I injured my thoracic spine and ended up with sciatic nerve pain shooting across my left buttock and down my leg. They usually send a copy to your doctor with a cover letter asking them to agree or disagree with the IME report: Doctor, if you disagree, write a lengthy report. At Chisholm Chisholm & Kilpatrick LTD, our team of experienced attorneys and professionals has assisted clients throughout the long-term disability claim process. This funding gives you the money you need to cover personal expenses now. Basically, an IME is your right, whereas for a change in treating physicians, you must really show good cause to the Commission, which is not always so easy. You may have a nurse case manager assigned to help you with your claim. Why is it important to speak with a lawyer if the IME doctor says you can work? That means limiting benefits and wage payouts to injured workers whenever possible. It is NOT formal legal advice. They told me it was just a bad ankle sprain. Consult with a licensed attorney in your state before relying on any information found on this site. For the most part, this is true. You cant refuse the insurance companys request for an IME or youll risk losing all your workers comp benefits. Even when doctors would normally recommend those diagnostic or therapeutic services, in workers comp cases, they wont mention it to the injured worker. Do I have recourse after I was kicked off Workers Comp because of an IME? Honesty is the most important part of all interactions with your worker's compensation doctor. The number, frequency, timing, and reason for IMEs can be questioned throughout the dispute process. During the IME examination the examining doctor makes an assessment of the injury victim, including: General Appearance. Tell the IME doctor every detail about your pain management, mobility struggles, and how your work injury is affecting your activities of daily living. The following rules and administrative codes outline your right to dispute an IME: Understand this about an IME complaint. They have little interest in seeing your problems. }); Do I need to ask for a work release note from my doctor? Financial pressure: IME doctors whose sole practice and income is from IMEs paid by insurers Contracts with insurers - one doctor who responded to the survey said the insurer agrees to a minimum number of IMEs per year. One of the most important things that a claimant needs to understand is that these medical exams arent as independent from the insurance company as they might sound. This is a difficult situation, and the best thing you can do is consult with a local attorney about your workers compensation rights promptly. ---Filing for Social Security DisabilityAppealing a SSD DenialShort/Long Term Disability Claim The IME doctor will be looking for inconsistencies in your story, so dont let anyone rush you. Instead, their job is to protect the best interests of the insurance company. case or situation. Examining physicians spend lots of time with your medical records and only a little time examining you. I am a restaurant manager for a very busy chain restaurant. 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. 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. If a nurse threatens to stop your workers comp benefits if you wont let her come to your doctor appointments, immediately contact a personal injury attorney for advice. Reasonable requests should be accommodated. If they are being paid by your insurance provider, its unavoidable that theyll be some biases somewhere along the way. IMEs are designed to end your time loss & medical care and close your claim with no settlement or less settlement money than you deserve. As a result, you shouldnt consider the IME to be over until you are completely behind closed doors in your home. Then, L&I or the Self Insurer will take the IME and your doctors concurrence and move your claim toward the IMEs conclusions. In reality, they are recruiting professional opinions allowing them to have their way with your L&I claim. You only get a short period of time to salvage what you can from your L&I claim. A base of a work basket was hit by another associate by mistake which moved the front end of the basket. Think about that. As a judge, when he saw a report from an out-of-state doctor, "my antennae immediately pop up," Schaeve said. You will also need an attorney if youre the subject of a workers compensation investigation. Approval takes < 24 hours with no credit checks and no obligation you only pay it back if you win your claim. There is no such thing as a truly independent medical exam. You agree these messages may be auto-dialed or pre-recorded, and consent is not a condition of purchase. TALK WITH YOUR DOCTOR BEFORE THEY AGREE WITH A BAD IME! It is not uncommon to see IME reports saying, . What Are Your Chances of Getting Disability for Arthritis. 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. I fell on a broken step and injured my back. How To Write A Disability Appeal Letter (With Sample). I recently accepted and. Try Avvo Advisor at instant.avvo.com if you want to speak directly with myself or another attorney right away. To do so, IME exams are scheduled with doctors who will help them manage a claim. The IME doctor will examine your medical records and the injury reported. He can help you contest your IME doctors opinion and get the benefits you deserve too. How Long Does A Social Security Disability Review Take? Yes, they are. An L&I settlement is money paid at claim closure. There are several types of settlements an injured worker will want to learn about and understand to ensure they get the best possible settlement for their claim. All too often there is no good solution for significant injuries. You should prepare yourself for two basic scenarios: the IME doctor agrees with your doctor or disagrees with your doctor. or viewing does not constitute, an attorney-client relationship. New York State law concerning Independent Medical Examinations was extensively amended in 2000. Call Dabdoub Law Firmtoday at (800) 969-0488 to speak with an attorney about your case. Dabdoub Law Firm is a highly specialized disability insurance law firm based in South Florida offering representation to disability claimants across the country. 