After all, there are a lot of factors that can affect a workers comp claim. 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. What will the state agency do? 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. If your case is taken to court, the judge will most likely believe the IME doctor more than you or your treating doctor. This means that your lawyer asks the IME doctor questions under oath to determine the basis for his opinions in the report. The bottom line is that every case is different, but if you are being asked to go to more than one IME it's at least suspicious and potentially against the law. The same doctor was referred to in parliamentary documents accusing him of bullying claimants in South Australia. I recently accepted and. They: People in charge of your claim can request an IME and follow-up IMEs. 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. 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. It is your choice. I suggest you do something to help yourself. The IME doctor will look for any inconsistencies in your behavior. 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. Remember, its you against the insurance company, and the nurse case manager is just another of their employees. Most doctors who perform Independent Medical Exams have little incentive to take the necessary time to study all the documentation related to your claim. I am a restaurant manager for a very busy chain restaurant. I never consider a an IME exam to be independent because you are required pursuant to the terms of your disability . The doctor will then use this information to determine whether they agree with your personal doctor or not. Joe Osterbauer, Esq. So while your doctor usually has your best interests, the IME doctor doesnt. If L&I requests a legitimate IME, it is extremely important for the injured worker to arrive alert and prepared for the examination. But if you feel that the IME doctors recommendation is detrimental to your health, you should tell them so. But you may qualify for pre-settlement funding. You just received the independent medical examination report, and the doctor disagrees with your primary treating physician about nearly everything. It never hurts to have your own witness to the exam. and the Osterbauer Law Firm stand up for injured Minnesota workers rights. Especially if you are still in main or experiencing physical limitations, it will be important for you to speak with a lawyer before you do anything that could jeopardize your legal rightsor your physical recovery. Unfortunately, based on your answers, we will not be able to help you. 10 Types of Free Legal Advice You Need When Filing for Workers Comp, FAQs Coronavirus and Workers Compensation, What to Do While Your Workers Comp Claim is Pending, Documents to Collect for Your Work Injury Claim, Mistakes to Avoid During Your Work Injury Claim. Workers' compensation benefits you can receive based on your injury, either an Agreed Medical Evaluator (AME) or a Qualified Medical Evaluator. Talk to a workers compensation attorney. If writing is difficult, try speaking your notes into a cell phone app, or ask someone to write for you. Step", So far so good! That in his opinion I was at MMI or maximum medical improvement from my injury. Instead, these doctors make their living performing IMEs for insurance companies, who provide generous compensation for one-time examinations. The history and physical examination must be provided as a narrative of the findings. Ex. Additionally, those who have a physical or mental disability can make additional travel arrangements to assist in traveling to the exam. Before the hearing, your lawyer may need to take the deposition of the IME doctor. With twenty years of experience to offer, our clients have full confidence in us with all of their legal services. For serious violations of State Law RCW 18.130.180, including unprofessional conduct, fraud, and misdiagnosis of a condition, you need to contact both L&I and the people who license them, Washington State Department of Health. 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. Theoretically, they should be. if(hash != ""){ Request a copy of the IME doctors report. A lawyer can help mitigate that impact and perhaps improve chances of a favorable settlement. An IME doctor is not your doctor - The evaluation does not create a doctor patient-relationship. For instance, if you came in with a limp and suddenly dont have it when you walk out the front door to the clinic, theres a good chance that the doctors are taking note of that, especially if this information affects your claim. }, 1000); You can choose to take notes by recording yourself saying it with your phone, or you can take handwritten notes. The number, frequency, timing, and reason for IMEs can be questioned throughout the dispute process. And as such, the WorkCover insurer refuses to pay for any medical treatment related to the depression. Saying or doing the wrong thing in front of the workers' comp doctor could cause your claim to be denied. In addition, if the insurance company has offered a settlement due to the IME report, your lawyer can assess the settlement value and help you negotiate. Self-Insured employers. Its easier for the IME doctor to just side-step having to deal with your frustration or controversy with the insurance company. This means that it may not be as easy to receive the long-term disability benefits that you deserve, but it doesnt mean its impossible. RCW 51.32.110 (3), WAC 296-20-1103, and L&I Claim Adjudication Guidelines. An IME doctor is selected by the Board. An IME is a medical examination or evaluation by a third-party workers comp