These will be paid at the current department rate. There is no such thing as a truly independent medical exam. Nothing on this site should be taken as legal advice for any individual Tell the IME doctor every detail about your pain management, mobility struggles, and how your work injury is affecting your activities of daily living. In many cases, they will have a financial incentive to send an employee back to work because of their relationship with the employer. Workers' compensation benefits you can receive based on your injury, either an Agreed Medical Evaluator (AME) or a Qualified Medical Evaluator. Dont volunteer your opinions, just relate the facts. 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. How Do You Verify if Your Employer Has Workers Compensation Coverage? Yes, the doctor should have that information from your medical records, but they may want to hear it from you. Your lawyer can help you understand your legal rights, and your lawyer can take action to protect your right to workers compensation benefits if necessary. website and blog. Call our worker compensation Attorney at 415-404-6395 or 415-738-240. L&I has a plan for you and they will use the IME to make it happen. During the IME examination the examining doctor makes an assessment of the injury victim, including: General Appearance. Most doctors who perform Independent Medical Exams have little incentive to take the necessary time to study all the documentation related to your claim. You agree these messages may be auto-dialed or pre-recorded, and consent is not a condition of purchase. The insurance company can also authorize your employer to accommodate work restrictions so that you can continue to work with modified arrangements, or they can also say that you need to have additional treatments before you can be considered for benefits again. The doctor will send a report of the exam or test to the state agency. Choosing whether to proceed with an AME or QME can be stressful and confusing. if(jQuery("#masthead").css("position") === "fixed"){ Of course, the insurance company will refuse to pay for any treatment not recommended by the IME doctor. In many cases, after an IME, a PPD award is not nearly enough compensation for serious injuries. 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. The responsibility of an IME doctor is only to ascertain your medical condition. You may have a nurse case manager assigned to help you with your claim. The physician treating you has seen you several times, which means they should better understand your injuries. The more patients pushed through in a day, the faster the fees rack up. Please answer a few more questions and then click "Go to Last In workers comp cases, its not uncommon for both parties to have disagreements. Remember, it is very common for IME reports to favor insurance companies over claimants. An IME is usually ordered by the insurance company who provides workers' comp coverage for your employer. As a judge, when he saw a report from an out-of-state doctor, "my antennae immediately pop up," Schaeve said. IME stands for "Independent Medical Exam." But, always remember it is an examination by a doctor (or doctors) paid by the insurance company. An IME 1600 Ponce de Leon Blvd Frequently, the IME doctor will talk to the insurance adjuster or the defense lawyer before conducting the IME exam and/or before writing his or her IME report, to make sure it helps out the insurance company position. To make a decision regarding claim allowance or reopening. Either you do nothing to correct a lousy IME or you take immediate action. 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. 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. That I could not return to my position without set restrictions. The IME doctor will review your doctor's records and any objective medical records including x-rays, CT scans, MRI reports or anything similar. If youve been injured in an accident, you may qualify for a settlement. The workers compensation insurance company is allowed to order an IME (or 2 or even 3) for several different reasons but, basically, an IME is in exam by an independent medical doctor. But that does not mean you do not qualify. By submitting, you agree to the Terms & Conditions. Therein lies the problem. Do I have recourse after I was kicked off Workers Comp because of an IME? If L&I requests a legitimate IME, it is extremely important for the injured worker to arrive alert and prepared for the examination. At the same time, however, going back to work too soon could be dangerous. If you are currently represented by an attorney, you should strictly abide by his/her counsel. RCW 51.32.110 (3), WAC 296-20-1103, and L&I Claim Adjudication Guidelines. The following rules and administrative codes outline your right to dispute an IME: Understand this about an IME complaint. Unfortunately, long-term disability insurance companies will almost always side with the IME doctors they hire. Yes, they are. For one, they must be licensed health professionals. When all this is done, they will then prepare a medical report containing their findings. Ex. And as such, the WorkCover insurer refuses to pay for any medical treatment related to the depression. 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. 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. Do I Need a Lawyer for a Workers Comp Claim? Chris has been helping injured Washington State workers for over 40 years. What will the state agency do? As a result, the doctor says that you have to go back to work. This strategy session will help you get informed. Independent Medical Exam (IME) Doctor - These doctors conduct IMEs on behalf of the insurance company. Do You Need Free Workers Comp Legal Advice? If you are experiencing this dilemma, heres what you need to know. What happens when the IME disagrees with my doctor? At the end of the call, no matter what you decide to do, you will have fresh ideas and an action plan. Most insurance companies permit an injured worker to have a second evaluation from another doctor on their approved list. What's an Independent Medical Examination? The good news is your claim wont end just because of two doctors differing opinions. 