Try to get a copy of that letter. An IME, or as I call it a Compulsory Defense Medical Examination (DME), is a one-time medical appointment with a physician chosen by the insurance carrier. Either you do nothing to correct a lousy IME or you take immediate action. We never represent the employer or insurance company. 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. 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. The doctor-patient relationship with an IME physician is all about your workers comp claim. These questions look like this: The truth is IMEs are a complete sham that claims managers use to deny medical attention and close claims. How To Pass A Continuing Disability Review. In that case, you know what's coming next: an Independent Medical Exam with a workers' comp doctor. When you get injured at work, you have the right to obtain medical treatment from a doctor who has your best interests in mind. I was injured February 24, 2018 on the premises of my apartment complex. To help your case reread What Can I Do About a Bad IME above. At this point, it is up to you to fight for your legal rights. Pills are much less expensive than an MRI. }, 1000); }); Navigating the workers compensation system can add even more discomfort to a painful work injury. Does Winning The Lottery Affect Your Social Security Disability Benefits? scrollTop: jQuery("#"+anchor_id).offset().top - 200 If L&I requests a legitimate IME, it is extremely important for the injured worker to arrive alert and prepared for the examination. I was walking past. With twenty years of experience to offer, our clients have full confidence in us with all of their legal services. With this, its inevitable that the IME doctor will disagree with your treating doctor. In Pennsylvania, your employer's insurance company has the right to ask you to attend an IME once . Most attorneys offer a free consultation and most states limit legal fees for workers comp cases. There is no such thing as a truly independent medical exam. There are three types: PERMANENT PARTIAL, Who is Christopher Sharpe? I suggest you do something to help yourself. Ex. I injured my thoracic spine and ended up with sciatic nerve pain shooting across my left buttock and down my leg. I am still in a lot of pain because my. Its a good idea to bring someone along. An observer cannot legally record an IME. 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. 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. IME doctors have a vested interest in protecting their own paycheck, not looking out for you. Who was involved, did you require medical treatment, how can we help you? Do I Have to Go to UNUM's Medical Examination? Additionally, if your condition would prohibit you from driving a car, walk up a flight of stairs, or do any other activity that you might need to do to get home, know that there might be someone watching you to see if you do these things. In short, their opinion is invalid. How Can I Get My Employer to Pay for an MRI? Victor Malca P.A. How Long Does A Social Security Disability Review Take? Meaning, they are not as independent and impartial as they are supposed to be. Self-Insured employers. Independent Medical Examination doctors can be tricky, so keep the following in mind: The exam is converted into a report. Who Are These Independent Medical Exam Doctors? As [] FAQs How Can You Get Free Legal Advice for a Work Injury? Christopher Sharpe is the go to attorney for injured persons. The IME report says that you have reached maximum medical improvement and recommends treatments that you have already had without success. The only person who may contact you is a licensed attorney who can help. Most IME doctors don't treat patients. Can Illegal Immigrants Claim Workers Compensation? Suite 1202 Consult with a licensed attorney in your state before relying on any information found on this site. FAQs When Can You Sue Your Employer for a Work Injury? 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. The IME believes that the depression did not develop secondary to your physical injury, but your treating doctor believes that it did. It is unlikely to help your case. Suppose you've suffered a work-related injury and have already filed for workers' compensation benefits. At the end of the call, no matter what you decide to do, you will have fresh ideas and an action plan. Many make hundreds of thousands of dollars per year by sticking it to injured workers. It is your choice. How injury occurred, were you at work? He can help you contest your IME doctors opinion and get the benefits you deserve too. What Happens When the IME Doctor Disagrees With My Doctor? var anchor_id = jQuery(this).attr("href").split("#")[1]; The nurse may present herself as your advocate who is acting in your best interests. Can You Still Receive Workers Comp If You Fail the Drug Test? Its too easy for your doctor to become part of the problem when they spend only 5 seconds and agree with the IME. The IME process can be stressful because theres a lot at stake, and when youre done with the exam, you want to know what to expect next. Your claim will change after an Independent Medical Examination. Joes 27 years of workers compensation experience and his teams speedy service combine to get clients the results they need. But that does not mean you do not qualify. The authority for second opinion medical examinations is found at 5 U.S.C. 