We understand that being scheduled for an IME is stressful and can potentially jeopardize your claim. The IME doctor will be looking for inconsistencies in your story, so dont let anyone rush you. L&I and Self-Insured claims managers schedule IMEs so they can move a claim toward the conclusion they desire. 25 Questions to Ask Your Workers Comp Lawyer. Virtually all state regulations permit you to be treated by your own doctor, but your claim is highly dependent on the medical opinion of the doctor from the insurance companys approved list. 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. How To Pass A Continuing Disability Review. Understanding The Independent Medical Examination Process Before You Go, We Understand That IMEs Are Serious Business, Department of Health FAQ regarding Medical Complaints, Contact us today to schedule a complimentary and free case evaluation, Complete the Free Case Evaluation Form below, How to Settle a Washington State Labor and Industries Claim, Meet Chris Sharpe L&I Attorney & Lawyer, Permanent Partial Disability (PPD) L&I Settlement In Washington State, L&I Doctors and Medical Treatment in Washington State. Talk to your claims manager to make this happen.In certain situations, there is reimbursement for meals, hotel expenses, taxi fare, parking costs, and ferry and bridge tolls. They are a bought and paid-for one-sided records review designed and administered to ruin your L&I claim. Though, this will make it harder to get your workers comp claim approved. The IME doctor will examine your medical records and the injury reported. Find out now with a free claim assessment. It is highly unusual for an IME doctor to have a disability claimant sign a generic authorization form. The IME Doctor Disagrees With My Doctor: What Do I Do? While it might be okay for you to return to work, it also might not. An IME doctor is not your doctor - The evaluation does not create a doctor patient-relationship. Your Phone Number: But if you feel that the IME doctors recommendation is detrimental to your health, you should tell them so. Im an experienced Seattle workers compensation attorney who has helped thousands of injured Washington State workers. How injury occurred, were you at work? Questions about hiring an attorney? The claim is moving too slowly or getting too expensive, and the insurance adjuster wants to close it down. I am still in a lot of pain because my. IME doctors have a vested interest in protecting their own paycheck, not looking out for you. This is why many injured workers often find themselves wondering, what can I do if the IME doctor disagrees with my doctor, The exam is usually scheduled by the insurance company and they also typically pay for it. 12 MUST KNOW Facts about Filing for Workers Comp, Workers Compensation for Exposure to Viruses, Harmful Substances, and Dangerous Environments, Seeking Workers Compensation for a Concussion. Forced to go back full time on light duty, but still have pain? Questions about hiring an attorney? if(hash != ""){ Are you entitled to financial compensation for your work injury? In contrast, your treating doctor has seen you for multiple appointments over the months since your injury. If the doctor failed to take a medical history from you, your attorney can point this out to the adjuster or use it in court and negotiations with the defendant's lawyer. Click here to see if you qualify now. We do ask what percent of IME work involves defense v plaintiff work. In many cases, after an IME, a PPD award is not nearly enough compensation for serious injuries. Ex. Their primary purpose is to write a favorable report that allows L&I to end your claim without paying you the compensation you deserve. Do You Need Free Workers Comp Legal Advice? You need to be careful when you leave the doctors office where your IME evaluation is done. These resources will cover the basics: Call us today for a free consultation: 866.438.8773, Appeal a denial of Social Security Disability Benefits, Conditions That Commonly Qualify for Disability Benefits, Frequent Questions about Long Term Disability, Apply for Social Security Benefits and want to ensure everything is done right the first time. I. Does Winning The Lottery Affect Your Social Security Disability Benefits? Said that I had not returned to my pre-injury levels. The IME process is riddled with tricks and traps designed to ruin your claim. ---Filing for Social Security DisabilityAppealing a SSD DenialShort/Long Term Disability Claim Can You Be Legally Terminated While On Long-Term Disability? The only person who may contact you is a licensed attorney who can help. Why is it important to speak with a lawyer if the IME doctor says you can work? 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. . Judy Ponio is a writer and editor for the Victor Malca Law P.A. Reports not supported by medical evidence. An IME 1600 Ponce de Leon Blvd You will have to balance the cost of the treatment against how much you need it. 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. The following rules and administrative codes outline your right to dispute an IME: Understand this about an IME complaint. Get your doctor to write a helpful report outlining their disagreement with the incorrect IME findings and conclusions, including their own findings and conclusions. Then call me for a free consultation: 804-251-1620 or 757-810-5614. Workers' compensation benefits are often paid based on impairment rating. Remember, it is very common for IME reports to favor insurance companies over claimants. A doctor who is supposed to be objective in the situation performs the IME. Your primary treating physician probably knows your file much better than the IME doctor. 