What is an Independent Medical Examination and why is my Work Comp Insurance sending me to one?
If you were injured at work and have a Minnesota Workers’ Compensation claim, you may be asked to submit to an Independent Medical Examination (IME). During an IME, you will be evaluated by a doctor chosen by your date of injury Employer or Insurer. You are statutorily required to submit to an IME at the employer’s request and this evaluation must take place within 120 days after a claim petition has been served.
Ideally, the IME will be performed by a neutral physician who will provide an objective opinion as to the extent of your work injury. However, because the doctor has been chosen by the employer/insurer and will be paid by the employer/insurer, this is often a Red Flag for Workers Comp Claims because it is not uncommon for IME doctors to issue an opinion which favors the employer/insurer. Many IME doctors consistently craft their summary of your medical history and IME conclusion to favor the employer/insurer, despite contrary medical records which support your work injury claim.
Client Success Story
A custodian at an elementary school fell on the school’s pool deck. She landed on the left side of her body, injuring her shoulder and her knee. When her doctors took her out of work, the workers’ compensation insurer accepted liability for her injuries and began to pay her wage loss benefits. However, when her doctor recommended shoulder surgery, the workers’ compensation insurer began to push back.
The insurer sent her to an independent medical exam and made her wait weeks while they decided whether or not to pay for the surgery. She turned to Fields Law Firm for help. We stepped in and put pressure on the insurance company to provide a timely response regarding surgery. We also talked our client through alternate options for undergoing the surgery. In the end, the insurer did agree to pay for the surgery and Fields Law Firm was there to make sure that they processed all of the bills timely and continued to pay wage loss associated therewith. Our client was happy she did not have to take on the insurer alone.
Some IME doctors will find that your work injury was a temporary injury which resolved shortly after the date of injury or was not a result of your work duties. Because the IME doctor has been appointed by the employer/insurer, it is not a surprise that their conclusion would limit or even eliminate the employer’s liability for your work injury.
It’s Important To Attend Your Scheduled IME
Even though we have a general idea of what the IME report will indicate and know that it will most likely be favorable to your employer/insurer, it is still very important for you to attend a scheduled IME. Failure to attend an IME may result in the discontinuance of your workers compensation benefits, including wage benefits. In some cases, you may even have to pay a penalty for missing your IME without a valid reason or without letting the employer/insurer know within a reasonable time frame that you will be unable to attend the IME.
The IME appointment will usually take place at a facility within 150 miles of your home and typically lasts about an hour. The employer is responsible for reimbursing you for travel costs such as mileage and parking. Additionally, if you are currently working and have to miss work to attend the IME, the employer must also pay you for your time off work.
About The IME Appointment
During your IME appointment, the doctor will perform a physical examination of you as well as engage in general discussion with you regarding your work injury and subsequent symptoms during the appointment. You will be asked questions related to your medical history, how your injury occurred, the kinds of symptoms you initially felt, and the symptoms you currently have. Additionally, the IME doctor will review your medical history, including medical records and imaging reports. These medical records may include records of injuries unrelated to your work injury.
Remember, the IME doctor was chosen by your employer/insurer for the sole purpose of evaluating you and rendering an opinion regarding your workers’ compensation injury. There is no patient-doctor relationship established between you and the IME doctor. Thus, the IME doctor may reveal any and all information you reveal during your discussion IME appointment.
Be Honest and Cooperative
It is very important to be honest with the IME doctor regarding your injuries, symptoms, and medical history—the doctor will either have reviewed your medical records or will review the records shortly after your IME appointment. Providing inconsistent or incomplete information will only hurt your workers’ compensation claim.
Additionally, remember to cooperate with the IME doctor – give your best effort in completing any exercises you are asked to do. If you are unable to complete an exercise or feel any pain, let the IME doctor know. Again, the IME doctor has your medical records so any pertinent information regarding your restrictions or the activities you can or cannot do will be in your medical records.
If you have any questions regarding an upcoming IME that has been scheduled for your workers’ compensation claim, contact a Workers’ Compensation lawyer at Fields Law Firm for more information. We will take the time to understand your situation and explain your legal options.