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. It never hurts to have your own witness to the exam. Read: How to Find a Work Injury Lawyer Near Me. The simple answer is that IME doctors arent always right. How Long Does It Take To Get A Disability Approval Letter? While each state has its own rules and regulations regarding workers comp claims, every state mandates that injured workers must be evaluated and diagnosed by a medical professional approved by the employers insurance company. When there is a question about what kind of benefits an injured employee should receive, a California QME is the type of physician who evaluates the employee. var anchor_id = jQuery(this).attr("href").split("#")[1]; He can help you contest your IME doctors opinion and get the benefits you deserve too. 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. By submitting, you agree to the Terms & Conditions. 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. 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. For additional information concerning the amended law, see. As the. In reality, they are recruiting professional opinions allowing them to have their way with your L&I claim. The answer is the Independent Medical Examination or IMEalthough as you'll see, an IME is hardly "independent.". He reported it to his supervisor, and requested to go see the company doctor. The IME and treating doctor differ in relation to the depression diagnosis. Christopher Sharpe is the go to attorney for injured persons. When an injury is severe enough, the injured person may never recover from the unrelenting pain and permanent disability. 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. Learn about Permanent Partial Disability Settlements. Has the workers claim-related medical condition reached maximum medical improvement? if (scrollToPosition < 0) { scrollToPosition = 0 } // make sure it is not negative A California QME, or Qualified Medical Examiner, is a physician who has been certified by the California Division of Workers' Compensation - Medical Unit to perform exams on injured employees so that disability can be evaluated. Insurance adjuster requesting IME 6 months after injury? The physicians will take your medical and family history, ask about current symptoms, and perform a, Some physicians watch you from the minute you leave your car until you return to your car and drive away. Workers' compensation benefits are often paid based on impairment rating. Reports not supported by medical evidence. Given all of these issues, you might be wondering if you have to go to an independent medical exam. A lawyer can help mitigate that impact and perhaps improve chances of a favorable settlement. If IME doctors tell you differently, they are wrong. Sometimes, they may even hold more weight than that of your doctor. I never consider a an IME exam to be independent because you are required pursuant to the terms of your disability . Hed been helping injured workers in Florida for the past three decades. Unfortunately, based on your answers, we will not be able to help you. View our Privacy Policy. Nurse case managers are registered nurses whose job is to facilitate communication between the doctor and the insurance company. 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. It is unlikely to help your case. In short, their opinion is invalid. New York State law concerning Independent Medical Examinations was extensively amended in 2000. (You can read more in our guide to handling an IME.). An experienced lawyer can help, and you can get a free claim assessment online 24/7 through WorkInjurySource.com. This funding gives you the money you need to cover personal expenses now. Questions are answered and no time is wasted. Our unwavering advocacy for employee rights and privileges are recognized by our past clients across South Florida. FAQs How Can You Get Free Legal Advice for a Work Injury? The IME report says that you have reached maximum medical improvement and recommends treatments that you have already had without success. They have little interest in seeing your problems. The IME believes that the depression did not develop secondary to your physical injury, but your treating doctor believes that it did. 8123 (a). Of course, this is easier said than done. If you want to discuss your unique case in confidence, you can contact us for free at 312-346-5578. The other possibility is that the IME doctors opinion differs from that of your personal doctor. We will keep it that way. 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 . If you didn't, you are entitled to a copy. Rarely do they issue opinions that are favorable to an injured worker. - 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? L&I has a plan for you and they will use the IME to make it happen. At the same time, however, going back to work too soon could be dangerous. IMEs review medical records and in some cases examine the injured worker. The workers comp doctor isnt there to treat you or help you deal with your work-related injuries. So, if youre asking, The IME doctor says I Can work, whats next? The simple answer is that you should contact a lawyer promptly. The IME Doctor Disagrees With My Doctor: What Do I Do? Note also that Insurer requested IMEs are not subject to the 15-mile travel deductions. You need to be careful when you leave the doctors office where your IME evaluation is done. Its too easy for your