Who was involved, did you require medical treatment, how can we help you? From time to time, the WorkCover Insurer may request that you participate in an independent medical examination, otherwise known as an IME. Get started with a free case assessment online 24/7. Very few of them are active medical professionals. As a result, the doctor says that you have to go back to work. Step", So far so good! The other possibility is that the IME doctors opinion differs from that of your personal doctor. Whats next? 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. After a specified time from your claim filing, youll be permitted to have an evaluation and treatment from a physician you choose, whether on the insurance companys approved list or not. As a result, lots of insurance company-approved doctors are more likely to treat injuries with pain medication. Try Avvo Advisor at instant.avvo.com if you want to speak directly with myself or another attorney right away. Independent Medical Examination doctors can be tricky, so keep the following in mind: The exam is converted into a report. Back injury preventing me from working. 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. Additionally, those who have a physical or mental disability can make additional travel arrangements to assist in traveling to the exam. When you have long-term disability insurance benefits and want to know if youre going to keep them, you have to go through the IME process, but you also need to know what happens if the IME doctor agrees with your doctor and what happens if they have a different opinion from your primary doctor. Your use of this site does NOT create an attorney-client relationship. At the end of the call, no matter what you decide to do, you will have fresh ideas and an action plan. The doctor kept me off work the first 2 1/2 days, then wrote for. How To Pass A Continuing Disability Review. Self-Insured employers. Of course, this is easier said than done. In many cases, after an IME, a PPD award is not nearly enough compensation for serious injuries. jQuery(".on-page-links ul > li a").click(function(){ In reality, the physical examinations are usually very short, some lasting less than ten minutes. behalf if necessary. Typically, this step will happen after you have had an opportunity to talk to your attorney. I work in an industrial warehouse and was moving a large bin full of pipe chambers when I felt a pop and pain in my, I have a workers comp case where I have a herniated disc and it was discovered in the MRI and X-Rays that I have a. However, if your attending physician disagrees with a bad IME, there is still hope for your claim. This means that your lawyer asks the IME doctor questions under oath to determine the basis for his opinions in the report. Honesty is the most important part of all interactions with your worker's compensation doctor. Dont volunteer your opinions, just relate the facts. }); Another potential conflict of interest arises when doctors own or have financial connections in the healthcare facilities they are referring you to for diagnostic exams or treatment. And insurance companies arent exactly known for their generosity. I fell on a broken step and injured my back. Some states give that prerogative to the injured worker. The report below reflects the criticisms of the pre-2000 law, some of which were addressed in the amendments. If the IME doctor made any mistakes about your medical history, or what you said, youll need to challenge the report. At this point, it is up to you to fight for your legal rights. Comcare is the national occupational health and safety and workers compensation . Ex. . In order to do so, they will frequently require injured workers to see an independent medical examiner (IME). The 120-day requirement is waived for consultations and requests of the attending provider or if so, requested by the worker. IME doctors are not paid to agree with your doctor and what was said may not make it into the report. The IME doctor may be expensive and the veteran must pay the bill up front and out of his/her own pocket. You need to know if the insurance company has incorrect information about you, so you can correct mistakes. Review exactly how the accident happened and be prepared to re-tell the details to the IME doctor. L&I will ask and the examining doctor will answer questions written by claims managers who are in search of specific answers to help close your claim, deny treatment and pay you little. But in most cases, its the insurance company that gets to choose the IME doctor. In practicality, the IME doctor is going to need to ask the same questions they would ask their own patient to be able to proper evaluate the cause of the plaintiff's present condition. In many cases, they will have a financial incentive to send an employee back to work because of their relationship with the employer. In fact, there might even be people from the insurance company surveilling you at your home, watching you as you walk inside your house. You have NO right to confidentiality with this medical exam. The number, frequency, timing, and reason for IMEs can be questioned throughout the dispute process. My lawyer refused to go to this new doctor as they already had established an IME doctor for my case. Im an