How Can I Get My Employer to Pay for an MRI? 12 MUST KNOW Facts about Filing for Workers Comp, Workers Compensation for Exposure to Viruses, Harmful Substances, and Dangerous Environments, Seeking Workers Compensation for a Concussion. It is your choice. Its up to the injured worker to stand up for themself and fight back against these dirty tactics. In this case, the independent third party refers to the IME doctor. This hearing will be a battle of the experts. During this process, a doctor looks at your previous medical records and does an examination on your to determine whether or not you fit the qualifications. So what happens if the IME doctors opinion disagrees with the opinion of your treating physician? Please be sure to indicate the best answer. Independent medical examiners routinely dispute doctors treatment recommendations. Or the doctor gave you a completely different disability rating than your doctor. The IME is a type of medical examination where an independent third party evaluates the condition of an injured worker. I was lifting a. Click the button below to find out in 60 seconds or less! Do You Need Free Workers Comp Legal Advice? They told me it was just a bad ankle sprain. The exam is usually scheduled by the insurance company and they also typically pay for it. Im an experienced Seattle workers compensation attorney who has helped thousands of injured Washington State workers. and the Osterbauer Law Firm stand up for injured Minnesota workers rights. Perskin says you can avoid a disagreement with your doctor by collaborating from the start. 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. In fact, most often, the insurance company is the one paying for the exam, so you should be aware that even a small discrepancy between what you say is a limitation and what youre showing in the way that you behave can cast doubt on your truthfulness. Virginia Beach, VA 23462 (757) 455-8889 (888) 694-1671 (757) 455-6757 Elizabeth City Office (by appointment only) 507 E Main St #K 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 . Your attending physician will be asked by L&I to agree with the IME. *By requesting a free consultation, you confirm that you are 18 or older and do not have an attorney. The history and physical examination must be provided as a narrative of the findings. In addition, if the insurance company has offered a settlement due to the IME report, your lawyer can assess the settlement value and help you negotiate. Doctors have various reasons for deciding to work for an insurance company, but like most people in the workforce, their goal is a paycheck. 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. I fell on a broken step and injured my back. Depending on where you live, this may be a doctor of your own choosing, or it may be a doctor who has been pre-selected by your employer. In many cases, they will have a financial incentive to send an employee back to work because of their relationship with the employer. when theres doubt about your workers compensation claim. Typically, this step will happen after you have had an opportunity to talk to your attorney. 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). 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. So far so good! Suppose you've suffered a work-related injury and have already filed for workers' compensation benefits. Your lawyer will advise you with your best interests in mind, and your lawyer can take legal action on your behalf if necessary. They also know the insurance company wont like it. His experience and continued success when fighting for his clients puts him among the most trusted workers compensation attorneys in Florida. Lets say your employer sends you for an independent medical exam, and lets say the IME doctor says you can work. Your use of this site does NOT create an attorney-client relationship. If L&I requests a legitimate IME, it is extremely important for the injured worker to arrive alert and prepared for the examination. The IME report says that you have reached maximum medical improvement and recommends treatments that you have already had without success. Therein lies the problem. The IME process is riddled with tricks and traps designed to ruin your claim. Questions are answered and no time is wasted. Chris has been helping injured Washington State workers for over 40 years. If you dont like what shows up in your IME report, there are steps you can take to counteract that bad IME. These IME opinions may cost from $600.00 to $1500.00 or more. Saying or doing the wrong thing in front of the workers' comp doctor could cause your claim to be denied. Is It Time to Speak with a Work-Related Injury Lawyer? . I was injured February 24, 2018 on the premises of my apartment complex. 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. What happens when the IME disagrees with my doctor? What Happens When the IME Doctor Disagrees With My Doctor? Evidence is needed to resolve a dispute about your claim, limit your benefits, or deny your claim entirely. We will keep it that way. Take your time. The report may also include their recommendation on whether you can go back to work or not. 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. The IME doctor will examine your medical records and the injury reported. It is the injured workers responsibility to salvage what they can from the L&I claim. Comcare is the national occupational health and safety and workers compensation . }); It is NOT formal legal advice. 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. 25 Questions to Ask Your Workers Comp Lawyer. There might also be an arbitrator, who will decide whether the IME doctor or your doctor is more credible. How injury occurred, were you at work? }else{ If your doctor says you need a surgery and the IME doc says you don't then you'll have a battle on your hands . Self-Insured employers. What Are Your Chances of Getting Disability for Arthritis. 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. Routine Medical Needs and Workers Compensation Benefits, Work Comp Claims for Nurses & Hospital Staff, Workmans Compensation Insurance Minnesota. careful about your next steps. Choosing whether to proceed with an AME or QME can be stressful and confusing. 