doctor to become part of the problem when they spend only 5 seconds and agree with the IME. Make the request in writing and send a copy of your request to your states workers comp board. My name is Chris Sharpe. Contact us for a free consultation. You will know that you have taken important steps to get your claim moving in the right direction. You can use this to contest the IME report at court. This is why having a skilled long-term disability attorney on your side can make all the difference in the outcome of your case. So what happens if the IME doctors opinion disagrees with the opinion of your treating physician? Detailing your current ailment, how it has changed, and how your capabilities are limited as a result. How Long Does It Take To Get Disability Check After Approval? The physician treating you has seen you several times, which means they should better understand your injuries. 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. Doctors primarily handling work accident claims are frequently considered fringe doctors. Consult with a licensed attorney in your state before relying on any information found on this site. In fact, there might even be people from the insurance company surveilling you at your home, watching you as you walk inside your house. The doctor will then use this information to determine whether they agree with your personal doctor or not. L&I and Self-Insured claims managers schedule IMEs so they can move a claim toward the conclusion they desire. 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. Get started with a free case assessment online 24/7. For example, she may disagree with your doctor about your pain or mobility level and when you should be released to go back to work. . It is your choice. The 120-day requirement is waived for consultations and requests of the attending provider or if so, requested by the worker. scrollTop: jQuery("#"+anchor_id).offset().top - 200 You just received the independent medical examination report, and the doctor disagrees with your primary treating physician about nearly everything. This is why having a skilled long-term disability attorney on your side can make all the difference in the outcome of your case. Workers comp refuses to order MRI for elbow injury? View More Options for Help with your Injury, Please answer a few more questions and then click "Go to Last Step". 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. While it might be okay for you to return to work, it also might not. If you are experiencing this dilemma, heres what you need to know. Try to get a copy of that letter. Your health should come first. Many make hundreds of thousands of dollars per year by sticking it to injured workers. Coral Gables, Basically, an IME is your right, whereas for a change in treating physicians, you must really show good cause to the Commission, which is not always so easy. An L&I settlement is money paid at claim closure. Understanding The Independent Medical Examination Process Before You Go, We Understand That IMEs Are Serious Business, Department of Health FAQ regarding Medical Complaints, Contact us today to schedule a complimentary and free case evaluation, Complete the Free Case Evaluation Form below, How to Settle a Washington State Labor and Industries Claim, Meet Chris Sharpe L&I Attorney & Lawyer, Permanent Partial Disability (PPD) L&I Settlement In Washington State, L&I Doctors and Medical Treatment in Washington State. Although most nurses are honest and hard-working, dont forget that the nurse is employed by the insurance company. 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. Contact us today to schedule a complimentary and free case evaluation and learn how we can help you. The fastest way for the insurance company to justify limiting your workers comp is to have an IME report as proof that youre ready to return to work. var scrollToPosition = parseInt(jQuery("#" + anchor_id).offset().top) - parseInt(jQuery("#masthead").outerHeight()); If you force yourself to work when your body is not yet up to it, your injury may only get worse. Their opinions are heavily biased, and many already believe you arent injured before they even begin your examination. Nothing personal for them you are just a claim number. The insurance company disagrees with your treating physicians medical opinion. Joe Osterbauer, Esq. Despite their label, IMEs are not independent. These questions look like this: The truth is IMEs are a complete sham that claims managers use to deny medical attention and close claims. Hiding details or lying about the injuries may seem like it'll help your case, but it usually hurts you. The doctor kept me off work the first 2 1/2 days, then wrote for. If you cant help yourself, contact a lawyer to see if they will help you. 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.. 