It is possible that you can still reach a settlement in your workers’ comp. case after you submit to an IME, short for Independent Medical Examination. If you’ve been asked to undergo an IME by the insurance company, there are potential changes on the horizon in your workmans comp PA case. This raises the question of how an IME will affect your case and the possibility that you will receive a settlement after IME. Rest assured, an IME is a common part of the workers’ comp. process, and many injured workers – especially those represented by the workers’ compensation lawyers at Pearson Koutcher Law — receive a favorable settlement after IME with an insurance company doctor.
IME stands for independent medical examination and is a process typically requested by your employer’s insurance company that involves a physician examining your work-related injuries and asking questions regarding the accident. An IME is a defense medical examination. Read on for the complete guide to IMEs and FAQs answered by expert workers’ compensation lawyer at Pearson Koutcher Law.
An Independent Medical Examination (IME) is an evaluation of you by a doctor hired by the insurance company. The workers’ compensation insurance company will ask that you be examined during an independent medical examination anytime you have a work injury. The doctor can ask you questions, have you complete an information sheet or questionnaire, and perform a physical exam. Ideally, the doctor is supposed to determine objectively whether you have fully recovered from your work injury and are able to return to work. However, these doctors are often not objective and provide an opinion that is in the best interests of the insurance company. The independent medical exam is not intent upon treatment, and no establishment of a doctor-patient relationship is typical. The insurance company is permitted to schedule you for periodic IMEs (a maximum of two per year), and you are required to attend. If you don’t, a Workers’ Compensation Judge will likely compel you to attend. Based on the opinion of the IME doctor, the insurance company may file a petition to terminate, suspend, or modify your benefits. Don’t worry, though — if you disagree with the opinion of the IME doctor and want to contest the petition filed against you based on that opinion, you can hire an experienced workers’ compensation lawyer near me – we recommend Pearson Koutcher Law — to fight this petition before the Judge. If you have questions about what will happen during an IME, contact a workers’ compensation lawyer PA at Pearson Koutcher Law.
Although you can theoretically continue to receive weekly workmans comp PA payments indefinitely, often cases are resolved by a settlement. In this process, you would agree to give up future benefits in exchange for a lump sum of money. There are various reasons for settling, such as you can obtain a quicker resolution as opposed to fighting your case before a Judge.
If you have undergone an IME and are interested in settlement after IME in yourPA workers’ comp case, contact Pearson Koutcher Law. One of our workers’ compensation lawyers near you will attempt to obtain a favorable lump sum settlement on your behalf from the insurance company.
Every case is different. Contact theworkers’ compensation Philadelphia lawyers at Pearson Koutcher Law for more information. We provide Free Consultations and will go through the specifics of your case.
While you are receiving or in the middle of fighting for your workers’ comp benefits, you may receive a letter from your employer’s insurance company requesting an Independent Medical Examination (IME). An IME is a doctor’s appointment paid for by the insurance company to question your injuries and whether you should or should not continue to receive workers’ compensation benefits. There is nothing independent about it.
During an IME, there is no patient / doctor confidentiality. The doctor will report everything you say and do back to the insurance company and your employer.
As previously mentioned, an IME is a doctor’s appointment. The doctor will likely ask you questions concerning your injury, as well as any past injuries, and then perform an examination.
After an IME, the doctor will review medical records from doctors who have treated you for your work injuries. The doctor then writes an IME report, providing opinions on your diagnosis, ability to work, and whether you have fully recovered from your injury to determine if you should continue to receive workers’ comp benefits.
Complete recovery from your work injury and return to the job you were doing at the time of your work accident is one scenario in which insurance companies may request deposition.
While doctors are paid well for the IMEs they perform, it’s a drop in the bucket compared to what they get paid to do depositions. They receive thousands of dollars to give a deposition. Therefore, physicians have a substantial incentive to provide an opinion. The insurance company can use it to its advantage in your case.
After your IME, you should sit down for a few minutes and take notes on your phone or a pad of paper while the appointment is fresh in your mind. Write down everything you remember from the IME including questions from the doctor and how you responded, what the doctor had you do during the exam and anything the doctor might have said about your injury or illness. This may help your workers’ comp lawyer compose a solid answer to the workers’ comp IME report to work toward a settlement after IME in your case.
Yes, you are required to attend an IME (2 times a year) to continue to collect workers’ compensation benefits. If you refuse to attend an IME workers’ compensation, the insurance company can ask a Judge stop your benefits even if you are still suffering from your work injury and unable to work.
