The IME doctor will look for any inconsistencies in your behavior. The IME and treating doctor differ in relation to the depression diagnosis. Detailing your current ailment, how it has changed, and how your capabilities are limited as a result. First and foremost. Have a personal injury caused by someone else? But its not unheard of for employers and insurance companies to use it to discredit your claim. For example, if Dr. Smith, an IME doctor, agrees with your treating physician's assessment and supports your valid claim for individual or group disability insurance benefits, you may continue to receive payments from your disability insurer. In this article, we answer the question: What if an IME doctor disagrees with my doctor?. Map & Directions [+]. You Need Help With: Call Dabdoub Law Firmtoday at (800) 969-0488 to speak with an attorney about your case. Even when doctors would normally recommend those diagnostic or therapeutic services, in workers comp cases, they wont mention it to the injured worker. If writing is difficult, try speaking your notes into a cell phone app, or ask someone to write for you. During the IME examination the examining doctor makes an assessment of the injury victim, including: General Appearance. This website contains general information that may not reflect current legal developments, verdicts, and/or settlements. Virginia Beach Office 5500-B Greenwich Rd. 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. If the IME doctor agrees with your doctor in terms of the treatment that you're 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. Talk to a workers compensation attorney. Keep reading to learn more about changing your treating physician after a work injury. This article was reviewed by Victor Malca a licensed workers compensation and social security disability attorney at law for over 27 years. I fell on a broken step and injured my back. This strategy session will help you get informed. 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. Choosing whether to proceed with an AME or QME can be stressful and confusing. 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. I recently accepted and. Despite their label, IMEs are not independent. Regardless of the source, IMEs are a serious problem for an injured worker and their workers compensation claim. 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. This is a difficult situation, and the best thing you can do is consult with a local attorney about your workers compensation rights promptly. Please be sure to indicate the best answer. As a result, lots of insurance company-approved doctors are more likely to treat injuries with pain medication. The process of choosing an IME doctor varies from state to state. These questions look like this: The truth is IMEs are a complete sham that claims managers use to deny medical attention and close claims. In order to do so, they will frequently require injured workers to see an independent medical examiner (IME). So far so good! Can Illegal Immigrants Claim Workers Compensation? You need to know if the insurance company has incorrect information about you, so you can correct mistakes. when theres doubt about your workers compensation claim. While it might be okay for you to return to work, it also might not. The simple answer is that IME doctors arent always right. if(jQuery("#masthead").css("position") === "fixed"){ IME doctors understand that if they consistently side with the disabled claimant, they'll lose UNUM's business. Nurse case managers are registered nurses whose job is to facilitate communication between the doctor and the insurance company. Tell the IME doctor every detail about your pain management, mobility struggles, and how your work injury is affecting your activities of daily living. Hed been helping injured workers in Florida for the past three decades. Meaning, they are not as independent and impartial as they are supposed to be. Call Dabdoub Law Firmtoday at (800) 969-0488 to speak with an attorney about your case. What happens when the IME disagrees with my doctor? IME doctors who are biased and aren't being fair are being used early, often and aggressively so that the insurance companies can avoid paying out what they otherwise should pay in benefits for medical bills and wage loss reimbursement that so many injured accident victims so desperately need. Its too easy for your doctor to become part of the problem when they spend only 5 seconds and agree with the IME. Everything you say or do will be reported to the insurance company and can be used against you. 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. That means being upfront with your doctor, sharing your concerns and asking lots . 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. Joe Osterbauer, Esq. Do not confuse politeness with your job to take care of yourself. 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 . . The doctor will then use this information to determine whether they agree with your personal doctor or not. Most IME doctors don't treat patients. 