The insurance company disagrees with your treating physicians medical opinion. Its a good idea to bring someone along. An observer cannot legally record an IME. The exam is usually scheduled by the insurance company and they also typically pay for it. Pills are much less expensive than an MRI. We cover all of Illinois. You might also be able to request a second outside opinion, but youll likely need an attorney to get the process going. You are endorsing it all: the IME doctors' version of your patient's medical history and all the facts surrounding the injury; their examination findings, diagnosis and opinion on causation; their prognosis and opinion on permanent disability; and all their answers to all the questions posed by the workers' compensation adjuster or attorney. Questions about hiring an attorney? Contact your claims adjuster immediately and request a different date. 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. 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. Nurse case managers are registered nurses whose job is to facilitate communication between the doctor and the insurance company. Lets say your employer sends you for an independent medical exam, and lets say the IME doctor says you can work. 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 . Under the Workers Compensation Act your employer or its insurer can force you to attend one IME per medical specialty per year. Call Dabdoub Law Firmtoday at (800) 969-0488 to speak with an attorney about your case. So while your doctor usually has your best interests, the IME doctor doesnt. An independent medical examination (IME) is usually requested when theres doubt about your workers compensation claim. I. Address:404 3rd Ave N #201,Minneapolis, MN 55401Phone:+1 612-334-3434. console.log("fxiedd"); Meaning, they are not as independent and impartial as they are supposed to be. In order to do so, they will frequently require injured workers to see an independent medical examiner (IME). During one exam, the doctor suggested there was an issue with his lungs and referred the employee to another doctor. The insurance company calls it a request, but the hard truth is that if you refuse to undergo the IME, your claim will be flatly denied. You consent that the law firm 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. 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. 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. 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. Judy Ponio is a writer and editor for the Victor Malca Law P.A. Your attorney can also start preparing to dispute the IMEs report (as this will most likely be necessary); and, after the appointment, your attorney can deal with the insurance company on your behalf. Its up to the injured worker to stand up for themself and fight back against these dirty tactics. We never represent the employer or insurance company. Very few of them are active medical professionals. Do I have recourse after I was kicked off Workers Comp because of an IME? An IME doctor is not your doctor - The evaluation does not create a doctor patient-relationship. Get an expert opinion about your claim, from an experienced lawyer. The responsibility of an IME doctor is only to ascertain your medical condition. My finger got caught in a shopping cart and then smashed on a conveyor belt while I was working in the state of Hawaii. Get a free consultation from a lawyer: Tell us about your concerns and let us show you some smart choices you can make for your claim. Independent medical examiners routinely dispute doctors treatment recommendations. Questions are answered and no time is wasted. Injured on the job? 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. But its not unheard of for employers and insurance companies to use it to discredit your claim. Talk to a workers compensation attorney. That report is now also called the IME. Book a free consultation today. website and blog. For instance, lets say you have a medical condition that got worse after your injury. If your attending physician agrees with a lousy IME, YOU HAVE A BIG PROBLEM. state agency. Most doctors who perform Independent Medical Exams have little incentive to take the necessary time to study all the documentation related to your claim. 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. While it might be okay for you to return to work, it also might not. Im an experienced Seattle workers compensation attorney who has helped thousands of injured Washington State workers. console.log("hash::"+hash); Yes, they are. Your use of this site does NOT create an attorney-client relationship. The doctor-patient relationship with an IME physician is all about your workers comp claim. Remember that insurance companies often have injured workers under surveillance. Don't compare your claim to someone else's. According to RCW 51.36.070, you can dispute the scheduling of an IME, both before and after the IME. But if you feel you are being played by the workers comp insurance company, or you arent sure youre getting the benefits you deserve, dont wait to protect your claim. It is your choice. Victor Malca P.A. In cases like this, an experienced workers compensation lawyer like Victor Malca can help you. At the end of the call, no matter what you decide to do, you will have fresh ideas and an action plan. They also know the insurance company wont like it. Sometimes, they may even hold more weight than that of your doctor. They work for the insurance companies; and, unlike your doctor, they do not have your best interests in mind. 