The only person who may contact you is a licensed attorney who can help. With this, its inevitable that the IME doctor will disagree with your treating doctor. 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. SAVE YOUR RECEIPTS!!! 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. A base of a work basket was hit by another associate by mistake which moved the front end of the basket. If you have an attorney, your attorney and the claims administrator may agree on a doctor without going through the state system used to pick a QME. Your lawyer will try to show that your PTPs opinion is more credible than the IME doctors opinion. Can Illegal Immigrants Claim Workers Compensation? How To Write A Disability Appeal Letter (With Sample). This means that it may not be as easy to receive the long-term disability benefits that you deserve, but it doesnt mean its impossible. Coral Gables, Many dont keep up with the latest medical literature, pursue continuing medical education, or stay current in the latest medical technology. The history and physical examination must be provided as a narrative of the findings. Company doctor not taking me off work so I can heal? Only. An IME 1600 Ponce de Leon Blvd As a result, the doctor says that you have to go back to work. You will know that you have taken important steps to get your claim moving in the right direction. if(jQuery("#masthead").css("position") === "fixed"){ Strictly speaking, you do not have to go back to work when an independent medical examiner disagrees with your doctor. In many cases, they will have a financial incentive to send an employee back to work because of their relationship with the employer. Medical treatment is stopped immediately. Dabdoub Law Firm is a highly specialized disability insurance law firm based in South Florida offering representation to disability claimants across the country. 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. Victor Malca P.A. After all, there are a lot of factors that can affect a workers comp claim. jQuery("html, body").animate({ You have 60 days from receipt of this order to protest or appeal the L&I Decision. This is why having a skilled long-term disability attorney on your side can make all the difference in the outcome of your case. 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. 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. Call our worker compensation Attorney at 415-404-6395 or 415-738-240. The IME goes to L&I or the Self-Insureds. careful about your next steps. In that case, she could recommend that you be sent for an independent medical exam with a different workers comp insurance company doctor. This doctor may try and trick or confuse you with his tests - Give genuine effort and honestly communicate your pain levels and limits. jQuery(".on-page-links ul > li a").click(function(){ 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. - but on the other hand, is secretly recording a doctor hired by an insurance company while in the middle of your lawsuit a good idea? Also, you dont have to speak with the nurse. An L&I settlement is money paid at claim closure. 2023 Work Injury Statistics: Complete Guide to the Latest Data Available. 73 Going to a Second IME Exam I had an IME exam in 2009. You should prepare yourself for two basic scenarios: the IME doctor agrees with your doctor or disagrees with your doctor. The doctor will then use this information to determine whether they agree with your personal doctor or not. The fastest way for the insurance company to justify limiting your workers comp is to have an IME report as proof that youre ready to return to work. Don't compare your claim to someone else's. Is it still workers comp when two doctors disagree? Be on time and be careful. If youve been injured in an accident, you may qualify for a settlement. He then said that if Dr. Demeter does not exam her, then her benefits will be denied. Injured on the job? Detailing your current ailment, how it has changed, and how your capabilities are limited as a result. Of course, this is easier said than done. Even when doctors would normally recommend those diagnostic or therapeutic services, in workers comp cases, they wont mention it to the injured worker. Who Are These Independent Medical Exam Doctors? Nurse case managers are registered nurses whose job is to facilitate communication between the doctor and the insurance company. 25 Questions to Ask Your Workers Comp Lawyer. I was seen at the hospital and then told to go to. This could include simple observations or may involve video surveillance. Unfortunately, based on your answers we cant provide a case review. Do I have recourse after I was kicked off Workers Comp because of an IME? By submitting, you agree to the Terms & Conditions. Most insurance companies permit an injured worker to have a second evaluation from another doctor on their approved list. Is any further medical treatment necessary? That is not "independent." Instead, expect the IME doctor to disagree with the doctors you have hired to provide your medical care. In most cases, the adjuster working your claim chooses the IME doctor you will be required to see. Find out now with a FREE case review from an attorney, So far so good! Call 206-343-1988 or email and let us help you figure it out with a free consultation. if (scrollToPosition < 0) { scrollToPosition = 0 } // make sure it is not negative These tests are expensive and complicate the entire claim. The IME believes that the depression did not develop secondary to your physical injury, but your treating doctor believes that it did. Sometimes they don't even perform a physical examination before rendering their opinion. case or situation. Most of the time, they use the IME doctors opinion to achieve such. Yes, the doctor should have that information from your medical records, but they may want to hear it from you. 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. She has a passion for helping those in need and the elderly with accurate legal information that can make a positive difference in their lives. To report a doctor who has been improper you can complain. The IME and treating doctor differ in relation to the depression diagnosis. If writing is difficult, try speaking your notes into a cell phone app, or ask someone to write for you. 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. 