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. You can expect to be scheduled for an independent medical exam when: And if your treating physician determines you have a total or partial disability, you can bet the insurance company will be sending you for an independent medical exam with their handpicked doctor. This hearing will be a battle of the experts. Independent medical examination. 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. } If you dont help yourself, who will do it for you? The insurance company will send copies of your medical records to the IME doctor well before the scheduled exam date, usually along with a cover letter telling the doctor what they want to know about your condition. The responsibility of an IME doctor is only to ascertain your medical condition. His law firm is helpful, honest, and knowledgeable about workers' compensation and personal injury law in the State of Washington. Remember that insurance companies often have injured workers under surveillance. But its not unheard of for employers and insurance companies to use it to discredit your claim. In these situations, the Department of Labor and Industries (L&I) will attempt to pound the final nail in the coffin, using an Independent Medical Examination (IME), to end the injured workers claim. Reports not supported by medical evidence. Most states have stringent requirements when it comes to choosing an IME doctor. She enjoys helping people in need with questions about social security disability and workers compensation law. It is your choice. So, if you are being told that you need to see an IME, you should consult with a legal practitioner before doing so. 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. Your OWCP assigned Claims Examiner (CE) may request a second opinion examination at any time to clarify your accepted work-related condition, the extent of disability, work capacity, or other issues. Most IME doctors don't treat patients. Under state law, employers and workers' compensation insurance carriers are allowed to request an IME with a doctor of their choosing every six months. Keep reading to learn more about changing your treating physician after a work injury. An IME is usually ordered by the insurance company who provides workers' comp coverage for your employer. There are several ways in which the team at Osterhout Berger Disability Law can help you receive the benefit you deserve. Your Email: An Independent Medical Exam (IME) is an opportunity for the employer (really the employers workers compensation insurance company) to have you examined by a doctor of their choosing. Independent Medical Exam (IME) Doctor - These doctors conduct IMEs on behalf of the insurance company. Some injured workers do not realize the negative impact that the IME report can have on the insurance companies valuation of their cases. The report may also include their recommendation on whether you can go back to work or not. 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 . If the IME report is extremely negative and the adjuster is relying on it heavily in denying you a fair . Is It Time to Speak with a Work-Related Injury Lawyer? What Happens When the IME Doctor Disagrees With My Doctor? Regardless of the source, IMEs are a serious problem for an injured worker and their workers compensation claim. scrollTop: jQuery("#"+anchor_id).offset().top - 200 An independent medical examination (IME) is usually requested when theres doubt about your workers compensation claim. Independent medical examiners routinely dispute doctors treatment recommendations. The apartment. But, you can ratchet back some of the stress of facing an IME by thinking about what youll be asked by the doctor and being prepared to give complete and honest answers. Its a good idea to bring someone along. An observer cannot legally record an IME. Many dont keep up with the latest medical literature, pursue continuing medical education, or stay current in the latest medical technology. } As [] Make sure to include evidence to prove your claim. Christopher Sharpe is the go to attorney for injured persons. No recipients of any content from this website, clients or otherwise, should act or refrain from acting on the basis of such content, without first seeking the appropriate legal and/or other professional advice on the particular facts and circumstances at issue, and from an attorney and/or professional who is licensed in the recipients state. Can Illegal Immigrants Claim Workers Compensation? Unfortunately, based on your answers, we will not be able to help you. First of all, you need to know that its not uncommon for IME doctors to have a different opinion from your doctor. The information on this website is for general information purposes only. Step", So far so good! We were told that it was because they determined my injury was a new injury and not related back to my original injury. Virginia Beach Office 5500-B Greenwich Rd. First of all, you should take accurate notes about how long youre there, when you arrive, and when you leave. 5 Signs That You Will Be Approved For Disability. 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. Saying or doing the wrong thing in front of the workers' comp doctor could cause your claim to be denied. Finding a Compromise. Routine Medical Needs and Workers Compensation Benefits, Work Comp Claims for Nurses & Hospital Staff, Workmans Compensation Insurance Minnesota. Questions about hiring an attorney? 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. 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. Expertise counts, so use it to your advantage. We respect your privacy. 8123 (a). 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. 2023 Work Injury Statistics: Complete Guide to the Latest Data Available. The IME doctor may be expensive and the veteran must pay the bill up front and out of his/her own pocket. How Can I Get My Employer to Pay for an MRI? This will help them determine if there are any "objective" signs of an injury related to your workplace accident. Note also that Insurer requested IMEs are not subject to the 15-mile travel deductions. 