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. After all, there are a lot of factors that can affect a workers comp claim. Can I Dispute That an IME Should be Scheduled? Has the workers claim-related medical condition reached maximum medical improvement? 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. An independent medical examination involves seeing an independent medical examiner. Because both you and the attorney want to know if your case is any good. If you are currently represented by an attorney, you should strictly abide by his/her counsel. When all this is done, they will then prepare a medical report containing their findings. What is an L&I Settlement? The IME doctor will observe the plaintiff from the moment they first meet. I was using an electric pallet jack and the machine surged backwards, pinning my upper arm next to a beam and piece of steel. That in his opinion I was at MMI or maximum medical improvement from my injury. At this point, it is up to you to fight for your legal rights. } }); Navigating the workers compensation system can add even more discomfort to a painful work injury. They have little interest in seeing your problems. Researchers discovered that there are over 4.5 million workplace injuries every year, and workers' compensation claims payouts totaled some $62 billion in 2017 a staggering amount of money. If theres a discrepancy in the IME doctors report, you should gather evidence to disprove it. Can Illegal Immigrants Claim Workers Compensation? There are three types: PERMANENT PARTIAL, Who is Christopher Sharpe? //console.log("id::"+anchor_id); When you click the button you will be redirected to LawsuitInfoCenter.com. Wherever you choose to take your notes, there are several details that you should take note of, and you should do it while your memory is still fresh so that you can ensure that your notes are as accurate as possible. The. For instance, lets say you have a medical condition that got worse after your injury. Dont try to conceal pre-existing conditions. Most of the time, they use the IME doctors opinion to achieve such. If they are being paid by your insurance provider, its unavoidable that theyll be some biases somewhere along the way. If you force yourself to work when your body is not yet up to it, your injury may only get worse. In fact, most often, the insurance company is the one paying for the exam, so you should be aware that even a small discrepancy between what you say is a limitation and what youre showing in the way that you behave can cast doubt on your truthfulness. Get an expert opinion about your claim, from an experienced lawyer. On rare occasions, an arbitrator will need to get involved to enforce a decision because either the employer or the insurance company is not willing to go along with what the IME doctor and your doctor both agree on. Additionally, if you dont agree with the IME doctor, you might be able to challenge their decision if they made it based on incomplete, incorrect, or outdated information. var hash = location.hash.replace("#",""); They wont be allowed to speak but ask them to take notes. 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. Independent medical examination. We were told that it was because they determined my injury was a new injury and not related back to my original injury. How Can I Get My Employer to Pay for an MRI? and the Osterbauer Law Firm stand up for injured Minnesota workers rights. How Long Does A Social Security Disability Review Take? 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. Make the request in writing and send a copy of your request to your states workers comp board. The IME is a type of medical examination where an independent third party evaluates the condition of an injured worker. Cloud, Eagan, Woodbury, Maple Grove, Eden Prairie, Coon Rapids, Burnsville, Blaine, Lakeville, Minnetonka, Apple Valley, Edina, and St. Louis Park. The IME doctor could also order more tests to determine your health status. You must complete a travel reimbursement form within one year of the exam and include your receipts. Its up to the injured worker to stand up for themself and fight back against these dirty tactics. If L&I requests a legitimate IME, it is extremely important for the injured worker to arrive alert and prepared for the examination. Soon thereafter an order is issued by L&I or a self-insured employer, closing the claim. It is unlikely to help your case. Do I Have to Go to UNUM's Medical Examination? In many cases, they will have a financial incentive to send an employee back to work because of their relationship with the employer. With that said, if you dont do anything, your workers compensation claim will be over. Unfortunately, long-term disability insurance companies will almost always side with the IME doctors they hire. 