Attendance to your IME is integral to the insurance company’s gain. IMEs allow insurance companies to handpick the doctor to obtain a favorable opinion that benefits the insurance company. Then, the insurance company can begin trying to modify or even stop your workers’ compensation benefits. Sure, some doctors evaluate an injured worker objectively and fairly during a defense medical examination. A large majority of doctors who perform medical exams, however, are not fair or objective. Typically, insurance companies select the same physicians to perform these exams. The exams are brief, can be adversarial, and may leave the injured worker in more pain or symptomatic than when they arrive.
You may be asked to attend up to two IME’s a year. And, your IME’s must be at a reasonable time and location.
Free transportation to and from the IME is a requirement for the insurance to provide, should you need it. A driver will come to your home and pick you up, drive you to the exam, wait for you, and drive you home. You can attend the independent medical exam alone if you prefer.
IME doctors often conduct short evaluations, spending 10 minutes or less documenting a history (asking questions about how the injury occurred and the treatment plan) and performing the exam. If the doctor does conduct a short evaluation during your IME and then writes in his IME report that you fully recovered, your workers’ compensation lawyer can question the doctor on the length of the evaluation and make the argument to the Judge: How could the doctor conclude that you completely recovered from your injury based on such a short exam?
It depends. A friend or family member can drive you or accompany you to the examination location with the transportation provided by the insurance company. However, whether the physician permits that person to enter the examination is up to the doctor’s discretion. Ask the doctor’s office or your workers’ comp attorney before your Independent Medical Examination.
Ensure you tell the doctor about any existing injuries before your work injury.
Being Transparent During Your IME Is Essential:
Here is an example of why transparency during an IME is essential … A year before you injured yourself at work, you hurt your back when you were rear-ended in a car accident while driving to the grocery store. After the accident, you went to the hospital, missed a few days of work, and underwent some physical therapy – and then your back was fine. And then, nine months later, you injured your back again while lifting a heavy box at work.
If the IME doctor asks you about previous back injuries, you should tell him about the car accident – you injured your back, it wasn’t too serious, and your recovery took three months. However, if you don’t mention the accident because you’re afraid it might hurt your PA workers’ comp. case, the IME doctor may try to use that against you and note that you were not candid when giving a past medical history in their workers’ comp IME report.
Workers’ compensation lawyer PA professionals advise you to always be honest with the doctor. These doctors are known for writing in their reports that patients exaggerate their complaints based on the examination that they performed. IMEs typically include Maneuver tests called “Waddell Signs.” Doctors use Waddell Signs to determine if you are exaggerating your injuries.
For example, the doctor may lightly tap on your head and ask you if that hurts. Even if you have a significant back injury, a tap on the head should not spike a pain increase. If you cry out in pain when your doctor does this test, he will write that this response indicates exaggeration or malingering. Our advice is to tell it like it is – if the maneuver hurts, inform the doctor it does; if you don’t experience pain, share with the doctor it does not hurt.
How You Dress.
How You Walk Through The Parking Lot.
How You Enter The Office.
How You Leave The Office.
Are You Being Deceptive.
Are You Being Consistent.
Are You Exaggerating?
All these factors are part of the doctor’s evaluation in determining if you are injured and whether you are able to go back to work. This will have a huge impact on whether or not you will be able to continue receiving benefits.
The Pennsylvania Workers’ Compensation Act allows the employer to request that an injured worker submit to an examination by a physician as selected and paid by the employer. Procedures recommended by a physician during an IME must meet the standard of reasonable and necessary, relevant to the risk, intrusiveness, and scope of the examination. From the injured worker’s perspective, since there is no physician-patient relationship created during an IME, a physician during an IME should not be permitted to perform or request any procedure that involves any risk as there would be no legal recourse against the provider should something go wrong.
IME doctors can request diagnostic imaging during an exam. Diagnostic studies, such as MRI or X-rays, are therefore most likely to fall within the definition of physical examination, as would a request that an injured worker attend a Functional Capacity Evaluation (FCE). As long as the employer can show these studies and tests are necessary, involve no more than minimal risk, and are not unreasonably intrusive, the injured worker will most likely need to follow through with the suggestions of the IME physician.
Try and go into your IME as prepared and confident as you can by writing down the following:
Preparation may help you keep your answers consistent as well as brief and to the point.
Depending on the opinion of the examining insurance doctor, you may experience one of the following.
You need to be prepared for the IME so it’s important to contact a a workman’s comp attorney near me who specializes in workers’ compensation.
If you have more questions about your workmans comp PA claim, settlement after IME, IMEs, settlements or anything else pertaining to your claim, we urge you to contact Pearson Koutcher Law today. One of our experienced workers’ compensation attorneys can answer all your questions about your case during a free consultation. So if you are in need of a workers’ compensation lawyer near me, please call Pearson Koutcher Law today.