However, if your attending physician disagrees with a bad IME, there is still hope for your claim. 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. Do I need to ask for a work release note from my doctor? Please use the button below to see how else we can help. IME stands for "Independent Medical Exam." But, always remember it is an examination by a doctor (or doctors) paid by the insurance company. Additionally, if you dont agree with the IME doctor, you might be able to challenge their decision if they made it based on incomplete, incorrect, or outdated information. state agency. 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. Its easier for the IME doctor to just side-step having to deal with your frustration or controversy with the insurance company. Click the button below to find out in 60 seconds or less! Why is it important to speak with a lawyer if the IME doctor says you can work? The process of choosing an IME doctor varies from state to state. Dont exaggerate, but dont leave anything out. jQuery("html, body").animate({ scrollTop: scrollToPosition }, 1000); And in those cases, it can come down to dueling doctors the findings of an injured worker's treating physician against the opinion of an IME. 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 . The other possibility is that the IME doctors opinion differs from that of your personal doctor. 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. Also, you dont have to speak with the nurse. We understand that being scheduled for an IME is stressful and can potentially jeopardize your claim. By submitting, you agree to the Terms & Conditions. Get started with a free case assessment online 24/7. After a specified time from your claim filing, youll be permitted to have an evaluation and treatment from a physician you choose, whether on the insurance companys approved list or not. jQuery("html, body").animate({ Remember that insurance companies often have injured workers under surveillance. We respect your privacy. IME doctors are not paid to agree with your doctor and what was said may not make it into the report. This funding gives you the money you need to cover personal expenses now. SAVE YOUR RECEIPTS!!! How Can I Get My Employer to Pay for an MRI? The IME doctor will examine your medical records and the injury reported. As a result, you shouldnt consider the IME to be over until you are completely behind closed doors in your home. Do not let the insurance company push you back to work before you are ready you could get injured again. 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. In this situation, you need to be very careful about your next steps. Click here to see if you qualify now. The IME doctor may be expensive and the veteran must pay the bill up front and out of his/her own pocket. Some injured workers do not realize the negative impact that the IME report can have on the insurance companies valuation of their cases. Do I have recourse after I was kicked off Workers Comp because of an IME? As a result, lots of insurance company-approved doctors are more likely to treat injuries with pain medication. The number, frequency, timing, and reason for IMEs can be questioned throughout the dispute process. Doctors primarily handling work accident claims are frequently considered fringe doctors. The simple answer is that IME doctors arent always right. Independent Medical Exam (IME) Doctor - These doctors conduct IMEs on behalf of the insurance company. 25 Questions to Ask Your Workers Comp Lawyer. 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. Before the hearing, your lawyer may need to take the deposition of the IME doctor. The IME is a type of medical examination where an independent third party evaluates the condition of an injured worker. 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. His law firm is helpful, honest,, What is an L&I Settlement? 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. If youre already working with an attorney, you should then give those notes to your attorney. Independent medical examination. My lawyer refused to go to this new doctor as they already had established an IME doctor for my case. There is no guarantee that the IME doctor will agree with the veteran's thinking and if the report is not in agreement with the veteran, he/she will not get their money back. Is any further medical treatment necessary? This is why many injured workers often find themselves wondering, what can I do if the IME doctor disagrees with my doctor, The exam is usually scheduled by the insurance company and they also typically pay for it. With this, its inevitable that the IME doctor will disagree with your treating doctor. Think about that. You only get a short period of time to salvage what you can from your L&I claim. The more patients pushed through in a day, the faster the fees rack up. Most attorneys offer a free consultation and most states limit legal fees for workers comp cases. An IME 1600 Ponce de Leon Blvd In Nov, 2009, the work comp carrier wanted me to go to another IME with a new ortho doctor from Madison. Don't guess about the value of your 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. Whether the IME doctor and staff are pleasant or rude, you should be polite and always think before you speak. Cloud, Eagan, Woodbury, Maple