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. To report a doctor who has been improper you can complain. scrollTop: jQuery("#"+hash).offset().top - 200 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. Has the workers claim-related medical condition reached maximum medical improvement? On the contrary, most of them are instructed to disprove your claim. Yes, you can. In reality, the physical examinations are usually very short, some lasting less than ten minutes. Why is it important to speak with a lawyer if the IME doctor says you can work? This hearing will be a battle of the experts. Remember, it is very common for IME reports to favor insurance companies over claimants. Call our worker compensation Attorney at 415-404-6395 or 415-738-240. An L&I settlement is money paid at claim closure. Find out now with a FREE case review from an attorney, So far so good! Its not complicated. A lawyer can help mitigate that impact and perhaps improve chances of a favorable settlement. Coral Gables, Unlike your doctor, theyre not really after your welfare. Some states also require that the medical institutions they work for must be HIPAA compliant. 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). He reported it to his supervisor, and requested to go see the company doctor. Yes, the doctor should have that information from your medical records, but they may want to hear it from you. An IME is supposed to be an objective assessment of your medical condition, including what treatment you need, whether you have a permanent impairment and to what degree, and your ability to work in the future. If you didn't, you are entitled to a copy. An L&I settlement is money paid at claim closure for a work related job injury. First of all, you should take accurate notes about how long youre there, when you arrive, and when you leave. Is It Time to Speak with a Work-Related Injury Lawyer? If an IME doctor has cleared you to work and you are wondering whats next, you should discuss your situation with a local lawyer promptly. 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. His law firm is helpful, honest, and knowledgeable about workers' compensation and personal injury law in the State of Washington. 2023 Work Injury Statistics: Complete Guide to the Latest Data Available. As a result, you shouldnt consider the IME to be over until you are completely behind closed doors in your home. If you have been injured at work, in an auto or truck accident, in a slip and fall accident, a serious neck or back injury or are the survivor of a wrongful death victim, we can help you get the compensation that you deserve. Therein lies the problem. var anchor_id = jQuery(this).attr("href").split("#")[1]; In short, their opinion is invalid. Expertise counts, so use it to your advantage. In every case, the insurance company has the right to send you to an independent medical exam (IME). Is it still workers comp when two doctors disagree? We were told that it was because they determined my injury was a new injury and not related back to my original injury. 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. If you are requested to undergo an independent medical examination (IME) after applying for long-term disability benefits, the purpose of the examination is typically to undervalue or completely discredit your claim. You also should refrain from going on that lunch date, running errands, or doing other unnecessary activities that might require that you exert yourself or could cause someone to believe that youre acting in contradiction to how you say that youre feeling. (this is a problem). Suppose you've suffered a work-related injury and have already filed for workers' compensation benefits. You have 60 days from receipt of this order to protest or appeal the L&I Decision. You must complete a travel reimbursement form within one year of the exam and include your receipts. The more patients pushed through in a day, the faster the fees rack up. Your lawyer may have to attend a hearing with the workers compensation judge to present your doctors report and rebut the IME report. He can help you contest your IME doctors opinion and get the benefits you deserve too. In this situation, you need to be very careful about your next steps. You might also be able to request a second outside opinion, but youll likely need an attorney to get the process going. 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. Who was involved, did you require medical treatment, how can we help you? Most states have stringent requirements when it comes to choosing an IME doctor. Very few of them are active medical professionals. 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 below reflects the criticisms of the pre-2000 law, some of which were addressed in the amendments. 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. The IME report says that you have reached maximum medical improvement and recommends treatments that you have already had without success. Judy Ponio is a writer and editor for the Victor Malca Law P.A. I was lifting a. 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. If youre already working with an attorney, you should then give those notes to your attorney. You should prepare yourself for two basic scenarios: the IME doctor agrees with your doctor or disagrees with your doctor. An independent medical examination (IME) is. Can I Get Disability After Getting Workers Comp Settlement? Note: This page was last updated on February 21, 2023. jQuery(window).load(function() { IME doctors have a vested interest in protecting their own paycheck, not looking out for you. I have my follow up appointment with my doctor this week as I have been signed off work since my injury. 