Sometimes accidents happen and, when they happen in your workplace, there are certain steps that need to be taken to ensure that you are fully covered and compensated. If there is any disagreement about your medical condition in your workers’ comp case, you may be asked by the insurance company to receive an independent medical examination, or IME.
The results of this exam can have a serious impact on your case, so it is important for you to fully prepare for this exam and what is to follow. Here is why you need a workers’ attorney after undergoing a medical examination for your workers’ comp case.
Understanding an Independent Medical Examination
An independent medical examination is an objective assessment of your condition performed by a physician of the insurance company’s choosing. This examination also includes your treatment, diagnosis of the severity of your condition and assessing your ability to work in the future. Often times, the performing physician’s integrity and objectivity can come into question because they are paid and chosen by the insurance company.
An insurance company will request an IME when they disagree with your treatment or diagnosis. Doctors that perform IMEs often rely on referrals from the insurance companies. Because of this, these doctors have more of an incentive to work in the insurance companies’ favor.
Before your exam, all of your medical records and any other documents related to your injury will be sent to the IME physician for review. The insurance company may also write a letter to the doctor explaining your injury and treatment and questions about the extent or severity of your medical condition. The insurance company may ask questions like whether or not surgery recommended by your current doctor is necessary for your condition or if all of your symptoms originated from your work injury. Because of this, you should always request to review the documents sent to the IME doctor to check that everything is factual and accurate.
During your IME, you should understand that, because of the situation, there will be no doctor-patient privilege or privacy. Anything you say to the doctor will be reported back to the insurance company. Your statements could even be used against you in your workers’ comp hearing if the situation escalates to that point. While being examined, the doctor will ask you about how the injury happened, your current treatment and any related medical history.
Therefore, it is important to go over your notes beforehand to ensure that you are clear and accurate in your answers. It is also a very good idea for you to ask the doctor questions during your exam. At the end of the exam, the doctor will send the report to all related parties. You should also request one of these reports to ensure everything written is factual.
The Importance of a Workers’ Comp Attorney
Hiring an attorney for your workers’ comp case is essential, especially if you are requested to undergo an IME. As mentioned before, IME doctors can be biased, so it is necessary to consult an attorney first. IME doctors are also viewed as “experts” in a workers’ comp case and their reports may be given significant weight by hearing officers and judges. Because of this, it can be very difficult to discredit an IME doctor, especially if their findings go against your original diagnosis and treatment. In these instances, it is very important to have an attorney to help you cover all of your bases. An attorney will help you to protect your interests by scheduling a deposition to question the doctor, filing objections on your behalf and requesting another examination performed by a different physician.
If you have questions about your own workers’ comp case or are in need of a workers’ comp attorney, contact Heuser & Heuser LLP today.