These tests are expensive and complicate the entire claim. Independent medical exams requested by disability insurance companies can be dangerous. 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. In this case, the independent third party refers to the IME doctor. In this situation, you need to be very careful about your next steps. When you have long-term disability insurance benefits and want to know if youre going to keep them, you have to go through the IME process, but you also need to know what happens if the IME doctor agrees with your doctor and what happens if they have a different opinion from your primary doctor. With twenty years of experience to offer, our clients have full confidence in us with all of their legal services. We help individuals who need to. So, if you are wondering, Why does the IME doctor disagree with my doctor?, you are not alone. var hash = location.hash.replace("#",""); Workers' compensation benefits you can receive based on your injury, either an Agreed Medical Evaluator (AME) or a Qualified Medical Evaluator. Is it still workers comp when two doctors disagree? Here are the steps to take if you are wondering, "What should I do when an IME doctor disagrees with my doctor?": Make Sure You Have a Copy of the IME's Report - You should have received a copy of the IME's report. He reported it to his supervisor, and requested to go see the company doctor. 4604 49th St N, Suite 5006 St. Petersburg, FL 33709. Most insurance companies permit an injured worker to have a second evaluation from another doctor on their approved list. Only. Make the request in writing and send a copy of your request to your states workers comp board. Despite their label, IMEs are not independent. As [] You will know that you have taken important steps to get your claim moving in the right direction. I. The responsibility of an IME doctor is only to ascertain your medical condition. 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. } Are you going to let them do this to you? Hiding details or lying about the injuries may seem like it'll help your case, but it usually hurts you. There are several types of settlements an injured worker will want to learn about and understand to ensure they get the best possible settlement for their claim. To do so, IME exams are scheduled with doctors who will help them manage a claim. Is any further medical treatment necessary? He has built a successful law practice by thoroughly educating, honestly helping, and successfully representing workers throughout Washington State. A base of a work basket was hit by another associate by mistake which moved the front end of the basket. Are you entitled to financial compensation for your work injury? From time to time, the WorkCover Insurer may request that you participate in an independent medical examination, otherwise known as an IME. Virginia Beach, VA 23462 (757) 455-8889 (888) 694-1671 (757) 455-6757 Elizabeth City Office (by appointment only) 507 E Main St #K You consent that the funding company 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. The IME doctor will review your doctor's records and any objective medical records including x-rays, CT scans, MRI reports or anything similar. jQuery(".on-page-links ul > li a").click(function(){ Financial pressure: IME doctors whose sole practice and income is from IMEs paid by insurers Contracts with insurers - one doctor who responded to the survey said the insurer agrees to a minimum number of IMEs per year. Who was involved, did you require medical treatment, how can we help you? jQuery(window).load(function() { Dabdoub Law Firm is a highly specialized disability insurance law firm based in South Florida offering representation to disability claimants across the country. Does Winning The Lottery Affect Your Social Security Disability Benefits? She has a passion for helping those in need and the elderly with accurate legal information that can make a positive difference in their lives. Please be sure to indicate the best answer. However, if the deficit in both ranges of motion are moderate or higher, and the measures are within 10 degrees of each other, up to 10% may be added to the overall schedule loss of use, not to exceed ankylosis." In the 2018 Guidelines, note Table 5.4 (a), p. 31. Then call me for a free consultation: 804-251-1620 or 757-810-5614. The insurance company can also authorize your employer to accommodate work restrictions so that you can continue to work with modified arrangements, or they can also say that you need to have additional treatments before you can be considered for benefits again. Most attorneys offer a free consultation and most states limit legal fees for workers comp cases. 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. A free phone consultation or email gets that figured out quickly. The history and physical examination must be provided as a narrative of the findings. Also, you dont have to speak with the nurse. You need a lawyer who can advocate for the treatment you need. At the end of the call, no matter what you decide to do, you will have fresh ideas and an action plan. 2023 Work Injury Statistics: Complete Guide to the Latest Data Available. After all, there are a lot of factors that can affect a workers comp claim. IME doctors are also notorious for saying that an employee has fully recovered and can return to work without any restrictions. The bottom line is that every case is different, but if you are being asked to go to more than one IME it's at least suspicious and potentially against the law. Keep reading to learn more about changing your treating physician after a work injury. Injured on the job? 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. Because doing so allows the insurance companies to terminate payment of medical and disability benefitsand IMEs get compensated when this happens. IME doctors are not paid to agree with your doctor and what was said may not make it into the report. 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. However, the true purpose of an IME is to use that determination toward insidious ends. 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. 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. But this isnt always the case in reality. What Are Your Chances of Getting Disability for Arthritis. 'Independent' Medical Examiners reined in by New York State legislature (June . 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. Request a copy of the IME doctors report. 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. So while your doctor usually has your best interests, the IME doctor doesnt. They are a bought and paid-for one-sided records review designed and administered to ruin your L&I claim. 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. Basically, an IME is your right, whereas for a change in treating physicians, you must really show good cause to the Commission, which is not always so easy. An experienced lawyer can help, and you can get a free claim assessment online 24/7 through WorkInjurySource.com. So what happens if the IME doctors opinion disagrees with the opinion of your treating physician? 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. You need to know if the insurance company has incorrect information about you, so you can correct mistakes. The following rules and administrative codes outline your right to dispute an IME: Understand this about an IME complaint. For the most part, this is true. Independent Medical Examination doctors can be tricky, so keep the following in mind: The exam is converted into a report. If your IME doctor neglected to include such detail in their report, you should write to your insurance company and inform them about it. The deposition may reveal that the doctor never even looked at your old medical records and spent only minutes examining you. Most of the time, they use the IME doctors opinion to achieve such. The simple answer is that IME doctors arent always right. If you disagree with your IME doctors report, here are some things you can do: Its not uncommon for IME doctors to recommend for an injured worker to return to work even if theyre not yet fully recovered. - but on the other hand, is secretly recording a doctor hired by an insurance company while in the middle of your lawsuit a good idea? Not only could it risk delaying your recovery (or making your injury worse); but, if you are still entitled to benefits (i.e. My lawyer refused to go to this new doctor as they already had established an IME doctor for my case. 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