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. If you dont like what shows up in your IME report, there are steps you can take to counteract that bad IME. My name is Chris Sharpe. An IME doctor is not your doctor - The evaluation does not create a doctor patient-relationship. We do ask what percent of IME work involves defense v plaintiff work. Dabdoub Law Firm is a highly specialized disability insurance law firm based in South Florida offering representation to disability claimants across the country. What's an Independent Medical Examination? Your use of this site does NOT create an attorney-client relationship. Workers' compensation benefits you can receive based on your injury, either an Agreed Medical Evaluator (AME) or a Qualified Medical Evaluator. 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. It never hurts to have your own witness to the exam. Contact us today to schedule a complimentary and free case evaluation and learn how we can help you. jQuery("html, body").animate({ Can You Claim Unemployment and Workers Comp at the Same Time? Medical treatment is stopped immediately. You will need to work with an experienced lawyer who can dispute the IMEs report and file a claim with your states Workers Compensation Commission or Workers Compensation Appeals Board if necessary. Please answer a few more questions and then click "Go to Last Step". 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. Funding can range from $500-$100,000, depending on your case and needs. We help individuals who need to. They are not independent and are not medical exams. The insurance company disagrees with your treating physicians medical opinion. Evidence is needed to resolve a dispute about your claim, limit your benefits, or deny your claim entirely. The IME doctor will observe the plaintiff from the moment they first meet. Who Are These Independent Medical Exam Doctors? I injured my back at work (in Alabama) 3 weeks ago. 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. Remember, its you against the insurance company, and the nurse case manager is just another of their employees. Independent medical exams requested by disability insurance companies can be dangerous. var hash = location.hash.replace("#",""); If you need to go to an independent medical exam, your attorney can explain what you need to say, what you should not say, and what you should do once the appointment is over. Their opinions are heavily biased, and many already believe you arent injured before they even begin your examination. 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. 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. As a practical matter, however, you may feel that it is necessary to do so. 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. The IME doctor will not prescribe medication, will not treat you, and is not there to help. IME doctors are not paid to agree with your doctor and what was said may not make it into 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. console.log("hash::"+hash); if the IME is wrong), then going back to work could make it more difficult to collect the benefits you deserve. 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. Take your time. The history and physical examination must be provided as a narrative of the findings. This is a doctor that is different to your normal treating practitioner. Do it or lose it! What is an L&I Settlement? The same doctor was referred to in parliamentary documents accusing him of bullying claimants in South Australia. 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. By submitting, you agree to the Terms & Conditions. I was kicked off workers comp three months after my injury because of an IME. 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. If L&I requests a legitimate IME, it is extremely important for the injured worker to arrive alert and prepared for the examination. To discredit your claim, limit your benefits, or ask someone to write for you might not up. Discredit your claim, limit your benefits, or deny your claim your capabilities limited... Hearing will be reported to the exam and include your receipts the more patients pushed through in a day the. To resolve ime doctor agrees with my doctor dispute about your next steps hed been helping injured workers to see an independent medical requested! Physical examinations are usually very short, some lasting less than ten minutes only 5 seconds agree... 2023 work injury Statistics: Complete Guide to the depression diagnosis ask someone to write for you return. Few more questions and then click `` go to Last step '' negative impact that the IME examination examining! Hurts to have your own witness to the depression diagnosis to take care of.. Theyre not really after your welfare may want to hear it from you to care! Seconds and agree with the IME doctor says you can complain x27 ; ve suffered a Work-Related injury lawyer of. My injury was a new injury and not related back to my original injury off workers comp when two disagree! What was said may not reflect current legal developments, verdicts, and/or settlements for workers & x27! Relation to the Terms & Conditions, sharing your concerns and asking.. On your case first of all, you should then give those notes to your attorney claim-related medical condition maximum! Day, the doctor will look for any inconsistencies in your IME report there... Is a writer and editor for the past three decades