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. My lawyer refused to go to this new doctor as they already had established an IME doctor for my case. For many injured workers, that means facing an Independent Medical Examination, or IME, ordered by the workers compensation insurance company. The doctor selected to perform your IME is supposed to study all the medical notes and documents related to your claim, discuss your injury, and examine you. Your attending physician will be asked by L&I to agree with the 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. But if you choose to take notes with pen and paper, take a picture with your phone, too, so that you have a time-stamped record of when you wrote those notes so that its less likely that someone can accuse you of having forgotten and taken inaccurate notes. As a result, lots of insurance company-approved doctors are more likely to treat injuries with pain medication. It is unlikely to help your case. The IME doctor will look for any inconsistencies in your behavior. If possible, have a friend or family member go with you to the IME. There is no guarantee that the IME doctor will agree with the veteran's thinking and if the report is not in agreement with the veteran, he/she will not get their money back. Nurse case managers are registered nurses whose job is to facilitate communication between the doctor and the insurance company. 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. 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. }else{ If you believe you have a valid complaint about your IME, there are several methods of recourse at your disposal. While it might be okay for you to return to work, it also might not. He will strive to point out flat out mistakes or negative remarks. Workers' compensation benefits are often paid based on impairment rating. if(hash != ""){ IME stands for "Independent Medical Exam." But, always remember it is an examination by a doctor (or doctors) paid by the insurance company. Before the hearing, your lawyer may need to take the deposition of the IME doctor. You can use this to contest the IME report at court. If writing is difficult, try speaking your notes into a cell phone app, or ask someone to write for you. Stephen Scott, the Aetna Claims Analyst called our office today and said that our client must sign the form or Dr. Demeter won't exam her. When Can Independent Medical Exams be Requested? Most of the time, they use the IME doctors opinion to achieve such. Strictly speaking, you do not have to go back to work when an independent medical examiner disagrees with your 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. SAVE YOUR RECEIPTS!!! 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. Please answer a few more questions and then click "Go to Last The insurance company wants to see if a new doctor will agree with the action or course of treatment the workers compensation doctor is recommending or to see if . An IME doctor is not your doctor - The evaluation does not create a doctor patient-relationship. state agency. Detailing your current ailment, how it has changed, and how your capabilities are limited as a result. When an injury is severe enough, the injured person may never recover from the unrelenting pain and permanent disability. Doctors hired to perform IMEs are paid by the workers comp insurance company handling your claim. Dont exaggerate, but dont leave anything out. If you are asked to endure an independent medical examination (IME) when you apply for long-term disability benefits, the reason Its not always easy to receive the insurance benefits that you know you rightfully deserve. This is why having a skilled long-term disability attorney on your side can make all the difference in the outcome of your case. 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. 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. 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. When there is a question about what kind of benefits an injured employee should receive, a California QME is the type of physician who evaluates the employee. Minor complaints, such as rudeness, can be handled by sending an IME comment form to L&I at the following address: IME Provider Review L&IPO Box 44322Olympia, WA 98504-4322. So what happens if the IME doctors opinion disagrees with the opinion of your treating physician? Your primary treating physician probably knows your file much better than the IME doctor. Coral Gables, You can call or text us at the number below: 2775 Harbor Avenue SW,Suite D, Seattle,WA98126-2138. Can I Dispute That an IME Should be Scheduled? Your use of this site does NOT create an attorney-client relationship. In Hoover, the employer required employees get medical evaluations from its doctor. If the IME doctor made any mistakes about your medical history, or what you said, youll need to challenge the report. It's understandable that recording doctor visits can help vulnerable or ill patients remember their doctor's instructions, suggestions, treatment details, medication, diagnosis ect. We never represent the employer or insurance company. My finger got caught in a shopping cart and then smashed on a conveyor belt while I was working in the state of Hawaii. 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. The IME doctor could also order more tests to determine your health status. You need to be careful when you leave the doctors office where your IME evaluation is done. You have the right to seek a second opinion if you feel the workers comp doctor isnt addressing your medical issues. Disagrees with your claim you have a different opinion from your doctor remember that insurance companies to use to! Unheard of for employers and insurance companies often have injured workers whenever possible injured workers do have! And personal injury law in the state of Washington injured persons opinion to achieve such for injured! 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