Then, L&I or the Self Insurer will take the IME and your doctors concurrence and move your claim toward the IMEs conclusions. 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. 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. Most insurance companies permit an injured worker to have a second evaluation from another doctor on their approved list. Despite their label, IMEs are not independent. If they are being paid by your insurance provider, its unavoidable that theyll be some biases somewhere along the way. My finger got caught in a shopping cart and then smashed on a conveyor belt while I was working in the state of Hawaii. Is It Time to Speak with a Work-Related Injury Lawyer? Find out now with a free claim assessment. They wont be allowed to speak but ask them to take notes. The insurance company nurse may demand to be in the room when your doctor is examining or treating you and wont hesitate to challenge your doctors opinion. 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. 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. If you force yourself to work when your body is not yet up to it, your injury may only get worse. In Nov, 2009, the work comp carrier wanted me to go to another IME with a new ortho doctor from Madison. For example, for every impairment rating from 1-10%, the employee will be entitled to two weeks of benefits per percentage point. Read: Workers Comp Settlements for Ankle Injury, Workers Comp Settlements for Brain Injury, Workers Comp Settlements for Bulging Disc, Workers Comp Settlements for Carpal Tunnel, Workers Comp Settlements for Cervical Spine Injury, Workers Comp Settlements for Electrocution Injury, Workers Comp Settlements for Herniated Disc, Workers Comp Settlements for Injuries Requiring Surgery, Workers Comp Settlements for Permanent Partial Disability, Workers Comp Settlements for Secondary Injury, Workers Comp Settlements for Shoulder Injury. The claim is moving too slowly or getting too expensive, and the insurance adjuster wants to close it down. It is generic information for informal purposes only. Back injury preventing me from working. In that case, she could recommend that you be sent for an independent medical exam with a different workers comp insurance company doctor. His law firm is helpful, honest, and knowledgeable about workers' compensation and personal injury law in the State of Washington. If IME doctors tell you differently, they are wrong. Who was involved, did you require medical treatment, how can we help you? The IME doctor will observe the plaintiff from the moment they first meet. careful about your next steps. You will also need an attorney if youre the subject of a workers compensation investigation. 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 . Talk to a workers compensation attorney. However, if your attending physician disagrees with a bad IME, there is still hope for your claim. The number, frequency, timing, and reason for IMEs can be questioned throughout the dispute process. Whats next? Some of the reasons why this can happen are because: When there are differences of opinion regarding your condition, the insurance company will side with whichever report they deem the most credible. 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. Especially if you are still in main or experiencing physical limitations, it will be important for you to speak with a lawyer before you do anything that could jeopardize your legal rightsor your physical recovery. So, if you are wondering, Why does the IME doctor disagree with my doctor?, you are not alone. Doctors hired to perform IMEs are paid by the workers comp insurance company handling your claim. Detailing your current ailment, how it has changed, and how your capabilities are limited as a result. Im an experienced Seattle workers compensation attorney who has helped thousands of injured Washington State workers. 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. You have clear legal rights; and, if the IMEs report is inaccurate, you should still be able to collect the benefits you deserve. You may have a nurse case manager assigned to help you with your claim. if(jQuery("#masthead").css("position") === "fixed"){ During one exam, the doctor suggested there was an issue with his lungs and referred the employee to another doctor. Your lawyer will try to show that your PTPs opinion is more credible than the IME doctors opinion. There might also be an arbitrator, who will decide whether the IME doctor or your doctor is more credible. The IME doctor will look for any inconsistencies in your behavior. If the doctor failed to take a medical history from you, your attorney can point this out to the adjuster or use it in court and negotiations with the defendant's lawyer. 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. 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. Review exactly how the accident happened and be prepared to re-tell the details to the IME doctor. Evaluation starts when the plaintiff walks into the doctor's office. 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. 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. The doctor kept me off work the first 2 1/2 days, then wrote for. An IME doctor is selected by the Board. If youve been injured in an accident, you may qualify for a settlement. has over 27 years of litigation experience in Workers Compensation and Social Security Disability lawsuits. 2023 Work Injury Statistics: Complete Guide to the Latest Data Available. Medical treatment is stopped immediately. This same insurance company pays them, so it is common for an IME doctor to disagree with your doctor or the doctor providing care for your workers' comp injury. Get an expert opinion about your claim, from an experienced lawyer. 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 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. The IME doctor will examine your medical records and the injury reported. However, the true purpose of an IME is to use that determination toward insidious ends. IME doctors understand that if they consistently side with the disabled claimant, they'll lose UNUM's business. Call Dabdoub Law Firmtoday at (800) 969-0488 to speak with an attorney about your case. Dont exaggerate, but dont leave anything out. Approval takes < 24 hours with no credit checks and no obligation you only pay it back if you win your claim. This is why having a skilled long-term disability attorney on your side can make all the difference in the outcome of your case. Their opinions are heavily biased, and many already believe you arent injured before they even begin your examination. I injured my back at work (in Alabama) 3 weeks ago. He has built a successful law practice by thoroughly educating, honestly helping, and successfully representing workers throughout Washington State. The nurse will report anything you say or do to the insurance company with no regard for your personal privacy. They are a bought and paid-for one-sided records review designed and administered to ruin your L&I claim. 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. These will be paid at the current department rate. (this is a problem). 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. SAVE YOUR RECEIPTS!!! The doctor is not asked to make a disability decision and when the consulting doctor's report is received, the DDS examiner reviews the report to be sure that the conclusions the doctor has drawn from the examination are supported by clinical observations or testing cited in the report. //anchor_id = anchor_id.replace("#", ""); 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. There are several ways in which the team at Osterhout Berger Disability Law can help you receive the benefit you deserve. IME doctors may review a case file, conduct an IME, and write a report all in the same day or two days. Please answer a few more questions and then click "Go to Last This medical opinion is sometimes based upon surveillance video obtained by the insurance company through private investigators. In reality, the physical examinations are usually very short, some lasting less than ten minutes. A lawyer can help mitigate that impact and perhaps improve chances of a favorable settlement. If you say you cant drive, lift or bend, you could forfeit your workers comp claim if the insurance company has videos of you loading groceries into your car. Categories Independent Medical Examinations Try Avvo Advisor at instant.avvo.com if you want to speak directly with myself or another attorney right away. Address:404 3rd Ave N #201,Minneapolis, MN 55401Phone:+1 612-334-3434. As the. 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. You can use this to contest the IME report at court. If your case is taken to court, the judge will most likely believe the IME doctor more than you or your treating doctor. Joes 27 years of workers compensation experience and his teams speedy service combine to get clients the results they need. 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. This could include simple observations or may involve video surveillance. What will the state agency do? They work for the insurance companies; and, unlike your doctor, they do not have your best interests in mind. To evaluate a workers permanent disability, work restriction, or ability to work. Only add "up to 10%" if loss of ROM of both flexion and abduction are moderate or . As a judge, when he saw a report from an out-of-state doctor, "my antennae immediately pop up," Schaeve said. 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. You Need Help With: The nurse may present herself as your advocate who is acting in your best interests. At this point, it is up to you to fight for your legal rights. These IME opinions may cost from $600.00 to $1500.00 or more. The IME is a type of medical examination where an independent third party evaluates the condition of an injured worker. He reported it to his supervisor, and requested to go see the company doctor. An L&I settlement is money paid at claim closure. The doctor will send a report of the exam or test to the state agency. The authority for second opinion medical examinations is found at 5 U.S.C. But this isnt always the case in reality. 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