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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. If IME doctors tell you differently, they are wrong. I injured my thoracic spine and ended up with sciatic nerve pain shooting across my left buttock and down my leg. I have my follow up appointment with my doctor this week as I have been signed off work since my injury. We do ask what percent of IME work involves defense v plaintiff work. Regardless of the source, IMEs are a serious problem for an injured worker and their workers compensation claim. With the nurse case manager in the room, anything you say or do during the examination can be used against you. 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. When you click the button you will be redirected to LawsuitInfoCenter.com. This medical opinion is sometimes based upon surveillance video obtained by the insurance company through private investigators. 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 . Your health should come first. Make sure to include evidence to prove your claim. He reported it to his supervisor, and requested to go see the company doctor. Evaluation starts when the plaintiff walks into the doctor's office. Find out now with a free claim assessment. Contact us today to schedule a complimentary and free case evaluation and learn how we can help you. 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. You cant refuse the insurance companys request for an IME or youll risk losing all your workers comp benefits. The doctor your attorney and the claims administrator agree on is called an agreed medical evaluator (AME). Researchers discovered that there are over 4.5 million workplace injuries every year, and workers' compensation claims payouts totaled some $62 billion in 2017 a staggering amount of money. At Chisholm Chisholm & Kilpatrick LTD, our team of experienced attorneys and professionals has assisted clients throughout the long-term disability claim process. 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? But if you feel you are being played by the workers comp insurance company, or you arent sure youre getting the benefits you deserve, dont wait to protect your claim. This information is not intended to create, and receipt case or situation. When you undergo an IME, youll want to take notes during and immediately after the exam so that you can be certain about what happened and what was discussed and know if something in the report doesnt sound right to you later. Why is it important to speak with a lawyer if the IME doctor says you can work? But in most cases, its the insurance company that gets to choose the IME doctor. Everything you say or do will be reported to the insurance company and can be used against you. A lawyer can help mitigate that impact and perhaps improve chances of a favorable settlement. 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. Your doctor can initial in 5 seconds and be done with it OR your doctor can spend an hour or more writing a report about their findings and how the other doctor is wrong. 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. L&I has a plan for you and they will use the IME to make it happen. Independent medical examination. Make the request in writing and send a copy of your request to your states workers comp board. You must complete a travel reimbursement form within one year of the exam and include your receipts. Who was involved, did you require medical treatment, how can we help you? 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. 5 Signs That You Will Be Approved For Disability. Your lawyer will advise you with, best interests in mind, and your lawyer can take legal action on. Book a free consultation today. var anchor_id = jQuery(this).attr("href").split("#")[1]; What You Should Not Tell Disability Doctors, How To Update Your Social Security Record After Becoming A Citizen. The IME Doctor Disagrees With My Doctor: What Do I Do? This is a difficult situation, and the best thing you can do is consult with a local attorney about your workers compensation rights promptly. What is an L&I Settlement? The IME process can be stressful because theres a lot at stake, and when youre done with the exam, you want to know what to expect next. You have clear legal rights; and, if the IMEs report is inaccurate, you should still be able to collect the benefits you deserve. 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. Getting a second (and sometimes third) medical opinion can help support your claim. jQuery(".on-page-links ul > li a").click(function(){ Many make hundreds of thousands of dollars per year by sticking it to injured workers. 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. Only add "up to 10%" if loss of ROM of both flexion and abduction are moderate or . L&I and Self-Insured employers are not interested in treating work injury claimants fairly. Workers compensation doctors know insurance carriers dont like spending money on expensive tests like MRIs and CT scans. I suggest you do something to help yourself. 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. On Jan 2nd 2015 I was battered by a patient of my employer. 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. In most states, you can refuse to have the nurse in the examination room with you while you are seeing the doctor. So, if you are wondering, Why does the IME doctor disagree with my doctor?, you are not alone. What Happens When the IME Doctor Disagrees With My Doctor? Be on time and be careful. The authority for second opinion medical examinations is found at 5 U.S.C. Who Are These Independent Medical Exam Doctors? But its not unheard of for employers and insurance companies to use it to discredit your claim. The doctor will send a report of the exam or test to the state agency. Most states have stringent requirements when it comes to choosing an IME doctor. Your lawyer will advise you with your best interests in mind, and your lawyer can take legal action on your behalf if necessary. We were told that it was because they determined my injury was a new injury and not related back to my original injury. if(jQuery("#masthead").css("position") === "fixed"){ To reduce the perception of bias, a random selection of IME doctors . Funding can range from $500-$100,000, depending on your case and needs. In that case, she could recommend that you be sent for an independent medical exam with a different workers comp insurance company doctor. Self-Insured employers. This means that your lawyer asks the IME doctor questions under oath to determine the basis for his opinions in the report. These IME opinions may cost from $600.00 to $1500.00 or more. They also know the insurance company wont like it. The insurance company disagrees with your treating physicians medical opinion. More than likely, the doctor and other staff members will be watching the way that you act as you leave. Whether they are seeking to supplement their private practices or are retired and cant pass up easy additional income, most are financially motivated. var hash = location.hash.replace("#",""); If L&I requests a legitimate IME, it is extremely important for the injured worker to arrive alert and prepared for the examination. The doctor will not take part in deciding whether you have a disability and will not prescribe treatment or medication for you. If this answer was helpful, please mark as helpful below. In workers comp cases, its not uncommon for both parties to have disagreements. 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. var scrollToPosition = parseInt(jQuery("#" + anchor_id).offset().top) - parseInt(jQuery("#masthead").outerHeight()); The IME doctor will examine your medical records and the injury reported. Independent medical examiners routinely dispute doctors treatment recommendations. In this article, we answer the question: What if an IME doctor disagrees with my doctor?. 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. Dont volunteer your opinions, just relate the facts. The Law in All 50 States. 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. But this isnt always the case in reality. IME doctors may review a case file, conduct an IME, and write a report all in the same day or two days. Can Illegal Immigrants Claim Workers Compensation? (You can read more in our guide to handling an IME.). Strictly speaking, you do not have to go back to work when an independent medical examiner disagrees with your doctor. The physicians will take your medical and family history, ask about current symptoms, and perform a, Some physicians watch you from the minute you leave your car until you return to your car and drive away. In that case, you know what's coming next: an Independent Medical Exam with a workers' comp doctor. It is highly unusual for an IME doctor to have a disability claimant sign a generic authorization form. //var anchor_id = jQuery(this).attr("href"); jQuery("html, body").animate({ Have a personal injury caused by someone else? You can use this to contest the IME report at court. Why Is an Independent Medical Exam Being Scheduled? You will know that you have taken important steps to get your claim moving in the right direction. Unfortunately, long-term disability insurance companies will almost always side with the IME doctors they hire. 250 (1964). 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. There might also be an arbitrator, who will decide whether the IME doctor or your doctor is more credible. Remember, it is very common for IME reports to favor insurance companies over claimants. We will keep it that way. 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. Are you entitled to financial compensation for your work injury?
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