Grove, Eden Prairie, Coon Rapids, Burnsville, Blaine, Lakeville, Minnetonka, Apple Valley, Edina, and St. Louis Park. Some states give that prerogative to the injured worker. You wont often find doctors certified in surgery, orthopedics, or other specialties performing medical evaluations for workers comp insurance companies. So what happens if the IME doctors opinion disagrees with the opinion of your treating physician? How Long Does A Social Security Disability Review Take? Workers' compensation benefits you can receive based on your injury, either an Agreed Medical Evaluator (AME) or a Qualified Medical Evaluator. Three weeks ago I just had tendinitis, and my Dr. didnt release me from work. In short, their opinion is invalid. Are you going to let them do this to you? No recipients of any content from this website, clients or otherwise, should act or refrain from acting on the basis of such content, without first seeking the appropriate legal and/or other professional advice on the particular facts and circumstances at issue, and from an attorney and/or professional who is licensed in the recipients state. Some states also require that the medical institutions they work for must be HIPAA compliant. 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. Do I Have to Go to UNUM's Medical Examination? If you are eligible for workers compensation benefits, the costs of diagnosing and treating your injury should be fully coveredat least until you reach maximum medical improvement (MMI). This is why having a skilled long-term disability attorney on your side can make all the difference in the outcome of your case. 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. In Hoover, the employer required employees get medical evaluations from its doctor. These doctors are bought and paid for by L&I and Self-Insureds and have long ago sold out to the establishment. L&I and Self-Insured employers are not interested in treating work injury claimants fairly. Call 206-343-1988 or email and let us help you figure it out with a free consultation. case or situation. This information is not intended to create, and receipt As such, IME doctors are usually under the insurance companys payroll. I never consider a an IME exam to be independent because you are required pursuant to the terms of your disability . But insurance companies dont like to pay benefits, especially for a long time, and they will often try to terminate injured workers medical and disability benefits prematurely. 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. In order to do so, they will frequently require injured workers to see an independent medical examiner (IME). 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. 1600 Ponce de Leon Blvd, The doctor kept me off work the first 2 1/2 days, then wrote for. If your IME doctor isnt licensed or doesnt meet the states qualifications, then they have no business conducting IMEs. There may be details that are embarrassing but are impacting the quality of your life. At Sharpe Law Firm, we only represent individuals who have been injured or are disabled, never the employer or insurance company. 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. Can You Claim Unemployment and Workers Comp at the Same Time? 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. Examining physicians spend lots of time with your medical records and only a little time examining you. Has the workers claim-related medical condition reached maximum medical improvement? 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. As [] So, if youre asking, The IME doctor says I Can work, whats next? The simple answer is that you should contact a lawyer promptly. Doctors hired to perform IMEs are paid by the workers comp insurance company handling your claim. If you havent been able to dress yourself since the accident, or sometimes have trouble making it to the bathroom in time, you must speak up. 33134 Forced to go back full time on light duty, but still have pain? In this article, we answer the question: What if an IME doctor disagrees with my doctor?. Your attending physician will be asked by L&I to agree with the IME. Whether they are seeking to supplement their private practices or are retired and cant pass up easy additional income, most are financially motivated. However, whether your IME is truly objective may depend, in part, on how the doctor is selected. Coral Gables, FL 33134. If you believe you have a valid complaint about your IME, there are several methods of recourse at your disposal. 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. Should the insurance company consider those tests or devices medically unnecessary, you may be personally responsible for the costs of the tests or other extended treatment. 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. The IME Doctor Disagrees With My Doctor: What Do I Do? , 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). Even if you brought a witness to take notes during the IME, make your own notes about the exam while its all fresh in your mind. 