physician to evaluate and provide another opinion about the extent of your injuries and how they affect your ability to work. Honesty is the most important part of all interactions with your worker's compensation doctor. How Long Does It Take To Get A Disability Approval Letter? Additionally, a work injury claimant should be given the required 28 days notice of the IME, except for IMEs to address claim allowance, which is 14 days. If youve suffered a tragic workplace injury and youre tired of fighting for the compensation you deserve, schedule a free case evaluation today to learn how we can help you fight these injustices. *By requesting a free consultation, you confirm that you are 18 or older and do not have an attorney. At Chisholm Chisholm & Kilpatrick LTD, our team of experienced attorneys and professionals has assisted clients throughout the long-term disability claim process. How To Pass A Continuing Disability Review. Unfortunately, long-term disability insurance companies will almost always side with the IME doctors they hire. At this point, it is up to you to fight for your legal rights. What Happens When the IME Doctor Disagrees With My Doctor? View our Privacy Policy. Some are general practitioners with limited or no previous experience in workplace injuries. //console.log("id::"+anchor_id); That I could not return to my position without set restrictions. The following entities may request an IME: An independent medical evaluation can be requested for various reasons, including. My husband felt a sudden snap in his arm while working. It is highly unusual for an IME doctor to have a disability claimant sign a generic authorization form. 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. The IME doctor will not prescribe medication, will not treat you, and is not there to help. The exam is usually scheduled by the insurance company and they also typically pay for it. Your claim will change after an Independent Medical Examination. For example, if your doctor agrees with the IME and says you are fixed and stable then L&I will move to close the claim. 25 Questions to Ask Your Workers Comp Lawyer. IME stands for "Independent Medical Exam." But, always remember it is an examination by a doctor (or doctors) paid by the insurance company. Some of the reasons why this can happen are because: When there are differences of opinion regarding your condition, the insurance company will side with whichever report they deem the most credible. With that said, if you dont do anything, your workers compensation claim will be over. careful about your next steps. Are you entitled to financial compensation for your work injury? Said that I had not returned to my pre-injury levels. If youve been injured in an accident, you may qualify for a settlement. Note also that Insurer requested IMEs are not subject to the 15-mile travel deductions. It's Important to Know That IMEs are not Independent These doctors are hired through vendors contracted with the insurance company. It is often not unusual for the IME doctor to send a rough draft to the adjuster or defense lawyer to read. If youre already working with an attorney, you should then give those notes to your attorney. Workers compensation doctors know insurance carriers dont like spending money on expensive tests like MRIs and CT scans. Despite their label, IMEs are not independent. In fact, it's often called a "DME," for "Defense Medical Examination.". In this case, the "independent third party" refers to the IME doctor. This strategy session will help you get informed. Depending on where you live, this may be a doctor of your own choosing, or it may be a doctor who has been pre-selected by your employer. Strictly speaking, you do not have to go back to work when an independent medical examiner disagrees with your doctor. If the IME doctor agrees, you might wonder if that means that youre free and clear and will continue to receive the benefits that you were set to receive before you were asked to complete the IME. 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. However, if your attending physician disagrees with a bad IME, there is still hope for your claim. Don't compare your claim to someone else's. Find out now with a free claim assessment. Especially if you are still in main or experiencing physical limitations, it will be important for you to speak with a lawyer before you do anything that could jeopardize your legal rightsor your physical recovery. Dont try to conceal pre-existing conditions. Yes, you can. An IME 1600 Ponce de Leon Blvd In contrast, your treating doctor has seen you for multiple appointments over the months since your injury. Comcare is the national occupational health and safety and workers compensation . scrollTop: jQuery("#"+hash).offset().top - 200 How To Write A Disability Appeal Letter (With Sample). If the IME doctor made any mistakes about your medical history, or what you said, youll need to challenge the report. For additional information concerning the amended law, see. What is an L&I Settlement? He then said that if Dr. Demeter does not exam her, then her benefits will be denied. Routine Medical Needs and Workers Compensation Benefits, Work Comp Claims for Nurses & Hospital Staff, Workmans Compensation Insurance Minnesota. Ex. The simple answer is that IME doctors arent always right. There might also be an arbitrator, who will decide whether the IME doctor or your doctor is more credible. But its not unheard of for employers and insurance companies to use it to discredit your claim. Your doctor - the evaluation does not exam her, then her benefits will be denied in report! 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