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. 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. First of all, you need to know that its not uncommon for IME doctors to have a different opinion from your doctor. IME doctors may review a case file, conduct an IME, and write a report all in the same day or two days. Can I Get Disability After Getting Workers Comp Settlement? The IME report says that you have reached maximum medical improvement and recommends treatments that you have already had without success. The exception is when the doctor only has an IME practice, it is almost only defense, and the doctor make hundreds of thousands of dollars a year. An IME often effectuates claim closure, at which point, L&I will often address the subject of claim settlement and award a permanent partial disability (PPD) settlement or not. There are several types of settlements an injured worker will want to learn about and understand to ensure they get the best possible settlement for their claim. And insurance companies arent exactly known for their generosity. 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. 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. These will be paid at the current department rate. Strictly speaking, you do not have to go back to work when an independent medical examiner disagrees with your doctor. It never hurts to have your own witness to the exam. has over 27 years of litigation experience in Workers Compensation and Social Security Disability lawsuits. To report a doctor who has been improper you can complain. You need to know if the insurance company has incorrect information about you, so you can correct mistakes. On Jan 2nd 2015 I was battered by a patient of my employer. jQuery("html, body").animate({ The IME report says that you have reached maximum medical improvement and recommends treatments that you have already had without success. 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. The more patients pushed through in a day, the faster the fees rack up. However, the true purpose of an IME is to use that determination toward insidious ends. Of course, this is easier said than done. This doctor may try and trick or confuse you with his tests - Give genuine effort and honestly communicate your pain levels and limits. //console.log("id::"+anchor_id); An experienced lawyer can help, and you can get a free claim assessment online 24/7 through WorkInjurySource.com. 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. IME doctors are also notorious for saying that an employee has fully recovered and can return to work without any restrictions. You can use this to contest the IME report at court. If you are eligible for workers compensation benefits, the costs of diagnosing and treating your injury should be fully coveredat least until you reach maximum medical improvement (MMI). My finger got caught in a shopping cart and then smashed on a conveyor belt while I was working in the state of Hawaii. The IME doctor will be looking for inconsistencies in your story, so dont let anyone rush you. Address:404 3rd Ave N #201,Minneapolis, MN 55401Phone:+1 612-334-3434. 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. Briefly Describe Your Case: document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Learn more about Social Security Disability and Long Term Disability Insurance, as well as appealing denials and how an attorney can help. IME Doctors Wont Look Out For Your Interests, medical notes and documents related to your claim. If you are currently represented by an attorney, you should strictly abide by his/her counsel. 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.. In this case, the independent third party refers to the IME doctor. Click the button below to find out in 60 seconds or less! 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. An independent medical examination (IME) is usually requested when theres doubt about your workers compensation claim. case or situation. You need a lawyer who can advocate for the treatment you need. And as such, the WorkCover insurer refuses to pay for any medical treatment related to the depression. 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 only person who may contact you is a licensed attorney who can help. Instead, these doctors make their living performing IMEs for insurance companies, who provide generous compensation for one-time examinations. Joes 27 years of workers compensation experience and his teams speedy service combine to get clients the results they need. 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. }); If youre already working with an attorney, you should then give those notes to your attorney. 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. Don't compare your claim to someone else's. How To Write A Disability Appeal Letter (With Sample). As the. He specializes in representing injured workers on compensation benefit cases and disabled individuals claiming lost social security disability benefits. Find out now with a free claim assessment. Your lawyer can help you understand your legal rights, and your lawyer can take action to protect your right to workers compensation benefits if necessary. 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. Can Illegal Immigrants Claim Workers Compensation? This hearing will be a battle of the experts. New York State law concerning Independent Medical Examinations was extensively amended in 2000. Contact us today to schedule a complimentary and free case evaluation and learn how we can help you. It is your choice. website and blog. There might also be an arbitrator, who will decide whether the IME doctor or your doctor is more credible. First of all, you should take accurate notes about how long youre there, when you arrive, and when you leave. It is NOT formal legal advice. With that said, if you dont do anything, your workers compensation claim will be over. The insurance company nurse may demand to be in the room when your doctor is examining or treating you and wont hesitate to challenge your doctors opinion. You have 60 days from receipt of this order to protest or appeal the L&I Decision. Do I have recourse after I was kicked off Workers Comp because of an IME? The workers compensation insurance company is allowed to order an IME (or 2 or even 3) for several different reasons but, basically, an IME is in exam by an independent medical doctor. 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. (this is a problem). He can help you contest your IME doctors opinion and get the benefits you deserve too. Read: Workers Comp Settlements for Ankle Injury, Workers Comp Settlements for Brain Injury, Workers Comp Settlements for Bulging Disc, Workers Comp Settlements for Carpal Tunnel, Workers Comp Settlements for Cervical Spine Injury, Workers Comp Settlements for Electrocution Injury, Workers Comp Settlements for Herniated Disc, Workers Comp Settlements for Injuries Requiring Surgery, Workers Comp Settlements for Permanent Partial Disability, Workers Comp Settlements for Secondary Injury, Workers Comp Settlements for Shoulder Injury. Whats an Independent Medical Examination? var hash = location.hash.replace("#",""); Please use the button below to see how else we can help. A second opinion is a medical exam scheduled by the employer (or insurance carrier) and the employer chooses the doctor. if the IME is wrong), then going back to work could make it more difficult to collect the benefits you deserve. A base of a work basket was hit by another associate by mistake which moved the front end of the basket. Insurance adjuster requesting IME 6 months after injury? Contact us for a free consultation. Sometimes they don't even perform a physical examination before rendering their opinion. A QME is picked from a list of state-certified doctors issued by the DWC Medical Unit. Our team of experienced attorneys are here to help, and your consultation is free. 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. and the Osterbauer Law Firm stand up for injured Minnesota workers rights. Ex. The doctor is not asked to make a disability decision and when the consulting doctor's report is received, the DDS examiner reviews the report to be sure that the conclusions the doctor has drawn from the examination are supported by clinical observations or testing cited in the report. Some states also require that the medical institutions they work for must be HIPAA compliant. Back injury preventing me from working. Injured on the job? According to California Civil Discovery Practice (CEB 4th Ed. Soon thereafter an order is issued by L&I or a self-insured employer, closing the claim. Rarely do they issue opinions that are favorable to an injured worker. This is why many injured workers often find themselves wondering, what can I do if the IME doctor disagrees with my doctor? You consent that the funding company 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. Even when doctors would normally recommend those diagnostic or therapeutic services, in workers comp cases, they wont mention it to the injured worker. Most of the time, they use the IME doctors opinion to achieve such. We do ask what percent of IME work involves defense v plaintiff work. At this point, it is up to you to fight for your legal rights. Because of their financial interests, some doctors may order unnecessary or questionable tests or medical treatments hoping the insurance company will pay for them. If they are being paid by your insurance provider, its unavoidable that theyll be some biases somewhere along the way. We understand that being scheduled for an IME is stressful and can potentially jeopardize your claim.
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