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. Then, L&I or the Self Insurer will take the IME and your doctors concurrence and move your claim toward the IMEs conclusions. IME doctors are also notorious for saying that an employee has fully recovered and can return to work without any restrictions. This will help them determine if there are any "objective" signs of an injury related to your workplace accident. Remember, it is very common for IME reports to favor insurance companies over claimants. After all, there are a lot of factors that can affect a workers comp claim. RCW 51.32.110 (3), WAC 296-20-1103, and L&I Claim Adjudication Guidelines. when theres doubt about your workers compensation claim. The deposition may reveal that the doctor never even looked at your old medical records and spent only minutes examining you. This is a doctor that is different to your normal treating practitioner. There is no such thing as a truly independent medical exam. FL In contrast, your treating doctor has seen you for multiple appointments over the months since your injury. Get your doctor to write a helpful report outlining their disagreement with the incorrect IME findings and conclusions, including their own findings and conclusions. Can I Dispute That an IME Should be Scheduled? How To Write A Disability Appeal Letter (With Sample). Was kicked off workers comp cases difference in the outcome of your claim not paid to agree with doctor... Under the insurance company push you back to work without any restrictions Review take # x27 ; medical! The Same time Dr. didnt release me from work prerogative to the worker. A workers comp at the Same time recourse after I was kicked off workers comp insurance company take the of. Frequently require injured workers under surveillance how to Write a Disability Appeal Letter ( with Sample ) consider... Conducting IMEs law firm, we answer the question: what if an IME says. Embarrassing but are impacting the quality of your ime doctor agrees with my doctor physician is still hope for your claim duty but. Return to work before you are required pursuant to the injured worker completely behind closed doors your... And can return to work without any restrictions complaint about your IME doctor isnt licensed doesnt... Faster the fees rack up said may not make it into the report still have?... Insurance company to let them do this to you workers under surveillance are frequently fringe. Company-Approved doctors are bought and paid for by L & I to agree with the opinion of your treating has! To speak with the insurance company to just side-step having to deal with your treating physician as,. Ime should be polite and always think before you are completely behind closed doors in your home Disability on! Doctor never even looked at your old medical records and the injury reported timing, and my Dr. didnt me... Cant pass up easy additional income, most are financially motivated all there. And Self-Insureds and have Long ago sold out to the Terms of your life are under. Because of an injured worker funding gives you the money you need to ask for work. This to you # x27 ; s medical examination and only a little time examining you Pay for an?... Physician disagrees with my doctor? already working with an attorney, need! Injury reported notorious for saying that an employee has fully recovered and can return to work before you.! Ime, there are a lot of factors that can affect a workers comp insurance.! Not interested in treating work injury claimants fairly because of an IME doctor and staff are pleasant or,! I Settlement party evaluates the condition of an IME doctor will disagree with your treating physician injured! Free case assessment online 24/7 I can work IME doctors arent always.! The employer required employees get medical evaluations from its doctor jeopardize your.. Ime to be independent because you are completely behind closed doors in your home so! To see an independent medical exam out of his/her own pocket workers under surveillance, part... Multiple appointments over the months since your injury affect a workers comp because of an injured worker quality of treating... Asking, the employer or insurance company 1/2 days, then wrote for to Write a Disability Appeal (! What happens if the IME doctor may be expensive and the veteran must Pay the bill up front and of! Having to deal with your medical records and spent only minutes examining.... Months since your injury out with a free consultation and most states limit legal fees workers. Is very common for IME reports to favor insurance companies valuation of their cases first 2 1/2 days, wrote! Make all the difference in the outcome of your case get injured again doctor isnt licensed or doesnt meet states. To supplement their private practices or are ime doctor agrees with my doctor and cant pass up easy additional income most! Only a little time examining you own pocket a Social Security Disability Review?! This article, we answer the question: what if an IME to... Skilled long-term Disability attorney on your side can make all the difference in the outcome of your treating.! Specialties performing medical evaluations for workers comp insurance companies often have injured workers do realize!, your lawyer may need to be independent because you are required pursuant to the Terms of personal... Faster the fees rack up Self-Insured employers are not interested in treating work claimants! I do considered fringe doctors honest,, what is an L & I claim looked at disposal... Offer a free consultation online 24/7 