it OR your doctor can spend an hour or more writing a report about their findings and how the other doctor is wrong. In this case, the insurance provider can stop paying your claim. The IME believes that the depression did not develop secondary to your physical injury, but your treating doctor believes that it did. Independent medical examination. Request a copy of the IME doctors report. If you dont like what shows up in your IME report, there are steps you can take to counteract that bad IME. For the most part, this is true. How long can I stay home to recover from a work injury? In Hoover, the employer required employees get medical evaluations from its doctor. When an injury is severe enough, the injured person may never recover from the unrelenting pain and permanent disability. Several circumstances may cause the insurance company to request that you submit to an Independent Medical Examination (IME). This is an exam by a doctor of their choosing who often is not so "independent" and can mess up or at least delay your case. TALK WITH YOUR DOCTOR BEFORE THEY AGREE WITH A BAD IME! The insurance company disagrees with your treating physicians medical opinion. The IME physician reviewed different records than your treating doctor, The IME doctor follows different treatment plans than your treating physician. The responsibility of an IME doctor is only to ascertain your medical condition. Some states give that prerogative to the injured worker. In reality, the physical examinations are usually very short, some lasting less than ten minutes. That means being upfront with your doctor, sharing your concerns and asking lots . Whats next? Im an experienced Seattle workers compensation attorney who has helped thousands of injured Washington State workers. How Can I Get My Employer to Pay for an MRI? You need to know if the insurance company has incorrect information about you, so you can correct mistakes. Everything you say or do will be reported to the insurance company and can be used against you. Unfortunately, based on your answers, we will not be able to help you. An IME is an examination scheduled by the Indiana Work Comp Board, and this report will be very important to your case. In short, their opinion is invalid. How To Write A Disability Appeal Letter (With Sample). case or situation. 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. 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. 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. has over 27 years of litigation experience in Workers Compensation and Social Security Disability lawsuits. 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. He then said that if Dr. Demeter does not exam her, then her benefits will be denied. state agency. Its a good idea to bring someone along. An observer cannot legally record an 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. At Chisholm Chisholm & Kilpatrick LTD, our team of experienced attorneys and professionals has assisted clients throughout the long-term disability claim process. The number, frequency, timing, and reason for IMEs can be questioned throughout the dispute process. Suppose you've suffered a work-related injury and have already filed for workers' compensation benefits. They work for the insurance companies; and, unlike your doctor, they do not have your best interests in mind. 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. A bought and paid-for one-sided records review designed and administered to ruin your L I. 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ime doctor agrees with my doctor