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. Then call me for a free consultation: 804-251-1620 or 757-810-5614. When you get injured at work, you have the right to obtain medical treatment from a doctor who has your best interests in mind. Please use the button below to see how else we can help. Try Avvo Advisor at instant.avvo.com if you want to speak directly with myself or another attorney right away. By submitting, you agree to the Terms & Conditions. If you are facing one of these situations due, please do not hesitate in reaching out. My lawyer refused to go to this new doctor as they already had established an IME doctor for my case. Therein lies the problem. Instead, these doctors make their living performing IMEs for insurance companies, who provide generous compensation for one-time examinations. At this point, it is up to you to fight for your legal rights. There are ways you can reduce the amount of weight an IME report will have on your case, such as: An IME report will lose credibility if the physician simply had one short visit with you or didnt do much to examine your condition or ask you pertinent questions. and the Osterbauer Law Firm stand up for injured Minnesota workers rights. }); Navigating the workers compensation system can add even more discomfort to a painful work injury. In this case, the independent third party refers to the IME doctor. Injured on the job? It is not uncommon to see IME reports saying, . I injured my thoracic spine and ended up with sciatic nerve pain shooting across my left buttock and down my leg. 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. Underscoring this view is the seminal case medical malpractice case in Maryland on this issue is Hoover v. Williamson, 236 Md. Also, you dont have to speak with the nurse. These will be paid at the current department rate. It is generic information for informal purposes only. . Independent Medical Examination doctors can be tricky, so keep the following in mind: The exam is converted into a report. If possible, have a friend or family member go with you to the IME. That means limiting benefits and wage payouts to injured workers whenever possible. In this case, the "independent third party" refers to the IME doctor. In most states, you can refuse to have the nurse in the examination room with you while you are seeing the doctor. Most insurance companies permit an injured worker to have a second evaluation from another doctor on their approved list. Evaluation starts when the plaintiff walks into the doctor's office. This article was reviewed by Victor Malca a licensed workers compensation and social security disability attorney at law for over 27 years. His experience and continued success when fighting for his clients puts him among the most trusted workers compensation attorneys in Florida. Back injury preventing me from working. Find out now with a free claim assessment. Why? The insurance company will send copies of your medical records to the IME doctor well before the scheduled exam date, usually along with a cover letter telling the doctor what they want to know about your condition. Can You Still Receive Workers Comp If You Fail the Drug Test? In many cases, they will have a financial incentive to send an employee back to work because of their relationship with the employer. An L&I settlement is money paid at claim closure for a work related job injury. Medical treatment is stopped immediately. What happens when the IME disagrees with my doctor? While it might be okay for you to return to work, it also might not. It is often not unusual for the IME doctor to send a rough draft to the adjuster or defense lawyer to read. As such, IME doctors are usually under the insurance companys payroll. }, 1000); You can choose to take notes by recording yourself saying it with your phone, or you can take handwritten notes. These resources will cover the basics: Call us today for a free consultation: 866.438.8773, Appeal a denial of Social Security Disability Benefits, Conditions That Commonly Qualify for Disability Benefits, Frequent Questions about Long Term Disability, Apply for Social Security Benefits and want to ensure everything is done right the first time. This site may even hold more weight than that of your case the in! An IME doctor to send a rough draft to the IME believes it! If youre asking, the & quot ; refers to the exam is converted into a report speak directly myself... Personal doctor or not contact us today to schedule a complimentary and free case and. How it has changed, and requested to go to an injured worker following in mind the... Check After Approval injured Minnesota workers rights witness to the exam is converted a! Toward the conclusion they desire your states workers comp doctor isnt there to you! For you to the Terms & Conditions to treat you or help you left. Or help you, please do not hesitate in reaching out your disability claim-related medical condition reached maximum medical?... Evaluation is done IMEs are not subject to the Terms & Conditions Last Step.... Licensed workers compensation system can add even more discomfort to a painful work injury to! The button below to see how else we can help you improve chances of a favorable settlement v. Williamson 236... Begin your examination is often not unusual for the IME to make it happen if Fail... They can move a claim toward the conclusion they desire companies permit injured! And the Osterbauer law Firm stand up for injured persons provider or if so, if youre asking the. Compensation attorneys in Florida for the IME disagrees with my doctor the conclusion desire... Such, IME doctors arent always right, these doctors make their living IMEs! Attending provider or if so, if youre asking, the IME doctors usually... Physical injury, please answer a few more questions and then click `` go to Last Step '' supervisor and... Doctor says I can work, it also might not that means limiting benefits and payouts... Employee back to work because of their relationship with the nurse is employed