Independent Medical Exams & How They Can Affect Your Workers’ Compensation Benefits
Getting hurt at work and being tossed head first into the workers’ compensation process can be an incredibly confusing and stressful experience. Even if you haven’t had any problems in your case, getting sent to an Independent Medical Examination, or IME for short, can all too often be the event that changes everything. Understanding these medical exams is very important, as they can have a serious impact on your case.
What is an Independent Medical Exams (IME)?
IMEs are medical exams designed to answer specific questions about your condition. For example, an IME might be conducted to determine the cause or extent of your injury. IMEs are also often used to determine the extent to which you have recovered from an injury. IMEs are used in a variety of legal cases, but they are used very frequently in worker’s compensation cases. Workers’ compensation insurance companies use the answers provided by the IME to make a variety of decisions in your case, from deciding whether to cover your injury to whether your benefits should continue.
Who conducts the IME?
Generally, an independent doctor or other healthcare professional will conduct the exam. This means that your treating doctor will not be the one to conduct the IME. Depending on your injury, the doctor may refer you to a specialist with expertise in treating your type of injury. The insurance company pays the doctor a fee to conduct the exam and write a report about your condition, which is then sent to the insurance company. While many IME doctors are extremely friendly, it is important to remember that they are being paid by the insurance company.
It is very important to remember that only a limited doctor-patient relationship exists during the IME. Because the IME doctor is not your treating physician, they are not bound to the same standards as your treating physician. For example, this limited relationship means that the normal confidentiality you enjoy with your treating physician is not present. While the IME doctor must still abide by normal HIPPA laws, they are allowed to disclose your statements made during the exam to the insurance company.
What happens during the IME?
The IME will normally begin with a brief introduction from the doctor, who should explain the limited doctor-patient relationship. The exam will begin with the doctor taking a history from you. This will typically include past medical problems, an explanation of how you were hurt at work, your treatment, and current symptoms. The doctor may also ask about family medical history or your own military history. The doctor will then transition into a physical examination. This will involve a variety of tests and maneuvers that the doctor will have you perform in order to assess your injury. For example, the doctor may have you walk around the room, or perform certain movements with your arms or legs. Depending on the type of injury you have, some of these movements may be more relevant to the doctor’s assessment than others. The entire process can vary in how long it takes. Some IME doctors will have you in and out in just a few minutes, while others may take an hour or more to conduct the exam.
Can I refuse to attend the IME?
Unfortunately, you cannot legally refuse to attend the IME. Insurance companies have a legal right to send you to an IME. However, they can only send you to an IME once every six months. If you cannot drive or otherwise find a ride to the exam, the insurance company can arrange transportation to and from the IME for you. If you refuse to go to the IME, the insurance company can get a court order requiring you to go. If you still refuse, a Workers’ Compensation Judge can suspend your benefits.
What effect can the IME have on my case?
An IME can have a serious impact on your case. In some situations, an IME can benefit your case. For example, the doctor might agree that the treatment you’ve had for your injury is reasonable and should continue without interruption. The doctor might also confirm your injuries and agree with your treating doctor that you should have restrictions placed on what you can do at work.
However, an IME can often have negative consequences on your case. If the IME doctor concludes that your injury did not occur at work, the insurance company may deny you workers’ compensation benefits out of the gate. If you are already receiving benefits, the insurance company may use the doctor’s conclusion that you are fully recovered as a justification to suspend or terminate your benefits.
What should I do?
If you’ve been hurt at work or are currently receiving workers’ compensation benefits, you shouldn’t try to navigate the system alone. IME doctors and the insurance company are not interested in looking after your best interests. Our expert workers’ compensation attorneys can help you through the IME process and will be by your side fight to protect your benefits following the exam.
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