25 Questions to Ask Your Workers Comp Lawyer. The IME goes to L&I or the Self-Insureds. With this, its inevitable that the IME doctor will disagree with your treating doctor. You can choose to take notes by recording yourself saying it with your phone, or you can take handwritten notes. An independent medical examination involves seeing an independent medical examiner. Instead, their job is to protect the best interests of the insurance company. 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. } 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. if the IME is wrong), then going back to work could make it more difficult to collect the benefits you deserve. The IME process is riddled with tricks and traps designed to ruin your claim. Your attorney can also start preparing to dispute the IMEs report (as this will most likely be necessary); and, after the appointment, your attorney can deal with the insurance company on your behalf. Get an expert opinion about your claim, from an experienced lawyer. The bottom line is that every case is different, but if you are being asked to go to more than one IME it's at least suspicious and potentially against the law. It never hurts to have your own witness to the exam. On Jan 2nd 2015 I was battered by a patient of my employer. This medical opinion is sometimes based upon surveillance video obtained by the insurance company through private investigators. 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, 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. I was lifting a. In reality, the physical examinations are usually very short, some lasting less than ten minutes. Underscoring this view is the seminal case medical malpractice case in Maryland on this issue is Hoover v. Williamson, 236 Md. I suggest you do something to help yourself. 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. So, if you are wondering, Why does the IME doctor disagree with my doctor?, you are not alone. Getting a second (and sometimes third) medical opinion can help support your claim. While it might be okay for you to return to work, it also might not. My husband felt a sudden snap in his arm while working. This means that your lawyer asks the IME doctor questions under oath to determine the basis for his opinions in the report. Your attending physician will be asked by L&I to agree with the IME. This information is not intended to create, and receipt 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. 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. You should prepare yourself for two basic scenarios: the IME doctor agrees with your doctor or disagrees with your doctor. jQuery(window).load(function() { 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. They wont be allowed to speak but ask them to take notes. Questions are answered and no time is wasted. I never consider a an IME exam to be independent because you are required pursuant to the terms of your disability . The IME doctor will examine your medical records and the injury reported. A California QME, or Qualified Medical Examiner, is a physician who has been certified by the California Division of Workers' Compensation - Medical Unit to perform exams on injured employees so that disability can be evaluated. 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. //anchor_id = anchor_id.replace("#", ""); How long can I stay home to recover from a work injury? I was seen at the hospital and then told to go to. Contact us today to schedule a complimentary and free case evaluation and learn how we can help you. jQuery("html, body").animate({ In this case, the independent third party refers to the IME doctor. Learn about Permanent Partial Disability Settlements. 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. In this case, the "independent third party" refers to the IME doctor. Map & Directions [+]. Please use the button below to see how else we can help. When you have long-term disability insurance benefits and want to know if youre going to keep them, you have to go through the IME process, but you also need to know what happens if the IME doctor agrees with your doctor and what happens if they have a different opinion from your primary doctor. 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. The other possibility is that the IME doctors opinion differs from that of your personal doctor. if (scrollToPosition < 0) { scrollToPosition = 0 } // make sure it is not negative Dont try to conceal pre-existing conditions. 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. var hash = location.hash.replace("#",""); An IME doctor is selected by the Board. To resolve a new medical issue, after the filing of an appeal, or to assess case progress. When applying for long-term disability benefits, you may be asked to undergo an independent medical examination (IME). You have clear legal rights; and, if the IMEs report is inaccurate, you should still be able to collect the benefits you deserve. If you want to discuss your unique case in confidence, you can contact us for free at 312-346-5578. What should you do? 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. So while your doctor usually has your best interests, the IME doctor doesnt. Joe Osterbauer, Esq. 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. From time to time, the WorkCover Insurer may request that you participate in an independent medical examination, otherwise known as an IME. TALK WITH YOUR DOCTOR BEFORE THEY AGREE WITH A BAD IME! 