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. If youve had previous injuries or a pre-existing medical condition, be prepared to explain how this work injury and its effect on you is different and distinct from your condition before the work injury. Coral Gables, The doctor will send a report of the exam or test to the state agency. state agency. He specializes in representing injured workers on compensation benefit cases and disabled individuals claiming lost social security disability benefits. Rarely do they issue opinions that are favorable to an injured worker. 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. Virginia Beach, VA 23462 (757) 455-8889 (888) 694-1671 (757) 455-6757 Elizabeth City Office (by appointment only) 507 E Main St #K TALK WITH YOUR DOCTOR BEFORE THEY AGREE WITH A BAD IME! Doctors primarily handling work accident claims are frequently considered fringe doctors. //var anchor_id = jQuery(this).attr("href"); In cases where your employer's insurance company disputes your injuries, illness or disabilities, they may ask you to undergo an independent medical examination (IME). 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. Remember, if you refuse to submit to an IME, the insurance company can legally deny your workers compensation claim and stop your medical and wage replacement benefits. The doctor will not take part in deciding whether you have a disability and will not prescribe treatment or medication for you. 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. Despite their label, IMEs are not independent. Yes, you can. Conclusions in the report must be consistent with the objective clinical findings found on examination and the claimant's symptoms, laboratory studies, and demonstrated response to treatment and on all available information, including the history. Victor Malca P.A. Independent medical examiners routinely dispute doctors treatment recommendations. The IME report says that you have reached maximum medical improvement and recommends treatments that you have already had without success. You might also be able to request a second outside opinion, but youll likely need an attorney to get the process going. The more patients pushed through in a day, the faster the fees rack up. These doctors are bought and paid for by L&I and Self-Insureds and have long ago sold out to the establishment. 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. The Law in All 50 States. An independent medical examination (IME) is. Their opinions are heavily biased, and many already believe you arent injured before they even begin your examination. They have little interest in seeing your problems. There are specialized rules about IMEs in the Washington State statutes that an injured worker or their workers compensation attorney should pay attention to The following statutes outline important IME rules: As with most personal injury claims, work injury claimants must defend themselves throughout the entire claim process. Your lawyer may have to attend a hearing with the workers compensation judge to present your doctors report and rebut the IME report. In this case, the "independent third party" refers to the IME doctor. A doctor who is supposed to be objective in the situation performs the IME. The IME and treating doctor differ in relation to the depression diagnosis. According to RCW 51.36.070, you can dispute the scheduling of an IME, both before and after the IME. jQuery("html, body").animate({ scrollTop: scrollToPosition }, 1000); We never represent the employer or insurance company. 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. Find out now with a FREE case review from an attorney, So far so good! I was walking past. IME doctors may review a case file, conduct an IME, and write a report all in the same day or two days. Call our worker compensation Attorney at 415-404-6395 or 415-738-240. Workers' compensation benefits you can receive based on your injury, either an Agreed Medical Evaluator (AME) or a Qualified Medical Evaluator. How To Write A Disability Appeal Letter (With Sample). Most insurance companies permit an injured worker to have a second evaluation from another doctor on their approved list. Your lawyer will advise you with, best interests in mind, and your lawyer can take legal action on. The doctor that performed that exam. Injured on the job? All too often there is no good solution for significant injuries. Some of the reasons why this can happen are because: When there are differences of opinion regarding your condition, the insurance company will side with whichever report they deem the most credible. 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. Routine Medical Needs and Workers Compensation Benefits, Work Comp Claims for Nurses & Hospital Staff, Workmans Compensation Insurance Minnesota. IT IS THE RESPONSIBILITY OF THE INJURED WORKER TO SALVAGE WHAT THEY CAN FROM THE L&I CLAIM. We understand that being scheduled for an IME is stressful and can potentially jeopardize your claim. These IME opinions may cost from $600.00 to $1500.00 or more. Given all of these issues, you might be wondering if you have to go to an independent medical exam. 250 (1964). Recalling the length of your visit with the IME doctor as well as what they said and did during the examination. var scrollToPosition = parseInt(jQuery("#" + anchor_id).offset().top) - parseInt(jQuery("#masthead").outerHeight()); I was injured February 24, 2018 on the premises of my apartment complex. My lawyer refused to go to this new doctor as they already had established an IME doctor for my case. You might choose to take notes on a few important issues when you get to your car, or you might choose to wait until youre home if you live near the doctors office. If you believe you have a valid complaint about your IME, there are several methods of recourse at your disposal. Instead, these doctors make their living performing IMEs for insurance companies, who provide generous compensation for one-time examinations. Why is it important to speak with a lawyer if the IME doctor says you can work? There are two common reasons why the IME doctor may disagree with your doctor: Some of the most common things they disagree on are: Unfortunately, an IME doctors opinion tends to hold a lot of weight even if theyre a little biased. Yes, the doctor should have that information from your medical records, but they may want to hear it from you. No recipients of any content from this website, clients or otherwise, should act or refrain from acting on the basis of such content, without first seeking the appropriate legal and/or other professional advice on the particular facts and circumstances at issue, and from an attorney and/or professional who is licensed in the recipients state. If you want to discuss your unique case in confidence, you can contact us for free at 312-346-5578. Dabdoub Law Firm is a highly specialized disability insurance law firm based in South Florida offering representation to disability claimants across the country. 