If you were injured on the job and filed a workers’ compensation claim, you may be shocked at what a battle it is to receive the benefits you are entitled to. Your employer’s insurance company could challenge whether you were really hurt on the job and the extent of your injuries. When the argument is about your injuries, the insurance adjuster could demand that you attend an independent medical examination (IME) with a doctor who is not your treating physician. You will need to prepare thoroughly for this exam to reduce the chances of it hurting your claim.
Who Picks the Doctor for an Independent Medical Examination?
An independent medical exam is a medical examination by a physician used to resolve questions regarding your medical condition. An insurance adjuster may request an IME if any of the following is true:
- Your recovery is taking longer than expected.
- There are disputes regarding what medical treatment is required.
- There are issues regarding the degree of your permanent impairment.
- There are questions regarding whether your injury was a pre-existing one or was caused in a workplace accident.
In most cases, the insurance adjuster will pick the doctor to conduct the independent medical examination. Unfortunately, many of the doctors selected are ones used regularly by workers’ compensation insurance companies, and performing these exams could be a large, lucrative part of their practice. This often causes these physicians to be biased in favor of the insurance company, and their goal is to minimize your injuries and find inconsistencies that can help the adjuster deny or reduce your workers’ comp benefits.
What You Need to Do to Prepare for an IME
You must attend the IME or you could be denied workers’ compensation benefits. It is critical that you go to your appointment prepared. The first thing you want to remember is that you will not have a patient-doctor relationship with the doctor, and he could use any of your statements against you. If you have any lapse of memory—even an innocent one—he could use it to show you are hiding something or that you really were not injured.
Prior to your exam, the doctor would have been provided with your medical records and any other documents relevant to your injuries like your accident report and any written statements you made. He may read these before your appointment—but not always—and you should not assume that his review was thorough.
If at all possible, you should obtain a copy of the letter the adjuster sent to your examiner with your referral to determine if there are any factual errors you will need to correct and to get a better sense of the questions the insurance company is looking to answer. You will also want to review all of your prior medical records, any statements you made, and the details of your workplace accident.
Knowing what the doctor will ask you about can help you prepare for your appointment. You should be prepared to discuss the following:
- Your prior medical history
- Any prior car accident, slip and fall, workplace, or sports injuries and the treatments you received
- Your social and recreational activities before your injury
- A detailed explanation of how your workplace accident occurred and what you may have done to contribute to the accident
- Description of your injuries
- A chronological history of all medical treatments you have received since your injury
- How you rated your pain at each appointment with a medical provider and how you rate your pain at this examination
- Your opinion as to your disability and impairments
- How your day-to-day activities, your ability to work, and your recreational activities were affected by your injury
- Any temporary and permanent restrictions your doctor placed on your activities
- Your physical exertion capacity in relation to jobs you could perform given your restrictions
- Any transferable work skills you may have
- Your work history after the accident
- Specific dates you have been off work since your accident
- Your future medical treatment and prognosis
If you have not retained an experienced workers’ compensation attorney, this should be your first step if the insurance adjuster asks for an IME. Your attorney may have experience with the doctor chosen if workers’ compensation insurance companies utilize his services regularly. Your attorney can use this information to prepare you for your examination and to challenge the doctor’s credibility in settling your case or at your trial.
I have been helping workers like you for over 20 years fight for the workers’ comp benefits they were entitled to. Call me at 877-360-0183 to schedule a free, no-obligation consultation.