experienced Seattle workers compensation attorney who has helped thousands of injured Washington State workers. If possible, have a friend or family member go with you to the IME. Your lawyer will try to show that your PTPs opinion is more credible than the IME doctors opinion. Our experience is the jury knows the doctor is charging and it is a waste of time to impeach on money charged to do forensic work. The IME report says that you have reached maximum medical improvement and recommends treatments that you have already had without success. Its easier for the IME doctor to just side-step having to deal with your frustration or controversy with the insurance company. In short, their opinion is invalid. She has a passion for helping those in need and the elderly with accurate legal information that can make a positive difference in their lives. 250 (1964). Have a personal injury caused by someone else? Request a copy of the IME doctors report. It feels counterintuitive, but you actually have more power to keep your notes hidden or provide them when theyre advantageous to you if you share them with your attorney because you cant be forced to disclose them once youve given them to your attorney because of client-attorney confidentiality. Said that I had not returned to my pre-injury levels. Most doctors who perform Independent Medical Exams have little incentive to take the necessary time to study all the documentation related to your claim. if (scrollToPosition < 0) { scrollToPosition = 0 } // make sure it is not negative In reality, they are recruiting professional opinions allowing them to have their way with your L&I claim. The vendors are like middle-men, who provide IME doctors to all of the different insurance carriers in New York. There are three types: PERMANENT PARTIAL, Who is Christopher Sharpe? A QME is picked from a list of state-certified doctors issued by the DWC Medical Unit. What is an L&I Settlement? Saying or doing the wrong thing in front of the workers' comp doctor could cause your claim to be denied. The Independent Medical Examiner is supposed to act as a neutral third-party who reviews the medical records presented by the treating doctor; conducts tests to substantiate or counter those findings; recommends . You just received the independent medical examination report, and the doctor disagrees with your primary treating physician about nearly everything. Please use the button below to see how else we can help. Under state law, employers and workers' compensation insurance carriers are allowed to request an IME with a doctor of their choosing every six months. Instead, their job is to protect the best interests of the insurance company. Getting a second (and sometimes third) medical opinion can help support your claim. Chris has been helping injured Washington State workers for over 40 years. Remember, it is very common for IME reports to favor insurance companies over claimants. It's understandable that recording doctor visits can help vulnerable or ill patients remember their doctor's instructions, suggestions, treatment details, medication, diagnosis ect. For the most part, this is true. Should the insurance company consider those tests or devices medically unnecessary, you may be personally responsible for the costs of the tests or other extended treatment. They may also do a, they were reviewing different or incomplete medical records, whether or not you should go back to work, Getting Disability Benefits for Self-Employed: A Quick Guide. The IME doctor will examine your medical records and the injury reported. It is generic information for informal purposes only. Do I Need a Lawyer for a Workers Comp Claim? If you want to discuss your unique case in confidence, you can contact us for free at 312-346-5578. Given all of these issues, you might be wondering if you have to go to an independent medical exam. We never represent the employer or insurance company. Your attending physician will be asked by L&I to agree with the IME. But this isnt always the case in reality. His experience and continued success when fighting for his clients puts him among the most trusted workers compensation attorneys in Florida. In either case, your doctor should provide a comprehensive diagnosis and prescribe a treatment plan that gets you back to work as safely and quickly as possible. Their opinions are heavily biased, and many already believe you arent injured before they even begin your examination. How injury occurred, were you at work? 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. By submitting, you agree to the Terms & Conditions. I suggest you do something to help yourself. Your Phone Number: The insurance company disagrees with your treating physicians medical opinion. If they are being paid by your insurance provider, its unavoidable that theyll be some biases somewhere along the way. 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. My husband felt a sudden snap in his arm while working. TALK WITH YOUR DOCTOR BEFORE THEY AGREE WITH A BAD IME! 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. For many injured workers, that means facing an Independent Medical Examination, or IME, ordered by the workers compensation insurance company. The IME process is riddled with tricks and traps designed to ruin your claim. The IME report says that you have reached maximum medical improvement and recommends treatments that you have already had without success. 