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. 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. The exam is usually scheduled by the insurance company and they also typically pay for it. This website contains general information that may not reflect current legal developments, verdicts, and/or settlements. What You Should Not Tell Disability Doctors, How To Update Your Social Security Record After Becoming A Citizen. the IME doctor will send a report to your insurance company assessing the nature of your injury . This could include simple observations or may involve video surveillance. How do I get a doctor to take me off work for severe pain? Unfortunately, in most cases, you do. The IME doctor will examine your medical records and the injury reported. website and blog. In that case, she could recommend that you be sent for an independent medical exam with a different workers comp insurance company doctor. Think about that. Christopher Sharpe is the go to attorney for injured persons. Dont volunteer your opinions, just relate the facts. Remember that insurance companies often have injured workers under surveillance. Nothing personal for them you are just a claim number. Strictly speaking, you do not have to go back to work when an independent medical examiner disagrees with your doctor. If L&I requests a legitimate IME, it is extremely important for the injured worker to arrive alert and prepared for the examination. 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 accuracy of information provided on this site is not guaranteed. 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. For the most part, this is true. }); Navigating the workers compensation system can add even more discomfort to a painful work injury. In this situation, you need to be very careful about your next steps. If you dont like what L&I is doing to you, you must do something about it. You must complete a travel reimbursement form within one year of the exam and include your receipts. 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. An IME is supposed to be an objective assessment of your medical condition, including what treatment you need, whether you have a permanent impairment and to what degree, and your ability to work in the future. The IME Doctor Disagrees With My Doctor: What Do I Do? They are a bought and paid-for one-sided records review designed and administered to ruin your L&I claim. It is highly unusual for an IME doctor to have a disability claimant sign a generic authorization form. Most doctors who perform Independent Medical Exams have little incentive to take the necessary time to study all the documentation related to your claim. The insurance company can also authorize your employer to accommodate work restrictions so that you can continue to work with modified arrangements, or they can also say that you need to have additional treatments before you can be considered for benefits again. Book a free consultation today. FAQs How Can You Get Free Legal Advice for a Work Injury? I recently accepted and. In some states, that should be taken into account when calculating your workers comp benefits. His law firm is helpful, honest,, What is an L&I Settlement? Examining physicians spend lots of time with your medical records and only a little time examining you. Doctors have various reasons for deciding to work for an insurance company, but like most people in the workforce, their goal is a paycheck. careful about your next steps. Request a copy of the IME doctors report. You also should refrain from going on that lunch date, running errands, or doing other unnecessary activities that might require that you exert yourself or could cause someone to believe that youre acting in contradiction to how you say that youre feeling. Im an experienced Seattle workers compensation attorney who has helped thousands of injured Washington State workers. You will know that you have taken important steps to get your claim moving in the right direction. 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? How Long Does It Take To Get Disability Check After Approval? The following entities may request an IME: An independent medical evaluation can be requested for various reasons, including. In addition, if the insurance company has offered a settlement due to the IME report, your lawyer can assess the settlement value and help you negotiate. 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. 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. It is also understood that an examining doctor may ask plaintiff their medical history. Yes, they are. } On Jan 2nd 2015 I was battered by a patient of my employer. With that said, if you dont do anything, your workers compensation claim will be over. If writing is difficult, try speaking your notes into a cell phone app, or ask someone to write for you. Map & Directions [+]. As mentioned, an IME doctor is an independent third party. 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. How To Pass A Continuing Disability Review. The IME goes to L&I or the Self-Insureds. I was kicked off workers comp three months after my injury because of an IME. In many cases, the doctor's sole source of income is performing IMEs. Please be sure to indicate the best answer. Get an expert opinion about your claim, from an experienced lawyer. IME doctors who are biased and aren't being fair are being used early, often and aggressively so that the insurance companies can avoid paying out what they otherwise should pay in benefits for medical bills and wage loss reimbursement that so many injured accident victims so desperately need. One of the most important things that a claimant needs to understand is that these medical exams arent as independent from the insurance company as they might sound. You need to be careful when you leave the doctors office where your IME evaluation is done. If the IME doctor agrees with your doctor in terms of the treatment that you're receiving and your overall abilities and disabilities, your employer will act in accordance with what the IME doctor has proposed for your treatment in the workplace. The IME doctor will examine your medical records and the . case or situation. Coral Gables, FL 33134. How can I get my doctor to put me on full work restriction? This strategy session will help you get informed. What is the Workers Compensation Appeals Board and How Does it Work? 