Worker's Compensation Claims & Your Independent Medical Examination

If there is any dispute regarding a worker's compensation claim regarding an on sight work accident, your insurance company may require you to go to an independent medical examination to make sure that you are not falsifying or exaggerating your claim. Generally speaking, IME doctors are there to discover the truth of the matter, so, as long as you are not falsifying your claim, they can support you with documents that lend credence to your disability claims in a court of law.

The outcome of such examinations is quite crucial to worker's comp cases, so it is important to know a bit about the phenomenon. Read on to learn more about what independent medical examinations are all about in order to get the compensation you deserve.

What Is an Independent Medical Examination? An IME is essentially a medical examination that is used to resolve any questions about the validity of your current medical condition, which includes what treatments will be deemed necessary and the extent of the permanency of your medical condition, if any. Although usually requested of your insurance company, there may be times where the presiding judge over your case may request that you be subject to an independent medical examination.

Who Chooses the IME Doctor? Your IME is supposed to be an objective measure of the extent of the damage and physical impairment that you received due to a work or related injury, but the true objectivity of the matter usually rests on how the doctor for such an exam is chosen.

One must take into consideration that the doctors that are chosen for IME are done so at the behest of the insurance company. These doctors are paid by the insurance companies and rely on referrals to other insurance companies and cases by the hired agencies. Thus, they tend to have incentive to minimize the amount of damage that you have incurred due to an on sight or related work injury.

In some states, you will have the right to contest the results of IMEs, in which case, you are in fact allowed to choose a doctor to form a secondary opinion on the original results of the IME. If you are requested to receive an IME by an insurance company, it is best to consult with a worker's comp attorney prior to going to the exam.

What Happens During an IME?

Before you actually attend the IME, the insurance company will send over your previous medical documents to the doctor in question, which will detail your medical history to date, highlighting anything that is specific to your worker's compensation claim. These documents will be used to frame the questions that the doctor asks of you throughout the examination.

It is highly recommended that you request to review the documents before the insurance company sends them to the physician in question, so you can dispute any erroneous information that may be present in your medical history. The normal dynamic between patient and physician is changed in this setting, and anything you say to the doctor is something he or she can actually bring up at a later date—including in court—that may be used to incriminate you.

It is highly recommended that you, for the most part, supply short and curt answers to any questions that may be asked of you. It is also recommended that you ask some questions of your own; mainly, how the doctor will calculate your permanent injury rating.

An IME can be a difficult and intimidating experience to endure, but so long as you are truthful, it can be a relatively painless experience.