At Chisholm Chisholm & Kilpatrick LTD, our team of experienced attorneys and professionals has assisted clients throughout the long-term disability claim process. Independent medical examination. Can I Get Disability After Getting Workers Comp Settlement? At the end of the call, no matter what you decide to do, you will have fresh ideas and an action plan. If L&I requests a legitimate IME, it is extremely important for the injured worker to arrive alert and prepared for the examination. In cases like this, an experienced workers compensation lawyer like Victor Malca can help you. 5-Step Disability Evaluation Under Social Security There is no such thing as a truly independent medical exam. I never consider a an IME exam to be independent because you are required pursuant to the terms of your disability . The. 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. Several circumstances may cause the insurance company to request that you submit to an Independent Medical Examination (IME). Many make hundreds of thousands of dollars per year by sticking it to injured workers. 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. View our Privacy Policy. While a second opinion may be helpful, keep in mind the other doctor is getting paid by the insurance company, just like the first one. In fact, it's often called a "DME," for "Defense Medical Examination.". To make a decision regarding claim allowance or reopening. Unfortunately, in most cases, you do. It is often not unusual for the IME doctor to send a rough draft to the adjuster or defense lawyer to read. I. On the contrary, most of them are instructed to disprove your claim. Questions about hiring an attorney? It's understandable that recording doctor visits can help vulnerable or ill patients remember their doctor's instructions, suggestions, treatment details, medication, diagnosis ect. Some states also require that the medical institutions they work for must be HIPAA compliant. He specializes in representing injured workers on compensation benefit cases and disabled individuals claiming lost social security disability benefits. This is a doctor that is different to your normal treating practitioner. 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. I was walking past. IME stands for "Independent Medical Exam." But, always remember it is an examination by a doctor (or doctors) paid by the insurance company. Under the Workers Compensation Act your employer or its insurer can force you to attend one IME per medical specialty per year. Remember that the workers comp insurance company will do whatever it takes to save money. 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. While it might be okay for you to return to work, it also might not. 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. When you get injured at work, you have the right to obtain medical treatment from a doctor who has your best interests in mind. What happens when the IME disagrees with my doctor? There might also be an arbitrator, who will decide whether the IME doctor or your doctor is more credible. The IME is a type of medical examination where an independent third party evaluates the condition of an injured worker. 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. Im an experienced Seattle workers compensation attorney who has helped thousands of injured Washington State workers. 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. Please use the button below to see how else we can help. Meaning, they are not as independent and impartial as they are supposed to be. 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. It is not uncommon to see IME reports saying, . } . The deposition may reveal that the doctor never even looked at your old medical records and spent only minutes examining you. The IME doctor will examine your medical records and the . In this case, the insurance provider can stop paying your claim. But in most cases, its the insurance company that gets to choose the IME doctor. Is It Time to Speak with a Work-Related Injury Lawyer? Coral Gables, FL 33134. Is any further medical treatment necessary? I have my follow up appointment with my doctor this week as I have been signed off work since my injury. Recalling the length of your visit with the IME doctor as well as what they said and did during the examination. Need help contesting the IME doctors report on your workplace injury? Review exactly how the accident happened and be prepared to re-tell the details to the IME doctor. If IME doctors tell you differently, they are wrong. He will strive to point out flat out mistakes or negative remarks. To do so, IME exams are scheduled with doctors who will help them manage a claim. You need to be careful when you leave the doctors office where your IME evaluation is done. It feels counterintuitive, but you actually have more power to keep your notes hidden or provide them when theyre advantageous to you if you share them with your attorney because you cant be forced to disclose them once youve given them to your attorney because of client-attorney confidentiality. 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. Not only could it risk delaying your recovery (or making your injury worse); but, if you are still entitled to benefits (i.e. If you cant help yourself, contact a lawyer to see if they will help you. if (scrollToPosition < 0) { scrollToPosition = 0 } // make sure it is not negative IME doctors may review a case file, conduct an IME, and write a report all in the same day or two days. When Can Independent Medical Exams be Requested? I work in an industrial warehouse and was moving a large bin full of pipe chambers when I felt a pop and pain in my, I have a workers comp case where I have a herniated disc and it was discovered in the MRI and X-Rays that I have a. Try Avvo Advisor at instant.avvo.com if you want to speak directly with myself or another attorney right away. In some states, that should be taken into account when calculating your workers comp benefits. 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. On the other hand, there are doctors who, either on their own doing or at the direction of others, ask the same questions that your client was asked in his deposition with the specific intent of getting some . But if you feel that the IME doctors recommendation is detrimental to your health, you should tell them so. That means limiting benefits and wage payouts to injured workers whenever possible. It is highly unusual for an IME doctor to have a disability claimant sign a generic authorization form. The same doctor was referred to in parliamentary documents accusing him of bullying claimants in South Australia. Doctors primarily handling work accident claims are frequently considered fringe doctors. The IME report says that you have reached maximum medical improvement and recommends treatments that you have already had without success. IMEs review medical records and in some cases examine the injured worker. During the IME examination the examining doctor makes an assessment of the injury victim, including: General Appearance. The doctor kept me off work the first 2 1/2 days, then wrote for. Get your doctor to write a helpful report outlining their disagreement with the incorrect IME findings and conclusions, including their own findings and conclusions. 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. With that said, if you dont do anything, your workers compensation claim will be over. The exam is usually scheduled by the insurance company and they also typically pay for it. His law firm is helpful, honest, and knowledgeable about workers' compensation and personal injury law in the State of Washington. In practicality, the IME doctor is going to need to ask the same questions they would ask their own patient to be able to proper evaluate the cause of the plaintiff's present condition. Very few of them are active medical professionals. 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. Soon thereafter an order is issued by L&I or a self-insured employer, closing the claim. During one exam, the doctor suggested there was an issue with his lungs and referred the employee to another doctor. They: People in charge of your claim can request an IME and follow-up IMEs. The following entities may request an IME: An independent medical evaluation can be requested for various reasons, including. Most doctors who perform Independent Medical Exams have little incentive to take the necessary time to study all the documentation related to your claim. 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. Or the doctor gave you a completely different disability rating than your doctor. Because of their financial interests, some doctors may order unnecessary or questionable tests or medical treatments hoping the insurance company will pay for them. 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 says that you are ready to go back to work, the insurance company will terminate your benefits, and you might need to work in order to cover your medical bills and other expenses. Here are the details: An observer can be a friend or relative, not your attorney, paralegal, or doctor. The observer can attend the physical examination but not the psychiatric assessment as per WAC 296-20-2025. This observer can see and take note of anything the IME doctors do which may not be appropriate. Remember, it is very common for IME reports to favor insurance companies over claimants. That in his opinion I was at MMI or maximum medical improvement from my injury. Regardless of the source, IMEs are a serious problem for an injured worker and their workers compensation claim. View More Options for Help with your Injury, Please answer a few more questions and then click "Go to Last Step". Examining physicians spend lots of time with your medical records and only a little time examining you. 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