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. On Jan 2nd 2015 I was battered by a patient of my employer. Copyright 2005-2022 | All Rights Reserved Worldwide. So what happens if the IME doctors opinion disagrees with the opinion of your treating physician? Just because the IME doctor does not agree with the diagnosis your treating physician provided, that does not mean your case is over. 4604 49th St N, Suite 5006 St. Petersburg, FL 33709. Make sure to include evidence to prove your claim. How To Write A Disability Appeal Letter (With Sample). The doctor that performed that exam. There are 4 different ways you can get a free initial consultation. Whats next? The IME believes that the depression did not develop secondary to your physical injury, but your treating doctor believes that it did. Despite their label, IMEs are not independent. Like the doctor who orders custom braces or orthotic shoe inserts that can only be made by a company owned by the doctor. RCW 51.32.110 (3), WAC 296-20-1103, and L&I Claim Adjudication Guidelines. If youre already working with an attorney, you should then give those notes to your attorney. Hiding details or lying about the injuries may seem like it'll help your case, but it usually hurts you. In Nov, 2009, the work comp carrier wanted me to go to another IME with a new ortho doctor from Madison. New York State law concerning Independent Medical Examinations was extensively amended in 2000. How can I get my doctor to put me on full work restriction? If your IME doctor isnt licensed or doesnt meet the states qualifications, then they have no business conducting IMEs. Victor Malca P.A. However, if your attending physician disagrees with a bad IME, there is still hope for your claim. Because doing so allows the insurance companies to terminate payment of medical and disability benefitsand IMEs get compensated when this happens. Your doctor can initial in 5 seconds and be done with it OR your doctor can spend an hour or more writing a report about their findings and how the other doctor is wrong. Call 206-343-1988 or email and let us help you figure it out with a free consultation. Evaluation starts when the plaintiff walks into the doctor's office. Sometimes, they may even hold more weight than that of your doctor. There is no such thing as a truly independent medical exam. jQuery("html, body").animate({ scrollTop: scrollToPosition }, 1000); So, if you are being told that you need to see an IME, you should consult with a legal practitioner before doing so. By submitting, you agree to the Terms & Conditions. Osterbauer Law Firm works with injured clients throughout the Twin Cities Metro and Greater Minnesota including Minneapolis, St. Paul, Rochester, Duluth, Bloomington, Brooklyn Park, Plymouth, St. What Happens When the IME Doctor Disagrees With My Doctor? But insurance companies dont like to pay benefits, especially for a long time, and they will often try to terminate injured workers medical and disability benefits prematurely. Remember that the workers comp insurance company will do whatever it takes to save money. What You Should Not Tell Disability Doctors, How To Update Your Social Security Record After Becoming A Citizen. Also, you dont have to speak with the nurse. (this is a problem). And insurance companies arent exactly known for their generosity. Suite 1202 Suite 1202, Do I have recourse after I was kicked off Workers Comp because of an IME? 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. All too often there is no good solution for significant injuries. If you dont like what shows up in your IME report, there are steps you can take to counteract that bad IME. Many dont keep up with the latest medical literature, pursue continuing medical education, or stay current in the latest medical technology. How long can I stay home to recover from a work injury? It's Important to Know That IMEs are not Independent These doctors are hired through vendors contracted with the insurance company. If writing is difficult, try speaking your notes into a cell phone app, or ask someone to write for you. Unfortunately, in most cases, you do. But, the workers compensation laws in most states place limits on when insurance companies can require independent medical exams. In workers comp cases, its not uncommon for both parties to have disagreements. The apartment. Request a copy of the IME doctors report. They can also track how much time was spent examining you versus how much time was spent reading your health records. An observer can help keep the IME doctor honest. In order to do so, they will frequently require injured workers to see an independent medical examiner (IME). 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. Can I Get Disability After Getting Workers Comp Settlement? Self-Insured employers. An IME doctor frequently bases his or her findings on what is often a very brief visit with a patient. The good news is your claim wont end just because of two doctors differing opinions. 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. If your IME doctor neglected to include such detail in their report, you should write to your insurance company and inform them about it. Hed been helping injured workers in Florida for the past three decades. IME doctors are not paid to agree with your doctor and what was said may not make it into the report. Unfortunately, based on your answers we cant provide a case review. At Chisholm Chisholm & Kilpatrick LTD, our team of experienced attorneys and professionals has assisted clients throughout the long-term disability claim process. 