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. In fact, it is very common for IME doctors to have different opinions than treating physicians. The IME is a type of medical examination where an independent third party evaluates the condition of an injured worker. 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. Reasonable requests should be accommodated. Remember, its you against the insurance company, and the nurse case manager is just another of their employees. Joe Osterbauer, Esq. 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. Because both you and the attorney want to know if your case is any good. Whats an Independent Medical Examination? 8123 (a). But its not unheard of for employers and insurance companies to use it to discredit your claim. In short, their opinion is invalid. Most of the time, they use the IME doctors opinion to achieve such. 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. jQuery("html, body").animate({ Stephen Scott, the Aetna Claims Analyst called our office today and said that our client must sign the form or Dr. Demeter won't exam her. This information is not intended to create, and receipt With twenty years of experience to offer, our clients have full confidence in us with all of their legal services. You can use this to contest the IME report at court. After a specified time from your claim filing, youll be permitted to have an evaluation and treatment from a physician you choose, whether on the insurance companys approved list or not. 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. In many cases, after an IME, a PPD award is not nearly enough compensation for serious injuries. Theoretically, they should be. They told me it was just a bad ankle sprain. That report is now also called the IME. The IME believes that the depression did not develop secondary to your physical injury, but your treating doctor believes that it did. Get a free claim assessment from a local attorney. An independent medical examination (IME) is usually requested when theres doubt about your workers compensation claim. If you dont like what shows up in your IME report, there are steps you can take to counteract that bad IME. I am a restaurant manager for a very busy chain restaurant. IME stands for "Independent Medical Exam." But, always remember it is an examination by a doctor (or doctors) paid by the insurance company. But if you choose to take notes with pen and paper, take a picture with your phone, too, so that you have a time-stamped record of when you wrote those notes so that its less likely that someone can accuse you of having forgotten and taken inaccurate notes. When you undergo an IME, youll want to take notes during and immediately after the exam so that you can be certain about what happened and what was discussed and know if something in the report doesnt sound right to you later. Though, this will make it harder to get your workers comp claim approved. 5-Step Disability Evaluation Under Social Security 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. While it might be okay for you to return to work, it also might not. They may also do a functional capacity evaluation. Take your time. Its a good idea to bring someone along. An observer cannot legally record an IME. Keep reading to learn more about changing your treating physician after a work injury. Consultations are free. I never consider a an IME exam to be independent because you are required pursuant to the terms of your disability . To resolve a new medical issue, after the filing of an appeal, or to assess case progress. Disability insurance companies will often rely on either an Independent Medical Exam (IME) or an External Medical File review without examination in order to deny a long term disability claim. In most cases, the adjuster working your claim chooses the IME doctor you will be required to see. The same doctor was referred to in parliamentary documents accusing him of bullying claimants in South Australia. It never hurts to have your own witness to the exam. behalf if necessary. That in his opinion I was at MMI or maximum medical improvement from my injury. To make a decision regarding claim allowance or reopening. - 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? Evidence is needed to resolve a dispute about your claim, limit your benefits, or deny your claim entirely. 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. As the. A QME is picked from a list of state-certified doctors issued by the DWC Medical Unit. If you have an attorney, your attorney and the claims administrator may agree on a doctor without going through the state system used to pick a QME. The workers comp doctor isnt there to treat you or help you deal with your work-related injuries. 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. The IME doctor will be looking for inconsistencies in your story, so dont let anyone rush you. 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. Independent medical examination. IMEs review medical records and in some cases examine the injured worker. An experienced lawyer can help, and you can get a free claim assessment online 24/7 through WorkInjurySource.com. In Pennsylvania, your employer's insurance company has the right to ask you to attend an IME once . My finger got caught in a shopping cart and then smashed on a conveyor belt while I was working in the state of Hawaii. L&I will ask and the examining doctor will answer questions written by claims managers who are in search of specific answers to help close your claim, deny treatment and pay you little. if the IME is wrong), then going back to work could make it more difficult to collect the benefits you deserve. Workers comp refuses to order MRI for elbow injury? Most IME doctors don't treat patients. Don't guess about the value of your claim. Do You Need Free Workers Comp Legal Advice? Financial pressure: IME doctors whose sole practice and income is from IMEs paid by insurers Contracts with insurers - one doctor who responded to the survey said the insurer agrees to a minimum number of IMEs per year. 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. 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. An Independent Medical Examination (IME) is an attempt to confirm - or more likely, to dispute - the treating doctor's management and care recommendations for an injured worker.. 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