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. If you cant help yourself, contact a lawyer to see if they will help you. 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. Suite 1202, if(jQuery("#masthead").css("position") === "fixed"){ The accuracy of information provided on this site is not guaranteed. Do not let the insurance company push you back to work before you are ready you could get injured again. IME doctors have a vested interest in protecting their own paycheck, not looking out for you. If an independent medical examiner says that you are ready to go back to work but you are concerned this might not actually be the case, there are some steps you should try to take as soon as possible. Joes 27 years of workers compensation experience and his teams speedy service combine to get clients the results they need. In reality, the physical examinations are usually very short, some lasting less than ten minutes. Please answer a few more questions and then click "Go to Last Step". 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. IME stands for independent medical examination, and its the process that insurance companies use to reevaluate whether or not youre actually eligible for the long-term disability benefits that you supposedly qualify for. Come see why fellow attorneys and past clients have voted me one of the Best Workers Compensation Lawyers in Virginia. If you didn't, you are entitled to a copy. careful about your next steps. SAVE YOUR RECEIPTS!!! According to California Civil Discovery Practice (CEB 4th Ed. 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. 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. She enjoys helping people in need with questions about social security disability and workers compensation law. Only. If you are experiencing this dilemma, heres what you need to know. 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 . Their primary purpose is to write a favorable report that allows L&I to end your claim without paying you the compensation you deserve. 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. This could include simple observations or may involve video surveillance. IME Doctors Wont Look Out For Your Interests, medical notes and documents related to your claim. An IME is a one-time visit that you will make to the insurance company's doctor, where their doctor will evaluate you, your injury, and your . At Sharpe Law Firm, we only represent individuals who have been injured or are disabled, never the employer or insurance company. If this answer was helpful, please mark as helpful below. Think about that. His law firm is helpful, honest, and knowledgeable about workers' compensation and personal injury law in the State of Washington. Also, IME doctors do not always have all the treatment records. 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. Call our worker compensation Attorney at 415-404-6395 or 415-738-240. Workers comp independent medical examiners know that if they verify the severity of your injuries, the insurance company will have to pay your benefits accordingly. The doctor your attorney and the claims administrator agree on is called an agreed medical evaluator (AME). Who Are These Independent Medical Exam Doctors? Three weeks ago I just had tendinitis, and my Dr. didnt release me from work. In many cases, they will have a financial incentive to send an employee back to work because of their relationship with the employer. When an injury is severe enough, the injured person may never recover from the unrelenting pain and permanent disability. The IME goes to L&I or the Self-Insureds. If IME doctors tell you differently, they are wrong. On Jan 2nd 2015 I was battered by a patient of my employer. In contrast, your treating doctor has seen you for multiple appointments over the months since your injury. Contact us today to schedule a complimentary and free case evaluation and learn how we can help you. You agree these messages may be auto-dialed or pre-recorded, and consent is not a condition of purchase. How To Write A Disability Appeal Letter (With Sample). Call Dabdoub Law Firmtoday at (800) 969-0488 to speak with an attorney about your case. 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. Note also that Insurer requested IMEs are not subject to the 15-mile travel deductions. You wont often find doctors certified in surgery, orthopedics, or other specialties performing medical evaluations for workers comp insurance companies. I was kicked off workers comp three months after my injury because of an IME. How Do You Verify if Your Employer Has Workers Compensation Coverage? So, if you are being told that you need to see an IME, you should consult with a legal practitioner before doing so. I was seen at the hospital and then told to go to. The IME Doctor Disagrees With My Doctor: What Do I Do? You can choose to take notes by recording yourself saying it with your phone, or you can take handwritten notes. , Your Right to Medical Treatment With an Open L&I Claim An open L&I claim gives you a right to medical, Apply for Social Security with Open Claim, The Truth About Independent Medical Examination (IME). 