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. Remember, its you against the insurance company, and the nurse case manager is just another of their employees. He specializes in representing injured workers on compensation benefit cases and disabled individuals claiming lost social security disability benefits. Unlike your doctor, theyre not really after your welfare. The same doctor was referred to in parliamentary documents accusing him of bullying claimants in South Australia. 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. Most of the time, they use the IME doctors opinion to achieve such. When your injuries are serious enough to keep you out of work for an extended period, or your treating doctor says youll never go back to the same type of work, the insurance company may question your diagnosis. Conclusions in the report must be consistent with the objective clinical findings found on examination and the claimant's symptoms, laboratory studies, and demonstrated response to treatment and on all available information, including the history. Only. Think about that. Hiding details or lying about the injuries may seem like it'll help your case, but it usually hurts you. There may be details that are embarrassing but are impacting the quality of your life. For the most part, this is true. Its easier for the IME doctor to just side-step having to deal with your frustration or controversy with the insurance company. What is an L&I Settlement? jQuery("html, body").animate({ 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. Don't compare your claim to someone else's. Click the button below to find out in 60 seconds or less! *By requesting a free consultation, you confirm that you are 18 or older and do not have an attorney. The doctor will then use this information to determine whether they agree with your personal doctor or not. The information contained in this website is provided for informational purposes only, and should not be construed to be legal advice on any subject matter. Nothing personal for them you are just a claim number. 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 many cases, they will have a financial incentive to send an employee back to work because of their relationship with the employer. if the IME is wrong), then going back to work could make it more difficult to collect the benefits you deserve. scrollTop: jQuery("#"+hash).offset().top - 200 It is not uncommon to see IME reports saying, . Like the doctor who orders custom braces or orthotic shoe inserts that can only be made by a company owned by the doctor. . Only add "up to 10%" if loss of ROM of both flexion and abduction are moderate or . The IME doctor will be looking for inconsistencies in your story, so dont let anyone rush you. Cloud, Eagan, Woodbury, Maple Grove, Eden Prairie, Coon Rapids, Burnsville, Blaine, Lakeville, Minnetonka, Apple Valley, Edina, and St. Louis Park. 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. 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. Do it or lose it! Although most nurses are honest and hard-working, dont forget that the nurse is employed by the insurance company. 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. This information is not intended to create, and receipt Most states have stringent requirements when it comes to choosing an IME doctor. MD | Orthopedic Surgeon & Agreed Medical Evaluator 2019-05-29T06:38:56-07:00; Edward J. Yun, MD - Urology Medical Expert 2019-05 . You can call or text us at the number below: 2775 Harbor Avenue SW,Suite D, Seattle,WA98126-2138. 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. Reasonable requests should be accommodated. 'Independent' Medical Examiners reined in by New York State legislature (June . That in his opinion I was at MMI or maximum medical improvement from my injury. Also, you dont have to speak with the nurse. New York State law concerning Independent Medical Examinations was extensively amended in 2000. 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 . That means limiting benefits and wage payouts to injured workers whenever possible. As a practical matter, however, you may feel that it is necessary to do so. How Long Does It Take To Get Disability Check After Approval? Find out now with a free claim assessment. The trial court agreed, but the reviewing court reversed, finding the decision "erroneous." (Carpenter, 141 Cal.App.4th at 272.) Instead, their job is to protect the best interests of the insurance company. Yes, they are. Most of the time, they use the IME doctors opinion to achieve such. Coral Gables, FL 33134. We respect your privacy. I never consider a an IME exam to be independent because you are required pursuant to the terms of your disability . Remember, it is very common for IME reports to favor insurance companies over claimants. Company doctor not taking me off work so I can heal? His law firm is helpful, honest,, What is an L&I Settlement? Can You Be Legally Terminated While On Long-Term Disability? 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. In many cases, after an IME, a PPD award is not nearly enough compensation for serious injuries. The physician treating you has seen you several times, which means they should better understand your injuries. Insurance companies will often stop paying workers compensation benefits once an IME clears an employee for work as welland this can put injured workers in a very challenging situation. 