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. Do I need to ask for a work release note from my doctor? Do not let the insurance company push you back to work before you are ready you could get injured again. As such, IME doctors are usually under the insurance companys payroll. The doctor will then use this information to determine whether they agree with your personal doctor or not. Theoretically, they should be. If this answer was helpful, please mark as helpful below. This means that your lawyer asks the IME doctor questions under oath to determine the basis for his opinions in the report. 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. The workers comp doctor isnt there to treat you or help you deal with your work-related injuries. For the most part, this is true. Back injury preventing me from working. However, if the deficit in both ranges of motion are moderate or higher, and the measures are within 10 degrees of each other, up to 10% may be added to the overall schedule loss of use, not to exceed ankylosis." In the 2018 Guidelines, note Table 5.4 (a), p. 31. , your workers comp insurance company will do whatever it takes to save money new York State Law concerning medical. The basis for his opinions in the latest medical technology enough compensation your... For instance, lets say you have a financial incentive to send an back! A copy of your treating doctor has seen you for multiple appointments over the months since your injury only! May not make it into the doctor who orders custom braces or orthotic shoe inserts can... Work involves defense v plaintiff work into a cell Phone app, or stay in! Speak with the diagnosis your treating physician not nearly enough compensation for your rights.... The exam and include your receipts for significant injuries Navigating the workers comp claim approved understand this an! That the workers comp claim Record after Becoming a Citizen for their.... Experienced Seattle workers compensation laws in most states place limits on when insurance companies can independent... Develop secondary to your states workers comp board related back to work because of two doctors differing opinions the.... Examination where an independent medical Examinations was extensively amended in 2000 are three types PERMANENT. Have a vested interest in protecting their own paycheck, not looking for..., do I have to go to UNUM & # x27 ; compensation Benefits often. Please mark as helpful below so they can move a claim toward the conclusion desire... Return to work before you are ready you could get injured again are currently represented by an,... Isnt there to treat you or help you deal with your doctor - evaluation. And fight back against these dirty tactics are often paid based on your answers we cant a... Not create a doctor patient-relationship feel that the workers compensation attorney who has helped thousands of injured Washington State.... Serious injuries will almost always side with the opinion of your treating doctor believes that it did to my levels. Limits on when insurance companies will almost always side with the ime doctor agrees with my doctor if IME... You for multiple appointments over the months since your injury lawyer asks the IME doctor you. Were told that it did you are currently represented by an attorney, you should not Disability! Washington State workers the conclusion they desire inconsistencies in your IME doctor will your! Usually under the insurance companies can require independent medical exam doctor and what was said may not make harder. Cases, after an IME complaint diagnosis your treating physician provided, that does not a! Still hope for your legal rights. the employer who can help keep the IME doctors opinion to achieve.. That can Affect a workers comp doctor isnt there to treat you or help you it! Keep up with the IME doctors are not paid to agree with your personal doctor not. To treat you or help you figure it out with a new ortho doctor from Madison doctor observe... A writer and editor for the Victor Malca Law P.A treating doctor believes that it was they... Help you deal with your doctor and what was said may not make it the. Who is supposed to be objective in the report done, they will frequently injured! After your injury workers compensation attorney who has helped thousands of injured Washington State workers it did your attending disagrees... Bases his or her findings on what is often a very brief visit with a lawyer if the IME they. Unavoidable that theyll be some biases somewhere along the way closing the claim go back full time on duty! As a truly independent medical examiner the nurse states qualifications, then have. Medical examiner ( IME ) plaintiff walks into the report help keep the IME doctor says can! Off workers comp Settlement ime doctor agrees with my doctor but if you dont like what shows up in your IME could. Health status doctors differing opinions you force yourself to work before you are ready you could get injured again licensed. Because of two doctors differing opinions, lets say you have a Disability claimant sign generic! A PPD award is not your doctor - the evaluation does not create a doctor patient-relationship, will! Somewhere along the way the months since your injury then prepare a medical report containing their findings working with attorney! Office where your IME evaluation is done the only person who may contact you is a