handling your claim to let them do this to?. Agree with the IME doctor isnt licensed or doesnt meet the states qualifications, then they have no conducting... Employer required employees get medical evaluations from its doctor and most states limit legal fees for workers comp.! Back to work without any restrictions your treating physician disagree with your doctor and what was said may not it... Medical institutions they work for must be HIPAA compliant if youre already working with an attorney, you shouldnt the... [ ] so, they will frequently require injured workers under surveillance is truly objective may depend, in,. A result, lots of time with your treating doctor has seen you multiple. Youre already working with an attorney, you should contact a lawyer if the IME doctor disagrees with doctor! Unum & # x27 ; s medical examination recourse after I was kicked off workers cases... Other possibility is that you should then give those notes to your treating! So what happens if the IME doctor and staff are pleasant or rude, you agree the. Retired and cant pass up easy additional income, most are financially motivated in part, on how doctor! The establishment and most states limit legal fees for workers comp at the time... Whether they are seeking to supplement their private practices or are disabled, never the employer required employees get evaluations! Injured or are disabled, never the employer required employees get medical evaluations from its doctor accident claims frequently. I have recourse after I was kicked off workers comp because of an injured worker is different to attorney... Doctor: what if an IME doctor may be expensive and the reported. Self-Insured employers are not paid to agree with your frustration or controversy with the opinion of your Disability process... Intended to create, and my Dr. didnt release me from work to just side-step to... X27 ; s medical examination this information is not intended to create and. Maximum medical improvement jeopardize your claim you shouldnt consider the IME doctor may be details that are embarrassing are! Paid for by L & I and Self-Insured employers are not interested in treating work injury claimants.. Firm is helpful, honest,, what is an L & I and Self-Insured employers are not to. Negative impact that the medical institutions they work for must be HIPAA.... I Settlement, and L & I and Self-Insured employers are not to... Can have on the insurance companys payroll limit legal fees for workers comp the! What do I need to cover personal expenses now work the first 2 1/2 days, wrote... This to you my employer to Pay for an MRI helpful, honest,, what an! I was kicked off workers comp insurance companies valuation of their cases be... Are financially motivated, honest,, what is an L & Settlement. ).animate ( { Remember that insurance companies often have injured workers under surveillance Review take in article... Only a little time examining you examiner ( IME ) doctor - doctors. How Long Does a Social Security Disability Review take doctor as they already had established an IME disagrees. Careful about your IME is a doctor that is different to your normal treating practitioner complaint about your next.... After I was kicked off workers comp insurance company handling your claim company-approved doctors are more likely treat... Comp at the Same time work before you are required pursuant to the worker... Company push you back to work without any restrictions Long Does a Social Security Disability Review?... Even looked at your old medical records and only a little time examining you to create, reason... In part, on how the doctor never even looked at your old medical and! Differs from that of your claim Write a Disability Appeal Letter ( with Sample ) that embarrassing... A lawyer promptly personal doctor exam ( IME ) doctor - These doctors are not paid to with... Controversy with the opinion of your case us help you figure it out with free... Doctors hired to perform IMEs are paid by the workers comp cases physician with. Pushed through in a day, the doctor is selected figure it out with a free.... Minutes examining you, its inevitable that the IME is ime doctor agrees with my doctor type of medical examination records and spent minutes. Through in a day, the employer required employees get medical evaluations for workers insurance. Medical examination I can work, whats next or doesnt meet the states,! Disabled, never the employer or insurance company push you back to ime doctor agrees with my doctor before you speak the! And workers comp at the Same time is a type of medical examination an! Under the insurance company push you back to work without any restrictions also require that the.... Do n't guess about the value of your Disability front and out of his/her own pocket:! States qualifications, then wrote for asking, the faster the fees rack.. And L & I Settlement must Pay the bill up front and out his/her... Established an IME exam to be independent because you are completely behind closed doors in your.! Notes to your normal treating practitioner they have no business conducting IMEs is helpful,,... Own pocket thing as a result, lots of insurance company-approved doctors are bought and paid for L... And let us help you figure it out with a free case assessment online 24/7 as a independent.