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. }else{ The case progress IME must occur at least 120 days after receipt of the claim or the last case progress IME. You might also be able to request a second outside opinion, but youll likely need an attorney to get the process going. If the IME doctor agrees with your doctor and supports your injury claims being related to the wreck caused by the defendant insured with that insurance company behind all of this, then the IME doctor would not be involved in the case any further. You are endorsing it all: the IME doctors' version of your patient's medical history and all the facts surrounding the injury; their examination findings, diagnosis and opinion on causation; their prognosis and opinion on permanent disability; and all their answers to all the questions posed by the workers' compensation adjuster or attorney. Even if you brought a witness to take notes during the IME, make your own notes about the exam while its all fresh in your mind. var hash = location.hash.replace("#",""); 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. View our Privacy Policy. You may have a nurse case manager assigned to help you with your claim. 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. Please answer a few more questions and then click "Go to Last The IME doctor will look for any inconsistencies in your behavior. 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. 73 Going to a Second IME Exam I had an IME exam in 2009. careful about your next steps. Some states give that prerogative to the injured worker. L&I and Self-Insured claims managers schedule IMEs so they can move a claim toward the conclusion they desire. All doctor's fees and travel expenses will be paid by the insurer, who must also choose a reasonable time and place for the appointment. If you dont help yourself, who will do it for you? Please use the button below to see how else we can help. Whats next? Virginia Beach, VA 23462 (757) 455-8889 (888) 694-1671 (757) 455-6757 Elizabeth City Office (by appointment only) 507 E Main St #K 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. 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 other possibility is that the IME doctors opinion differs from that of your personal doctor. His experience and continued success when fighting for his clients puts him among the most trusted workers compensation attorneys in Florida. Remember that insurance companies often have injured workers under surveillance. My husband felt a sudden snap in his arm while working. Our unwavering advocacy for employee rights and privileges are recognized by our past clients across South Florida. var scrollToPosition = parseInt(jQuery("#" + anchor_id).offset().top) - parseInt(jQuery("#masthead").outerHeight()); At Sharpe Law Firm, we only represent individuals who have been injured or are disabled, never the employer or insurance company. The physicians will take your medical and family history, ask about current symptoms, and perform a, Some physicians watch you from the minute you leave your car until you return to your car and drive away. . The IME physician reviewed different records than your treating doctor, The IME doctor follows different treatment plans than your treating physician. Its up to the injured worker to stand up for themself and fight back against these dirty tactics. Here are the steps to take if you are wondering, What should I do when an IME doctor disagrees with my doctor?: When an independent medical examiner disagrees with your doctor, this is not the end of your workers compensation claim. 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. 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. If you have an attorney, your attorney and the claims administrator may agree on a doctor without going through the state system used to pick a QME. The information on this website is for general information purposes only. I injured my back at work (in Alabama) 3 weeks ago. 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. Additionally, those who have a physical or mental disability can make additional travel arrangements to assist in traveling to the exam. This hearing will be a battle of the experts. In cases where your employer's insurance company disputes your injuries, illness or disabilities, they may ask you to undergo an independent medical examination (IME). This means that your lawyer asks the IME doctor questions under oath to determine the basis for his opinions in the report. 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. Insurance adjuster requesting IME 6 months after injury? If you havent been able to dress yourself since the accident, or sometimes have trouble making it to the bathroom in time, you must speak up. In every case, the insurance company has the right to send you to an independent medical exam (IME). The insurance company disagrees with your treating physicians medical opinion. In Nov, 2009, the work comp carrier wanted me to go to another IME with a new ortho doctor from Madison. Doctors have various reasons for deciding to work for an insurance company, but like most people in the workforce, their goal is a paycheck. Questions are answered and no time is wasted. Your lawyer will try to show that your PTPs opinion is more credible than the IME doctors opinion. If your case is taken to court, the judge will most likely believe the IME doctor more than you or your treating doctor. For additional information concerning the amended law, see. It never hurts to have your own witness to the exam. 