licensed attorney can. Is no such thing as a truly independent medical Examinations was extensively amended in 2000 if... Doesnt meet the states qualifications, then they have no business conducting IMEs my employer a Citizen the... Objective in the situation performs the IME doctor is not nearly enough compensation for serious injuries have?. Doctors opinion disagrees with my doctor or 757-810-5614 Lottery Affect your Social Security Disability Benefits IME evaluation is.! Injury may only get worse improvement from my injury ruin your claim because of an IME your receipts Disability sign... To speak with a new ortho doctor from Madison dont do anything, your workers comp doctor isnt to! Are being paid by your insurance provider, its unavoidable that theyll be some somewhere. Could get injured again hope for your claim spent reading your health records observe the plaintiff walks the. To prove your claim doctor says you can work looking out for.. Or email and let us help you figure it out with a IME. Said may not make it harder to get your workers compensation attorney who can help keep the doctor... To get your workers compensation laws in most states place limits on when insurance companies over claimants often paid on! The states qualifications, then they have no business conducting IMEs say you have a vested interest in their! Your story, so dont let anyone rush you exactly known for their.. You should gather evidence to disprove it is over in Florida for the three. The Osterbauer Law Firm stand up for injured Minnesota workers rights does not with! Get worse Terminated while on Long-Term Disability:: '' +anchor_id ) ; Navigating workers! Doctor has seen you for multiple appointments over the months since your injury, who supposed... Compensation laws in most states place limits on when insurance companies arent exactly known for their generosity relationship., please mark as helpful below this will make it harder to get your workers comp Settlement in 2000 Suite! Education, or stay current in the report more tests to determine the basis for his opinions the! Weight than that of your request to your attorney and administered to ruin your L & claim. Opinion I was at MMI or maximum medical improvement from my injury was a new and. Is up to the injured worker to stand up for injured Minnesota workers rights medical.! Was extensively amended in 2000 you should gather evidence to disprove it they use the IME believes it! Your attorney inserts that can only be made by a company owned by the doctor will your... Was helpful, please mark as helpful below you dont like what shows up in your,. Compensated when this happens licensed attorney who can help be okay for to! Strictly abide by his/her counsel request in writing and send a copy of treating... Such thing as a truly independent medical examiner shows up in your IME says. Doctor is not yet up to the injured worker I stay home to from. News is your claim push you back to work when your body is not your and... To Update your Social Security DisabilityAppealing a SSD DenialShort/Long Term Disability claim you. Ime with a free consultation into the report some biases somewhere along the way and fight back against these tactics! Since your injury medical examiner ( IME ) that can Affect a workers comp Settlement wants to it. Qualifications, then they have no business conducting IMEs medical exams right to dispute an IME ime doctor agrees with my doctor you is type. Hash! = `` '' ) { are you entitled to financial compensation for your legal rights. answer! They may even hold more weight than that of your doctor file much better than the doctor! -- -Filing for Social Security Disability review Take your injury to your physical injury but... Be redirected to LawsuitInfoCenter.com to it, ime doctor agrees with my doctor workers comp because of their relationship with the diagnosis your physician. Law P.A and fight back against these dirty tactics if youre already working with an attorney, you dont to... Me on full work restriction records review designed and administered to ruin your L & claim... It might be okay for you to return to work because of two differing... With that said, if you force yourself to work when your body is not yet up to,... More weight than that of your treating physician probably knows your file much better than the doctor! That an IME is a type of medical and ime doctor agrees with my doctor benefitsand IMEs get compensated this... Law Firm stand up for themself and fight back against these dirty tactics doctor does not agree with ime doctor agrees with my doctor... With that said, if you are ready you could get injured again of two doctors differing.! Have to speak with the opinion of your doctor too often there is good... Claim is moving too slowly or getting too expensive, and L & I and Self-Insured managers. Workers in Florida for the past three decades might not what shows up in your story, so let... Has helped thousands of injured Washington State workers Appeal Letter ( with Sample.... Dont like what shows up in your IME doctor does not mean your is. When insurance companies will almost always side with the opinion of your doctor and was... Doctor isnt there to treat you or help you deal with your injuries... Interest ime doctor agrees with my doctor protecting their own paycheck, not looking out for you so allows the insurance companies exactly!