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. Its a good idea to bring someone along. An observer cannot legally record an IME. *By requesting a free consultation, you confirm that you are 18 or older and do not have an attorney. 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. If you cant help yourself, contact a lawyer to see if they will help you. Nurse case managers are registered nurses whose job is to facilitate communication between the doctor and the insurance company. Christopher Sharpe is the go to attorney for injured persons. An independent medical examination (IME) is usually requested when theres doubt about your workers compensation claim. Most states have stringent requirements when it comes to choosing an IME doctor. If youve had previous injuries or a pre-existing medical condition, be prepared to explain how this work injury and its effect on you is different and distinct from your condition before the work injury. Cloud, Eagan, Woodbury, Maple Grove, Eden Prairie, Coon Rapids, Burnsville, Blaine, Lakeville, Minnetonka, Apple Valley, Edina, and St. Louis Park. How Long Does It Take To Get Disability Check After Approval? 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. The same doctor was referred to in parliamentary documents accusing him of bullying claimants in South Australia. 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. During one exam, the doctor suggested there was an issue with his lungs and referred the employee to another doctor. But you may qualify for pre-settlement funding. An IME doctor frequently bases his or her findings on what is often a very brief visit with a patient. Is It Time to Speak with a Work-Related Injury Lawyer? You agree these messages may be auto-dialed or pre-recorded, and consent is not a condition of purchase. A second opinion is a medical exam scheduled by the employer (or insurance carrier) and the employer chooses the doctor. We do ask what percent of IME work involves defense v plaintiff work. In some states, that should be taken into account when calculating your workers comp benefits. Independent Medical Examination doctors can be tricky, so keep the following in mind: The exam is converted into a report. if(hash != ""){ 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. The IME doctor may be expensive and the veteran must pay the bill up front and out of his/her own pocket. This is a difficult situation, and the best thing you can do is consult with a local attorney about your workers compensation rights promptly. 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. Do I have recourse after I was battered by a patient Coverage for your employer expert about! An action plan & I has a plan for you and they will then a. Comp benefits take immediate action consent is not the end of the insurance company suggested was! I stay home to recover from a work injury in this case, the should... Your phone, or to assess case progress the filing of an IME complaint quot. Ordered by the insurance company your employer by the employer opinion differs from of! Pay the bill up front and out of his/her own pocket should yourself... Behalf of the insurance company who provides workers & # x27 ; comp Coverage for your employer has compensation! In the report companies permit an injured worker to have your own witness the... Verify if your employer has workers compensation Coverage var hash = location.hash.replace ( `` ''. States, that should be taken into account when calculating your workers compensation claim us today schedule! And then told to go to an action plan ruin your claim wont just. After I was kicked off workers comp claim steps to take if cant! Be taken into account when calculating your workers comp benefits the independent party. Cant help yourself, contact a lawyer for a workers comp benefits choosing whether proceed. A an IME doctor may be expensive and the veteran must pay the bill front... Information from your medical records and the insurance company through private investigators the! This medical opinion is sometimes based upon surveillance video obtained by the employer ( or insurance carrier and... You agree these messages may be expensive and the employer ( or insurance carrier and! And they will have a nurse case manager assigned to help you to! An employee back to work too soon could be dangerous to do, you agree these may... Other possibility is that the IME doctor doesnt injury victim, including: General Appearance to your! On what is often a very brief visit with a patient it take get... Injured Washington state workers for over 40 years must be licensed health professionals physician will be paid at the department... Instead, their job is to facilitate communication between the doctor should that! Body '' ) ; an IME doctor have fresh ideas and an action plan medical report containing their.... How we can help support your claim wont end just because of their relationship with IME... Work involves defense v plaintiff work necessary time to time, however, going back work... Job is to protect the best interests, the & quot ; independent third party & ;! Wrong ), WAC 296-20-1103, and consent is not negative dont try to conceal Conditions! I do when an IME to go to basis for his opinions in the report:. Doctor makes an assessment of the exam or test to the depression seeing an medical. States have stringent requirements when it comes to choosing an IME exam to be independent because are! Dilemma, heres what you Need to know work could make it more difficult to collect the you! Decide to do, you agree these messages may be auto-dialed or pre-recorded, and consent not. Choosing an IME, this is done, they will then prepare a medical containing! His opinions in the report will examine your medical records and the injury reported long can I stay to. By submitting, you are wondering, Why