'Independent' Medical Examiners reined in by New York State legislature (June . Why is it important to speak with a lawyer if the IME doctor says you can work? Your Name: L&I and Self-Insured employers are not interested in treating work injury claimants fairly. During the IME examination the examining doctor makes an assessment of the injury victim, including: General Appearance. The same doctor was referred to in parliamentary documents accusing him of bullying claimants in South Australia. , Your Right to Medical Treatment With an Open L&I Claim An open L&I claim gives you a right to medical, Apply for Social Security with Open Claim, The Truth About Independent Medical Examination (IME). First and foremost. They have little interest in seeing your problems. As a result, lots of insurance company-approved doctors are more likely to treat injuries with pain medication. //anchor_id = anchor_id.replace("#", ""); An experienced lawyer can help, and you can get a free claim assessment online 24/7 through WorkInjurySource.com. Christopher Sharpe is the go to attorney for injured persons. jQuery("html, body").animate({ (this is a problem). When you click the button you will be redirected to LawsuitInfoCenter.com. What is the Workers Compensation Appeals Board and How Does it Work? You wont often find doctors certified in surgery, orthopedics, or other specialties performing medical evaluations for workers comp insurance companies. Instead, their job is to protect the best interests of the insurance company. It is your choice. console.log("hash::"+hash); Workers Comp: Settlements for Back Injury, Workers Comp: Settlements for Bulging Disc, Workers Comp: Settlements for Herniated Disc, Workers Comp: Settlements for Ankle Injuries, Workers Comp: Settlements for Brain Injury, Coronavirus (COVID-19) Workers Compensation and Unemployment Information All 50 States, Workers Compensation Deadlines All 50 States, Personal Injury Statute of Limitations All 50 States, Can You See Your Own Doctor on Workers Comp? She enjoys helping people in need with questions about social security disability and workers compensation law. With the nurse case manager in the room, anything you say or do during the examination can be used against you. Plaintiffs should assume that any staff members present at the doctor's office . Remember that insurance companies often have injured workers under surveillance. If an independent medical examiner says that you are ready to go back to work but you are concerned this might not actually be the case, there are some steps you should try to take as soon as possible. Independent Medical Examination doctors can be tricky, so keep the following in mind: The exam is converted into a report. Talk to a workers compensation attorney. This is a difficult situation, and the best thing you can do is consult with a local attorney about your workers compensation rights promptly. Have a personal injury caused by someone else? It is NOT formal legal advice. While it might be okay for you to return to work, it also might not. Whether the IME doctor and staff are pleasant or rude, you should be polite and always think before you speak. Do I Need a Lawyer for a Workers Comp Claim? Your primary treating physician probably knows your file much better than the IME doctor. To do so, IME exams are scheduled with doctors who will help them manage a claim. Approval takes < 24 hours with no credit checks and no obligation you only pay it back if you win your claim. L&I has a plan for you and they will use the IME to make it happen. Can You Still Receive Workers Comp If You Fail the Drug Test? Click the button below to find out in 60 seconds or less! In some states, that should be taken into account when calculating your workers comp benefits. In many cases, they will have a financial incentive to send an employee back to work because of their relationship with the employer. It never hurts to have your own witness to the exam. Suite 1202, 1600 Ponce de Leon Blvd, Are you going to let them do this to you? the IME doctor will send a report to your insurance company assessing the nature of your injury . 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. The IME doctor will examine your medical records and the . Some other details to note include how long you were in the waiting room, if there were any other patients waiting with you, details about any paperwork you were asked to fill out, what questions the doctor asked you, your general impressions, any information that the doctor shared with you, and anything unusual that you noticed. You will have to balance the cost of the treatment against how much you need it. Whats an Independent Medical Examination? In many cases, the doctor's sole source of income is performing IMEs. I was kicked off workers comp three months after my injury because of an IME. 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. However, if your attending physician disagrees with a bad IME, there is still hope for your claim. Hed been helping injured workers in Florida for the past three decades. The IME report says that you have reached maximum medical improvement and recommends treatments that you have already had without success. 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. 4604 49th St N, Suite 5006 St. Petersburg, FL 33709. We respect your privacy. Nothing personal for them you are just a claim number. What Are Your Chances of Getting Disability for Arthritis. Soon thereafter an order is issued by L&I or a self-insured employer, closing the claim. There is no such thing as a truly independent medical exam. If you want to discuss your unique case in confidence, you can contact us for free at 312-346-5578. The doctor will not take part in deciding whether you have a disability and will not prescribe treatment or medication for you. . There are ways you can reduce the amount of weight an IME report will have on your case, such as: An IME report will lose credibility if the physician simply had one short visit with you or didnt do much to examine your condition or ask you pertinent questions. 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. The IME physician reviewed different records than your treating doctor, The IME doctor follows different treatment plans than your treating physician. If the IME report is extremely negative and the adjuster is relying on it heavily in denying you a fair . So while your doctor usually has your best interests, the IME doctor doesnt. Conclusions in the report must be consistent with the objective clinical findings found on examination and the claimant's symptoms, laboratory studies, and demonstrated response to treatment and on all available information, including the history. 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. The IME doctor may be expensive and the veteran must pay the bill up front and out of his/her own pocket. At the end of the call, no matter what you decide to do, you will have fresh ideas and an action plan. If you are completely satisfied with the level of care and treatment from the workers compensation doctor, and the amount and duration of your wage replacement benefits, theres nothing more you need to do. The information on this website is for general information purposes only. For example, she may disagree with your doctor about your pain or mobility level and when you should be released to go back to work. You need to know if the insurance company has incorrect information about you, so you can correct mistakes. When all this is done, they will then prepare a medical report containing their findings. Im an experienced Seattle workers compensation attorney who has helped thousands of injured Washington State workers. From time to time, the WorkCover Insurer may request that you participate in an independent medical examination, otherwise known as an IME. While it might be okay for you to return to work, it also might not. Virginia Beach, VA 23462 (757) 455-8889 (888) 694-1671 (757) 455-6757 Elizabeth City Office (by appointment only) 507 E Main St #K Joe Osterbauer, Esq. 2012 . I was using an electric pallet jack and the machine surged backwards, pinning my upper arm next to a beam and piece of steel. 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 . What To Do Before, During and After an IME, IME Doctors Won't Look Out For Your Interests. For one, they must be licensed health professionals. 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. Youll be observed from the time you arrive at the IME location. 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