case or situation. By submitting, you agree to the Terms & Conditions. Can I Dispute That an IME Should be Scheduled? if the IME is wrong), then going back to work could make it more difficult to collect the benefits you deserve. Don't compare your claim to someone else's. The IME doctor will examine your medical records and the injury reported. Although most nurses are honest and hard-working, dont forget that the nurse is employed by the insurance company. You just received the independent medical examination report, and the doctor disagrees with your primary treating physician about nearly everything. This article was reviewed by Victor Malca a licensed workers compensation and social security disability attorney at law for over 27 years. 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. How Long Does It Take To Get A Disability Approval Letter? Some are general practitioners with limited or no previous experience in workplace injuries. The IME doctor will review your doctor's records and any objective medical records including x-rays, CT scans, MRI reports or anything similar. Nurse case managers are registered nurses whose job is to facilitate communication between the doctor and the insurance company. On Jan 2nd 2015 I was battered by a patient of my employer. Or the doctor gave you a completely different disability rating than your doctor. I injured my thoracic spine and ended up with sciatic nerve pain shooting across my left buttock and down my leg. Your use of this site does NOT create an attorney-client relationship. The IME doctor will observe the plaintiff from the moment they first meet. He has built a successful law practice by thoroughly educating, honestly helping, and successfully representing workers throughout Washington State. It's Important to Know That IMEs are not Independent These doctors are hired through vendors contracted with the insurance company. That I could not return to my position without set restrictions. Can I Get Disability After Getting Workers Comp Settlement? Have a personal injury caused by someone else? A second opinion is a medical exam scheduled by the employer (or insurance carrier) and the employer chooses the doctor. 5 Signs That You Will Be Approved For Disability. View our Privacy Policy. Address:404 3rd Ave N #201,Minneapolis, MN 55401Phone:+1 612-334-3434. Most doctors who perform Independent Medical Exams have little incentive to take the necessary time to study all the documentation related to your claim. How Can I Get My Employer to Pay for an MRI? Find out now with a free claim assessment. If IME doctors tell you differently, they are wrong. The history and physical examination must be provided as a narrative of the findings. You will have to balance the cost of the treatment against how much you need it. In reality, the physical examinations are usually very short, some lasting less than ten minutes. If your attending physician agrees with a lousy IME, YOU HAVE A BIG PROBLEM. This is an exam by a doctor of their choosing who often is not so "independent" and can mess up or at least delay your case. Get your doctor to write a helpful report outlining their disagreement with the incorrect IME findings and conclusions, including their own findings and conclusions. 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. In reality, they are recruiting professional opinions allowing them to have their way with your L&I claim. You have NO right to confidentiality with this medical exam. In this case, the insurance provider can stop paying your claim. According to California Civil Discovery Practice (CEB 4th Ed. The report may also include their recommendation on whether you can go back to work or not. With twenty years of experience to offer, our clients have full confidence in us with all of their legal services. Map & Directions [+]. Workers comp refuses to order MRI for elbow injury? We help individuals who need to. The workers comp doctor isnt there to treat you or help you deal with your work-related injuries. You need to be careful when you leave the doctors office where your IME evaluation is done. Disability insurance companies will often rely on either an Independent Medical Exam (IME) or an External Medical File review without examination in order to deny a long term disability claim. You consent that the law firm you are matched with or a call center may contact you by phone and/or text, even if you are on a Do Not Call Registry. You should also know that the exam isnt necessarily confined to the doctors office, and there are a few things that you should take notes about immediately after your exam so that you can have a record of what happened. 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. At Chisholm Chisholm & Kilpatrick LTD, our team of experienced attorneys and professionals has assisted clients throughout the long-term disability claim process. The only person who may contact you is a licensed attorney who can help. Can Illegal Immigrants Claim Workers Compensation? When applying for long-term disability benefits, you may be asked to undergo an independent medical examination (IME). if(hash != ""){ To make a decision regarding claim allowance or reopening. In Pennsylvania, your employer's insurance company has the right to ask you to attend an IME once . In order to do so, they will frequently require injured workers to see an independent medical examiner (IME). Be on time and be careful. But if you feel that the IME doctors recommendation is detrimental to your health, you should tell them so. They may also do a functional capacity evaluation. On the contrary, most of them are instructed to disprove your claim. 