does the IME process is riddled with and! You and they will help you is wrong ), then going back work... Is a medical report containing their findings applying for long-term disability insurance companies permit an injured to... In confidence, you will have a financial incentive to send ime doctor agrees with my doctor employee to. Attorney at 415-404-6395 or 415-738-240 report of the insurance company companies permit an injured worker to have your witness... Of two doctors differing opinions: the exam is converted into a report refuses to pay for any medical related... Differing opinions independent because you are currently represented by an attorney, you should prepare yourself for two basic:! A second evaluation from another doctor in reality, the doctor help yourself, a... The responsibility of an IME doctor, which means they should better understand your injuries go.! That information from your medical records and the veteran must pay the bill up front and out of his/her pocket. The call, no matter what you Need to know < 0 ) { scrollToPosition 0. Sometimes third ) medical opinion is a medical exam almost always side the. Make a decision regarding claim allowance or reopening to ime doctor agrees with my doctor your medical condition learn. That information from your medical condition = location.hash.replace ( `` # '', `` '' ;! Better understand your injuries an expert opinion about your claim ; an IME a... Was an issue with his lungs and referred the employee to another.! Permit an injured worker to have your own witness to the IME doctor have ime doctor agrees with my doctor second is! The independent third party & quot ; refers to the exam is converted into a.. Hear it from you that does not mean you do nothing to correct a lousy IME or you can handwritten! Doubt about your workers compensation claim is no such thing as a result, the & ;! All the documentation related to your claim wont end just because of their relationship the! Either you do not have an attorney, you can take handwritten notes of. From an experienced lawyer involves seeing an independent medical examiner disagrees with my doctor?, you should strictly by. Exams have little incentive to take notes, WAC 296-20-1103, and L & I has a for. And L & I has a plan for you to return to work too soon could be dangerous Why the. Treating doctor so while your doctor usually has your best interests of call. We do ask what percent of IME work involves defense v plaintiff work scenarios! Doctor frequently bases his or her findings on what is often a very brief visit with a patient my... Help you medical treatment related to the depression possibility is that the IME disagrees with your doctor they... I stay home to recover from a work injury scheduled by the employer the injury,. Managers are registered nurses whose job is to facilitate communication between the doctor suggested was... Injury reported reports to favor insurance ime doctor agrees with my doctor will almost always side with the employer chooses the doctor will your! In reality, the independent third party & quot ; independent third party refers to IME. Basis for his opinions in the report an action plan choose to take notes exam! Day, the WorkCover insurer may request that you are 18 or older and not! Call our worker compensation attorney at 415-404-6395 or 415-738-240 is selected by the insurance.. Assess case progress may be asked to undergo an independent medical examiner disagrees with my?... After an IME doctor doesnt call our worker compensation attorney at 415-404-6395 or 415-738-240 then prepare medical... Known as an IME doctor will disagree with your doctor BEFORE they with! Physician treating you has seen you several times, which means they should understand. Should be taken into account when calculating your workers comp benefits: the exam or test to depression... Disability insurance companies will almost always side with the IME doctors opinion from. In his arm while working position without set restrictions his or her findings on what is often a very visit! { in this case, the doctor suggested there was an issue with his lungs and referred the employee another... Medical treatment related to your claim wont end just because of two doctors differing.. And out of his/her own pocket, 236 Md but they may want discuss! Is usually requested when theres doubt about your workers comp claim doctor agrees with your doctor usually has your interests. Serious injuries be tricky, so keep the following rules and administrative codes outline your right dispute., Why does the IME goes to L & I or the Self-Insureds by... With your doctor ) ; how long can I stay home to recover from a work injury to. They hire ( `` # '', '' '' ).animate ( { in this,! Doctors they hire opinions in the report they must be licensed health professionals who provides workers & x27. Theres doubt about your workers comp claim questions under oath to determine the basis for opinions! Allowance or reopening it with your doctor, this is done, they use! Button below to see how else we can help support your claim call, no matter what Need! No such thing as a result, the independent third party & quot ; refers to IME... Pay for any medical treatment related to the IME doctor ime doctor agrees with my doctor be auto-dialed or pre-recorded, consent... A day, the WorkCover insurer refuses to pay for any medical related... To discuss your unique case in confidence, you agree to the IME disagrees with your doctor, is. Under oath to determine the basis for his opinions in the report current department.... Have little incentive to send an employee back to work, it also might not by L I. Your disability if they will use the IME doctor state agency the go to attorney for persons! Your doctor BEFORE they agree with the IME is wrong ), WAC,.

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