When there is a dispute about your medical condition in your workers’ comp case, the insurance company may ask you to undergo an independent medical examination by a doctor they choose. IME doctors issue reports that carry legal weight and can be used as evidence to establish the degree of your disability. Due to the outcome of these exams can greatly affect your workers’ comp case, it’s important to know the purpose of these medical exams.
An IME is a medical evaluation that is used to settle questions about your condition, including what treatment is necessary for your impairment. An IME is often requested by the insurance company when there is a question about what permanent disability rating you should be given. In some cases, the judge assigned to your case may also order an IME to resolve a disputed issue in your case.
An IME is an objective assessment of your medical condition. However, whether your IME is truly objective may depend, in part, on how the IME doctor is selected.
Most often, an IME is requested by the insurance company because it disagrees with your course of treatment. The IME is performed by a doctor selected by the insurance company. These doctors are paid by the insurance companies and often rely on the insurance companies for referrals. They have an incentive to minimize the scope of your injury and lower your workers’ comp award. If you have been asked to undergo an IME, you should consider consulting with your attorney.
You should review any letter sent to the IME doctor by the insurance company. That you can correct any factual mistakes and that the questions asked are appropriate in your case. You should also make your request in writing and file a copy with the state agency in which your workers’ comp claim is pending.
An IME can have a large impact on your case. IME doctors are often viewed as “experts,” and their reports may be given added weight by workers’ comp judges. They are not involved in your treatment, they are also seen as more objective. For these reasons, it can be difficult to discredit an IME doctor’s expert opinion.
They are some situations where it will be effective to challenge the IME report. For example, if the doctor’s opinion is based on incorrect information about some factual mistake, you should make that clear right away. You should write a letter to the doctor and the insurance company explaining the factual mistake and supporting it with documentation from your medical records. You should request that the doctor clarify his or her report. In some states, you can also request a second medical examination, performed by a doctor of your own choosing.
If you dispute the statements in the IME report and cannot get the issue informally resolved, and the IME is being used against you to limit or cut-off your benefits, you should consult with an attorney right away. An attorney can help protect your interests by filing objections, scheduling a deposition to question the doctor, or requesting another examination.