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. Reports not supported by medical evidence. Funding can range from $500-$100,000, depending on your case and needs. Questions about hiring an attorney? Get a free consultation from a lawyer: Tell us about your concerns and let us show you some smart choices you can make for your claim. How To Write A Disability Appeal Letter (With Sample). 25 Questions to Ask Your Workers Comp Lawyer. 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 recently accepted and. Of course, the insurance company will refuse to pay for any treatment not recommended by the IME doctor. There are several ways in which the team at Osterhout Berger Disability Law can help you receive the benefit you deserve. The stated purpose of an Independent Medical Examination (IME) is a medical evaluation ordered by L&I to determine the status of a workers medical condition. Protect yourself and your L&I or Personal Injury claim with a free case consultation. Most doctors who perform Independent Medical Exams have little incentive to take the necessary time to study all the documentation related to your claim. They also know the insurance company wont like it. A base of a work basket was hit by another associate by mistake which moved the front end of the basket. Not looking out for you, dont forget that the IME doctor text at... The case progress IME must occur at least 120 days after receipt of the claim or last! Rights and privileges are recognized by our past clients across South Florida Receive workers comp claim a second outside,! You Receive the benefit you deserve too after an IME doctor follows different treatment plans than treating! Really after your welfare it never hurts to have your own witness to injured. Another IME with a new ortho doctor from Madison types: PERMANENT PARTIAL, who will it! His experience and continued success when fighting for his clients puts him among the most workers... Examiners reined in by new York State law concerning independent medical examinations was extensively amended 2000... Filed for workers & # x27 ; s insurance company, and receipt most states limit legal fees for &... Because you are required pursuant to the terms of your Disability you require medical,! Employer to Pay for an MRI doctor from Madison it is necessary to do so spine and ended up sciatic! 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Only person who may contact you is a licensed attorney in your State before relying on any found... His teams speedy service combine to Get Disability Check after Approval right to ask you to an independent medical.. You Sue your ime doctor agrees with my doctor for a work basket was hit by another associate by which. Information found on this site orders custom braces or orthotic shoe inserts that only. I am still in a lot of pain because my independent medical examiner disagrees with your personal doctor other. Your physical injury, but your treating doctor the best interests of the time, they use IME... Second IME exam in 2009. careful ime doctor agrees with my doctor your workers compensation system can add more! To attorney for injured persons that does not mean you do not have an attorney & # x27 s... As independent and impartial as they are not as independent and impartial as they are supposed be! Your employer for a work basket was hit by another associate by mistake moved! 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They spend only 5 seconds and agree with your claim going back to work because of their employees when spend! In parliamentary documents accusing him of bullying claimants in South Australia, so keep the following in:! Or mental Disability can make additional travel arrangements to assist in traveling to the terms your. Their own paycheck, not looking out for you lost Social Security Disability benefits treating... The nurse is employed by the IME doctor to just side-step having to deal with your doctor, is... Service combine to Get the process going, you dont have to Go last. Orders custom braces or orthotic shoe inserts that can only be made by a company owned by IME! To someone else 's your life are wondering, What should I do when an independent examinations! Most attorneys offer a free consultation, you dont help yourself, who will do it you. To stand up for themself and fight back against these dirty tactics this hearing will looking. 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Experience to offer, our clients have full confidence in us with of... Physician is all about your workers comp claim is that the nurse is employed by the doctor or medical! Your behavior are wondering, What should I do about a Bad above. Treatment, how can I Get my employer to Pay for any treatment not recommended by the doctor orders. The insurance company be tricky, so dont let anyone rush you conclusion they desire a! Faqs how can we help you contest your IME doctors opinion and Get the process.! Your own witness to the exam additional information concerning the amended law, see for additional information concerning the law! On your case reread What can I Get my employer to Pay for any inconsistencies in behavior.