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. We never represent the employer or insurance company. You agree these messages may be auto-dialed or pre-recorded, and consent is not a condition of purchase. In that case, you know what's coming next: an Independent Medical Exam with a workers' comp doctor. With that said, if you dont do anything, your workers compensation claim will be over. 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. Legal authority for this exists in Section 12 of the Illinois Worker Compensation Act: "An employee entitled to receive disability payments shall be required, if . I never consider a an IME exam to be independent because you are required pursuant to the terms of your disability . Judy Ponio is a writer and editor for the Victor Malca Law P.A. They told me it was just a bad ankle sprain. I was seen at the hospital and then told to go to. I recently accepted and. It is also understood that an examining doctor may ask plaintiff their medical history. careful about your next steps. These questions look like this: The truth is IMEs are a complete sham that claims managers use to deny medical attention and close claims. Virginia Beach, VA 23462 (757) 455-8889 (888) 694-1671 (757) 455-6757 Elizabeth City Office (by appointment only) 507 E Main St #K In this case, the independent third party refers to the IME doctor. 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. Dabdoub Law Firm is a highly specialized disability insurance law firm based in South Florida offering representation to disability claimants across the country. Approval takes < 24 hours with no credit checks and no obligation you only pay it back if you win your claim. The. Back injury preventing me from working. The IME is a type of medical examination where an independent third party evaluates the condition of an injured worker. Only add "up to 10%" if loss of ROM of both flexion and abduction are moderate or . When an injury is severe enough, the injured person may never recover from the unrelenting pain and permanent disability. Please be sure to indicate the best answer. To report a doctor who has been improper you can complain. Strictly speaking, you do not have to go back to work when an independent medical examiner disagrees with your doctor. Make the request in writing and send a copy of your request to your states workers comp board. You just received the independent medical examination report, and the doctor disagrees with your primary treating physician about nearly everything. You have clear legal rights; and, if the IMEs report is inaccurate, you should still be able to collect the benefits you deserve. Our team of experienced attorneys are here to help, and your consultation is free. It is NOT formal legal advice. jQuery("html, body").animate({ scrollTop: scrollToPosition }, 1000); } The exam is usually scheduled by the insurance company and they also typically pay for it. You have the right to seek a second opinion if you feel the workers comp doctor isnt addressing your medical issues. 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. What should you do? Their opinions are heavily biased, and many already believe you arent injured before they even begin your examination. Because both you and the attorney want to know if your case is any good. There might also be an arbitrator, who will decide whether the IME doctor or your doctor is more credible. In either case, your doctor should provide a comprehensive diagnosis and prescribe a treatment plan that gets you back to work as safely and quickly as possible. 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. How can I get my doctor to put me on full work restriction? Florida Workers Comp Laws: A Quick Guide for Injured Workers. As a result, lots of insurance company-approved doctors are more likely to treat injuries with pain medication. Under the Workers Compensation Act your employer or its insurer can force you to attend one IME per medical specialty per year. 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. Independent medical examiners routinely dispute doctors treatment recommendations. 4604 49th St N, Suite 5006 St. Petersburg, FL 33709. They are a bought and paid-for one-sided records review designed and administered to ruin your L&I claim. Dont try to conceal pre-existing conditions. }, 1000); 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. Injured on the job? Your Name: Think about that. Said that I had not returned to my pre-injury levels. 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 not take part in deciding whether you have a disability and will not prescribe treatment or medication for you. ) and the attorney want to know if your case is any good are more likely to treat you help. Completely different disability rating than your doctor is more credible received the independent medical examiner disagrees with doctor... 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