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. As mentioned, an IME doctor is an independent third party. An IME 1600 Ponce de Leon Blvd At the same time, however, going back to work too soon could be dangerous. 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. These questions look like this: The truth is IMEs are a complete sham that claims managers use to deny medical attention and close claims. Cloud, Eagan, Woodbury, Maple Grove, Eden Prairie, Coon Rapids, Burnsville, Blaine, Lakeville, Minnetonka, Apple Valley, Edina, and St. Louis Park. 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. TALK WITH YOUR DOCTOR BEFORE THEY AGREE WITH A BAD IME! var hash = location.hash.replace("#",""); Your attending physician will be asked by L&I to agree with the IME. What Happens When the IME Doctor Disagrees With My Doctor? To evaluate a workers permanent disability, work restriction, or ability to work. 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. As a result, the doctor says that you have to go back to work. Not only could it risk delaying your recovery (or making your injury worse); but, if you are still entitled to benefits (i.e. Only add "up to 10%" if loss of ROM of both flexion and abduction are moderate or . Why Is an Independent Medical Exam Being Scheduled? For one, they must be licensed health professionals. It is not uncommon to see IME reports saying, . behalf if necessary. In most states, you can refuse to have the nurse in the examination room with you while you are seeing the doctor. Workers comp refuses to order MRI for elbow injury? 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, If an IME doctor has cleared you to work and you are wondering whats next, you should discuss your situation with a local lawyer promptly. How Long Does A Social Security Disability Review Take? The Court began its analysis with an evaluation of an IME Doctor's Duty: Even absent a formal doctor-patient relationship, a doctor conducting an Independent Medical Examination ('IME') owes a duty of reasonable care to his or her patient.It can arise from a relationship between the parties, a contractual relationship, or any number of . Whether the IME doctor and staff are pleasant or rude, you should be polite and always think before you speak. This website contains general information that may not reflect current legal developments, verdicts, and/or settlements. Youll be observed from the time you arrive at the IME location. 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. View More Options for Help with your Injury, Please answer a few more questions and then click "Go to Last Step". 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. Learn about Permanent Partial Disability Settlements. 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. We will keep it that way. If the IME doctor agrees with your doctor in terms of the treatment that youre 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. That in his opinion I was at MMI or maximum medical improvement from my injury. Funding can range from $500-$100,000, depending on your case and needs. If you dont like what shows up in your IME report, there are steps you can take to counteract that bad IME. The apartment. An IME is a medical examination or evaluation by a third-party workers comp physician to evaluate and provide another opinion about the extent of your injuries and how they affect your ability to work. 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. Approval takes < 24 hours with no credit checks and no obligation you only pay it back if you win your claim. 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. You only get a short period of time to salvage what you can from your L&I claim. 2023 Work Injury Statistics: Complete Guide to the Latest Data Available. 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. In that case, you know what's coming next: an Independent Medical Exam with a workers' comp doctor. 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. He specializes in representing injured workers on compensation benefit cases and disabled individuals claiming lost social security disability benefits. 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. These tests are expensive and complicate the entire claim. I suggest you do something to help yourself. If you dont like what L&I is doing to you, you must do something about it. You will also need an attorney if youre the subject of a workers compensation investigation. 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. Is It Time to Speak with a Work-Related Injury Lawyer? IMEs review medical records and in some cases examine the injured worker. 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. The IME believes that the depression did not develop secondary to your physical injury, but your treating doctor believes that it did. Talk to your claims manager to make this happen.In certain situations, there is reimbursement for meals, hotel expenses, taxi fare, parking costs, and ferry and bridge tolls. jQuery("html, body").animate({ The workers comp doctor isnt there to treat you or help you deal with your work-related injuries. If IME doctors tell you differently, they are wrong. 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. Is it still workers comp when two doctors disagree? It is often not unusual for the IME doctor to send a rough draft to the adjuster or defense lawyer to read. The IME location to you, you have a BIG PROBLEM on compensation benefit cases and disabled claiming! Discredit your claim, from an experienced lawyer Options for help with doctor! Also be able to request a different date wont like it doctor doesnt pay for it experienced compensation. 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