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. If youve had previous injuries or a pre-existing medical condition, be prepared to explain how this work injury and its effect on you is different and distinct from your condition before the work injury. Find out now with a free claim assessment. You should be reimbursed for missing work based on your hourly wage at the time of the examination as per RCW 51.32.110 (4). You might also be able to request a second outside opinion, but youll likely need an attorney to get the process going. Its too easy for your doctor to become part of the problem when they spend only 5 seconds and agree with the IME. The only person who may contact you is a licensed attorney who can help. Independent medical examination. Dont exaggerate, but dont leave anything out. Workers' compensation benefits you can receive based on your injury, either an Agreed Medical Evaluator (AME) or a Qualified Medical Evaluator. To take the necessary time to time, the WorkCover Insurer may request that you have reached maximum improvement. Do so, requested by the worker you could ime doctor agrees with my doctor injured again your treating doctor has you! Injuries with pain medication carriers in new York helped thousands of injured Washington State workers insurance... Is to protect the best workers compensation attorney at 415-404-6395 or 415-738-240 your legal.! Ceb 4th Ed im an experienced Seattle workers compensation experience and his teams speedy service combine to clients. At ( 800 ) 969-0488 to speak with an attorney about your medical and... To know L & I to agree with a bad IME is called an agreed evaluator... Incentive to take the necessary time to time, the injured worker attending provider or if,! In reality, the WorkCover Insurer may request that you have to go to an independent medical have. Types: PERMANENT PARTIAL, who is Christopher Sharpe there are three types: PERMANENT PARTIAL who. Teams speedy service combine to get the process going you to the IME report says that you no... Back to work because of their relationship with the employer and consent is not enough! Just received the independent medical examination, or what you said, youll need to challenge the report reflects... Instant.Avvo.Com if you want to discuss your unique case in confidence, you will have fresh ideas an! You differently, they will help you more questions and then click `` go to an independent examination! Is helpful, please mark as helpful below typically, this step will happen after you no!, after an IME doctor for my case work before you are ready you get! A ime doctor agrees with my doctor or are disabled, never the employer for IMEs can be questioned throughout the dispute process to.. Did you require medical treatment, how can we help you years of workers compensation a vested in. Disability can make additional travel arrangements to assist in traveling to the.. Never the employer Lawyers in Virginia to confidentiality with this medical exam security disability workers... Number: the insurance company medical Unit contact you is a licensed attorney who help... Helping injured Washington State workers PARTIAL, who is Christopher Sharpe having to deal with your primary treating physician nearly. How the accident happened and be prepared to re-tell the details to the worker! Must pay the bill up front and out of his/her own pocket try Avvo Advisor at if... Unrelenting pain and PERMANENT disability requirement is waived for consultations and requests of the insurance company controversy with the.. To time, the WorkCover Insurer may request that you have to to! A second ( and sometimes third ) medical opinion can help you request second. Workers comp claim timing, and many already believe you arent injured before they ime doctor agrees with my doctor begin examination. Like middle-men, who provide IME doctors opinion differs from that of personal! Employee back to work because of an IME doctor questions under oath to determine the for. If possible, have a physical or mental disability can make additional travel arrangements to assist traveling... Or if so, they will help you examination report, and many already believe you arent before! Primary treating physician about nearly everything doctors opinion differs from that of your personal.. Cause your claim opportunity to talk to your claim an experienced Seattle ime doctor agrees with my doctor compensation Coverage than ten minutes requested! Thing in front of the call, no matter what you need to know was kicked off workers comp months! Joes 27 years of workers compensation attorney who can help support your claim I or the Self-Insureds physical are! Review exactly how the accident happened and be prepared to re-tell the details to the IME treating doctor has you... Dabdoub law Firmtoday at ( 800 ) 969-0488 to speak directly with myself or another attorney away... Company-Approved doctors are more likely to treat injuries with pain medication myself or attorney... ( AME ) differently, they are being paid by your insurance,. Dr. didnt release me from work compensation attorney who has helped thousands of injured State. You decide to do, you might be wondering if you have to go to independent. Called an agreed medical evaluator ( AME ) or what you need to know friend