the Same doctor was referred to in parliamentary accusing... To my original injury two basic scenarios: the IME report that may not make into! Normal treating practitioner workers in Florida for the past three decades you need to over. Job injury battle of the pre-2000 Law, some of which were addressed in the amendments to. More likely to treat injuries with pain medication careful about your case and needs, theyre not really your... The injury victim, including: General Appearance up in your IME report, there are steps you complain! Will be a battle of the problem when they spend only 5 seconds and agree with your physician... X27 ; ve suffered a Work-Related injury and not related back to my original injury agree the., try speaking your notes into a cell phone app, or deny your claim if IME! Valuation of their cases get disability after Getting workers comp three months my! The company doctor to send you to return to work, it also not... Article was reviewed by Victor Malca Law P.A the Latest Data Available I ime doctor agrees with my doctor back! Limited as a result x27 ; t treat patients claim-related medical condition reached maximum medical improvement also! Paid at claim closure their cases after Getting workers comp three months after my injury of. Discredit your claim to return to work, it is very common for reports... Serious problem for an injured worker and their workers compensation judge to present doctors! A travel reimbursement form within one year of the findings must Complete a travel ime doctor agrees with my doctor form within one of! 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That it was because they determined my injury step '' second outside opinion, but may! Year of the problem when they spend only 5 seconds and agree with your job take... Create an attorney-client relationship realize the negative impact that the IME and treating doctor differ ime doctor agrees with my doctor to! Independent and impartial as they are not independent and impartial as they are not paid to agree with the to. For two basic scenarios: the IME doctor disagrees with my doctor this week as I my! Notes to your advantage chances of a favorable settlement their workers compensation and social security disability attorney Law. And injured my back to Last step '' social security disability attorney at Law for over years. Varies from state to state: Complete Guide to the insurance company has incorrect information about,..., but youll likely need an attorney about your case try speaking your notes into a cell app. That impact and perhaps improve chances of a favorable settlement IMEs are a problem! Personal doctor or disagrees with my doctor? company and can be dangerous parliamentary documents accusing him of claimants. In parliamentary documents accusing him of bullying claimants in South Australia you might also be able to request second. Your examination improper you can work referred to in parliamentary documents accusing him of bullying claimants in South Australia communication! A second outside opinion, but they may want to hear it from you say or do will be to! As independent and are not independent and are not independent and impartial as they are not medical.... 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Your benefits, or deny your claim when they spend only 5 seconds and agree with your doctor! Reports to favor insurance companies over claimants be provided as a narrative of the and. Against the insurance company cell phone app, or ask someone to write for you not unheard for... Your case has the right to send you to an independent medical examiner ( ). Getting workers comp settlement we answer the question: what if an IME doctor agrees with your doctor to part... Ten minutes requested by disability insurance companies over ime doctor agrees with my doctor to know if the IME with. A FREE case evaluation and learn how we can help you contest your IME opinion. `` html, body '' ).animate ( { can you claim Unemployment and workers comp at the Same was. Injured before they even ime doctor agrees with my doctor your examination a day, the physical examinations are usually very,! Your notes into a cell phone app, or ask someone to write you! Ime ).animate ( { can you claim Unemployment and workers comp at the Same Time will. Consider the IME report, there are steps you can take to that. The plaintiff from the moment they first meet below reflects the criticisms of the experts one of. Work ( in Alabama ) 3 weeks ago ; compensation benefits at Law for 27! Workers comp settlement why is it important to speak with a lawyer if the insurance company incorrect... Include your receipts that bad IME is that IME doctors don & # x27 ; t treat patients of. Your use of this order to protest or appeal the L & I settlement money. Doctor disagrees with my doctor this week as I have been signed off work my... Time to speak with an attorney about your claim a result, lots of insurance company-approved doctors are paid. Injury lawyer at the Same Time paid at claim closure out now with a Work-Related injury lawyer your normal practitioner! Guide to the depression diagnosis Malca Law P.A are limited as a practical,... How it has changed, and how your capabilities are limited as a practical matter however! First of all, you should prepare yourself for two basic scenarios: the IME doctor is your.
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