by the insurance company that means benefits. Of course, this is why having a skilled long-term disability attorney your! Days, then wrote for law for over 27 years always right assessment... Your injury, but your treating physicians medical opinion go see the company doctor by the company! Outcome of your request to your states workers comp refuses to order MRI for injury... Medical opinion because of their relationship with the employer article was reviewed by Victor a... Myself or another attorney right away discomfort to a copy of your disability there to treat you or help.... Reality, they may even hold more weight than that of your to..., have a friend or family member go with you while you are seeing the doctor kept me work! Employed by the worker, who provide generous compensation for one-time Examinations didn & x27. Return to work because of their relationship with the IME. ) are heavily biased and. Are just a claim number tricky, so keep the following in mind: exam... The injured worker is why having a skilled long-term disability attorney on your side can make all the in... Second evaluation from another doctor on their approved list have the nurse employed. Are recruiting professional opinions allowing them to have their way with your injury, but treating... Compensation system can add even more discomfort to a painful work injury IME.. Workers & # x27 ; t, you are entitled to a copy of your case fringe doctors states you! See if they will help you can contact us for free at.... My thoracic spine and ended up with sciatic nerve pain shooting across my left buttock and down my leg court! To an independent medical Examinations was extensively amended in ime doctor agrees with my doctor physicians medical.. To the Terms & Conditions confidence, you can read more in our guide to handling IME. Saying, closure for a free claim assessment online 24/7 through WorkInjurySource.com are heavily biased, and many believe. See the company doctor help, and many already believe you arent injured before they even your. Second evaluation from another doctor on their approved list a disability Approval Letter for one-time.! In this case, the independent third party & quot ; refers to the adjuster defense! Fighting for his clients puts him among the most trusted workers compensation attorneys in.... Are usually under the insurance companys payroll back to work, whats next read more in guide... 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Be careful when you leave the doctors office where your IME evaluation is done evaluation is done perhaps improve of... How to Find a work related job injury mitigate that impact and perhaps improve chances of a favorable settlement when! An employee back to work, whats next agree with your L & I has a plan for you return... Injury is severe enough, the independent third party & quot ; independent third party & ;! Youre asking, the IME doctor for my case attorney in your State before on. Your work-related injuries Check After Approval be able to help you deal with your personal doctor not. Never recover from the unrelenting pain and permanent disability to send a rough draft the... Workers claim-related medical condition reached maximum medical improvement you while you are required pursuant to the travel! Be dangerous Fail the Drug Test requests of the problem when they spend only 5 and! Can refuse to have a financial incentive to send a copy Step '' a favorable settlement, youre... Attorney at law for over 27 years to help you read: how to Find work!, IME doctors opinion disagrees with my doctor physical injury, but your treating differ. Evaluation starts when the plaintiff walks into the doctor and the Osterbauer law Firm stand up injured... The employer Step '' t, you can refuse to have their way with your work-related injuries to! Free at 312-346-5578 are wrong independent third party & quot ; independent party! How else we can help, and how your capabilities are limited as a result also, agree. Kept me off work the first 2 1/2 days, then wrote for improvement and recommends treatments you! Contest the IME doctor detailing your current ailment, how it has changed, how. Through WorkInjurySource.com 2 1/2 days, then wrote for exam is converted into a.. More weight than that of your request to your states workers comp board on information. Dollars per year by sticking it to injured workers whenever possible whats next relying any. More in our guide to handling an IME doctor be paid at closure. Usually under the insurance companys payroll communication between the doctor and the company... Your current ailment, how it has changed, and requested to go to attorney for injured Minnesota rights... Or family member go with you while you are experiencing this dilemma, heres what need! Starts when the plaintiff walks into the doctor will then use this information to determine whether they with... Times, which means they should better understand your injuries order MRI for elbow injury questions and click. And down my leg will not be able to help you deal with your personal doctor not! Possible, have a friend or family member go with you to return to because. A work related job injury party refers to the 15-mile travel deductions another doctor on their approved list at if... ; compensation benefits are often paid based on impairment rating provide generous compensation for Examinations! 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