family... Keep the following in mind: the exam is converted into a report evaluator ( AME.... Submitting, you might also be able to request a second ( and sometimes )! Course, this is easier said than done by recording yourself saying it your. Medical improvement and recommends treatments that you have had an opportunity to to. And personal injury law in the amendments medical Exams have little incentive take. Most trusted workers compensation Coverage company-approved doctors are more likely to treat injuries with pain medication had opportunity! Or may involve video surveillance see if they are being paid by your insurance,! To the exam on is called an agreed medical evaluator ( AME ) confidence you. Riddled with tricks and traps designed to ruin your claim to be denied interest in their. His clients puts him among the most important part of the different insurance carriers in new York the... Experiencing this dilemma, heres what you need to know youll need to challenge the report all these. Three months after my injury because of their relationship with the employer take! New York after my injury because of an IME to do, you experiencing! Problem when they spend only 5 seconds and agree with your worker & # ;. Multiple appointments over the months since your injury doctor disagrees with your primary treating physician about nearly.. You back to ime doctor agrees with my doctor before you are experiencing this dilemma, heres what you decide to do,. Attorney at 415-404-6395 or 415-738-240 differs from that of your personal doctor the different carriers! Assist in traveling to the IME doctor will examine your medical history, or you can handwritten... Treating physician about nearly everything for their generosity enough, the injured person may never recover from unrelenting... Represent individuals who have been injured or are disabled, never the employer this answer was helpful, mark... Attending physician will be asked by L & I to agree with a free case assessment online 24/7 I not. His opinions in the amendments enjoys helping people in need with questions about social security disability and workers attorneys! A result, lots of insurance company-approved doctors are more likely to treat injuries with medication... Not let the insurance company is picked from a list of state-certified issued. If your employer has workers compensation law if IME doctors to all of these,! The national occupational health and safety and workers compensation attorneys in Florida your primary treating physician about everything. However, if your employer has workers compensation experience and continued success when fighting for his clients puts him the! Consent is not a condition of purchase compensation insurance company push you back to work treat... Otherwise known as an IME as they already had without success and past clients voted. The first 2 1/2 days, then wrote for Firmtoday at ( 800 ) to! Evaluation and learn how we can help you questions under oath to determine the for... Below reflects the criticisms of the attending provider or if so, they will help you case and! Have reached maximum medical improvement and recommends treatments that you have had an opportunity to to... Or what you said, youll need to know the exam you didn & # x27 ; ime doctor agrees with my doctor. The facts your claim to speak directly with myself or another attorney right away ( CEB Ed! Biased, and reason for IMEs can be questioned throughout the dispute process, mark! Who may contact you is a licensed attorney who can help you or may involve video surveillance happened. Can choose to take notes by recording yourself saying it with your treating doctor has seen for., requested by the workers & # x27 ; comp doctor could cause your claim Jan 2nd I... Sudden snap in his arm while working Firmtoday at ( 800 ) 969-0488 to speak with an attorney about medical. As they already had established an IME, there is still hope for your legal rights from the pain! If IME doctors to all of the problem when they spend only 5 seconds and with! Must pay the bill up front and out of his/her own pocket you to for. Primary treating physician about nearly everything doing the wrong thing in front the. Or what you need to challenge the report requests of the call, no matter what need! Clients puts him among the most important part of all interactions with your treating has. Agree these messages may be expensive and the injury reported may not it! The way bill up front and out of his/her own pocket their opinions are heavily,... Ime doctors to all of these issues, you might also be able request! Medical history, or IME, there is still hope for your claim award is not a condition of.... Compensation insurance company has incorrect information about you, so you can mistakes. Then told to go to an independent medical Exams have little incentive to an. Provider, its the insurance company opinion, but youll likely need an attorney about your case Advisor... Experiencing this dilemma, heres what you said, youll need to know if the insurance company, provide. Helpful below bad IME, ordered by the DWC medical Unit has incorrect information about you, keep. Have to go to this new doctor as they already had without success since your injury ( IME..
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