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. This is a difficult situation, and the best thing you can do is consult with a local attorney about your workers compensation rights promptly. Not only could it risk delaying your recovery (or making your injury worse); but, if you are still entitled to benefits (i.e. If you dont like what L&I is doing to you, you must do something about it. You need a lawyer who can advocate for the treatment you need. Joe Osterbauer, Esq. 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. Your health should come first. What You Should Not Tell Disability Doctors, How To Update Your Social Security Record After Becoming A Citizen. Most IME doctors don't treat patients. Independent medical exams requested by disability insurance companies can be dangerous. How can I get my doctor to put me on full work restriction? Independent Medical Exam (IME) Doctor - These doctors conduct IMEs on behalf of the insurance company. They can also track how much time was spent examining you versus how much time was spent reading your health records. An observer can help keep the IME doctor honest. His law firm is helpful, honest,, What is an L&I Settlement? The IME doctor may be expensive and the veteran must pay the bill up front and out of his/her own pocket. But if you choose to take notes with pen and paper, take a picture with your phone, too, so that you have a time-stamped record of when you wrote those notes so that its less likely that someone can accuse you of having forgotten and taken inaccurate notes. 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. Despite their label, IMEs are not independent. It is often not unusual for the IME doctor to send a rough draft to the adjuster or defense lawyer to read. Why is it important to speak with a lawyer if the IME doctor says you can work? The IME doctor will review your doctor's records and any objective medical records including x-rays, CT scans, MRI reports or anything similar. Medical treatment is stopped immediately. This is why having a skilled long-term disability attorney on your side can make all the difference in the outcome of your case. IT IS THE RESPONSIBILITY OF THE INJURED WORKER TO SALVAGE WHAT THEY CAN FROM THE L&I CLAIM. An Independent Medical Exam (IME) is an opportunity for the employer (really the employers workers compensation insurance company) to have you examined by a doctor of their choosing. Dont volunteer your opinions, just relate the facts. If the IME doctor agrees with your doctor in terms of the treatment that you're receiving and your overall abilities and disabilities, your employer will act in accordance with what the IME doctor has proposed for your treatment in the workplace. Your lawyer may have to attend a hearing with the workers compensation judge to present your doctors report and rebut the IME report. Workers' compensation benefits you can receive based on your injury, either an Agreed Medical Evaluator (AME) or a Qualified Medical Evaluator. An IME 1600 Ponce de Leon Blvd 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. Dabdoub Law Firm is a highly specialized disability insurance law firm based in South Florida offering representation to disability claimants across the country. 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. Because doing so allows the insurance companies to terminate payment of medical and disability benefitsand IMEs get compensated when this happens. Be on time and be careful. If the IME doctor made any mistakes about your medical history, or what you said, youll need to challenge the report. Your Email: You need to know if the insurance company has incorrect information about you, so you can correct mistakes. Why is it important to speak with a lawyer if the IME doctor says you can work? Plaintiffs should assume that any staff members present at the doctor's office . My lawyer refused to go to this new doctor as they already had established an IME doctor for my case. The responsibility of an IME doctor is only to ascertain your medical condition. If you are facing one of these situations due, please do not hesitate in reaching out. Who Are These Independent Medical Exam Doctors? You have NO right to confidentiality with this medical exam. I am a restaurant manager for a very busy chain restaurant. For additional information concerning the amended law, see. In order to do so, they will frequently require injured workers to see an independent medical examiner (IME). Some states give that prerogative to the injured worker. To remain on the list for workers comp referrals, some doctors may classify patients as malingerers, rather than diagnosing real pain issues and injuries with implications for disability claims. Underscoring this view is the seminal case medical malpractice case in Maryland on this issue is Hoover v. Williamson, 236 Md. There is no such thing as a truly independent medical exam. Is it still workers comp when two doctors disagree? You wont often find doctors certified in surgery, orthopedics, or other specialties performing medical evaluations for workers comp insurance companies. 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. There are 4 different ways you can get a free initial consultation. You might choose to take notes on a few important issues when you get to your car, or you might choose to wait until youre home if you live near the doctors office. We cover all of Illinois. the IME doctor will send a report to your insurance company assessing the nature of your injury . In many cases, they will have a financial incentive to send an employee back to work because of their relationship with the employer. While each state has its own rules and regulations regarding workers comp claims, every state mandates that injured workers must be evaluated and diagnosed by a medical professional approved by the employers insurance company. Theyll be looking to see if you hop easily out of your car and walk briskly to the building, only to limp and groan as you struggle to ease into a chair in the waiting room. There are several things that you should take note of. 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