Do not confuse politeness with your job to take care of yourself. Hed been helping injured workers in Florida for the past three decades. L&I has a plan for you and they will use the IME to make it happen. Unfortunately, in most cases, you do. 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. Call 206-343-1988 or email and let us help you figure it out with a free consultation. Or the doctor gave you a completely different disability rating than your doctor. Briefly Describe Your Case: document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Learn more about Social Security Disability and Long Term Disability Insurance, as well as appealing denials and how an attorney can help. But you may qualify for pre-settlement funding. As the. The claim is moving too slowly or getting too expensive, and the insurance adjuster wants to close it down. Think about that. I was using an electric pallet jack and the machine surged backwards, pinning my upper arm next to a beam and piece of steel. Your attorney can also start preparing to dispute the IMEs report (as this will most likely be necessary); and, after the appointment, your attorney can deal with the insurance company on your behalf. If you are requested to undergo an independent medical examination (IME) after applying for long-term disability benefits, the purpose of the examination is typically to undervalue or completely discredit your claim. They: People in charge of your claim can request an IME and follow-up IMEs. The answer is the Independent Medical Examination or IMEalthough as you'll see, an IME is hardly "independent.". Plaintiffs should assume that any staff members present at the doctor's office . On rare occasions, an arbitrator will need to get involved to enforce a decision because either the employer or the insurance company is not willing to go along with what the IME doctor and your doctor both agree on. In this case, the insurance provider can stop paying your claim. Suite 1202, Who was involved, did you require medical treatment, how can we help you? jQuery(".on-page-links ul > li a").click(function(){ They usually send a copy to your doctor with a cover letter asking them to agree or disagree with the IME report: Doctor, if you disagree, write a lengthy report. Has the workers claim-related medical condition reached maximum medical improvement? It is NOT formal legal advice. Do not let the insurance company push you back to work before you are ready you could get injured again. These IME opinions may cost from $600.00 to $1500.00 or more. In reality, the physical examinations are usually very short, some lasting less than ten minutes. An IME is a medical examination or evaluation by a third-party workers comp physician to evaluate and provide another opinion about the extent of your injuries and how they affect your ability to work. . 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. Our unwavering advocacy for employee rights and privileges are recognized by our past clients across South Florida. Instead, these doctors make their living performing IMEs for insurance companies, who provide generous compensation for one-time examinations. Get an expert opinion about your claim, from an experienced lawyer. }else{ In this situation, you need to be very careful about your next steps. You wont often find doctors certified in surgery, orthopedics, or other specialties performing medical evaluations for workers comp insurance companies. But if you feel that the IME doctors recommendation is detrimental to your health, you should tell them so. You will know that you have taken important steps to get your claim moving in the right direction. Insurance adjuster requesting IME 6 months after injury? 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. This could include simple observations or may involve video surveillance. 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. Do You Need Free Workers Comp Legal Advice? The stated purpose of an Independent Medical Examination (IME) is a medical evaluation ordered by L&I to determine the status of a workers medical condition. 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. They are not independent and are not medical exams. So, if you are wondering, Why does the IME doctor disagree with my doctor?, you are not alone. If you are currently represented by an attorney, you should strictly abide by his/her counsel. case or situation. 73 Going to a Second IME Exam I had an IME exam in 2009. The process of choosing an IME doctor varies from state to state. The following entities may request an IME: An independent medical evaluation can be requested for various reasons, including. Osterbauer Law Firm works with injured clients throughout the Twin Cities Metro and Greater Minnesota including Minneapolis, St. Paul, Rochester, Duluth, Bloomington, Brooklyn Park, Plymouth, St. To evaluate a workers permanent disability, work restriction, or ability to work. But that does not mean you do not qualify. This is why having a skilled long-term disability attorney on your side can make all the difference in the outcome of your case. There are two common reasons why the IME doctor may disagree with your doctor: Some of the most common things they disagree on are: Unfortunately, an IME doctors opinion tends to hold a lot of weight even if theyre a little biased. If youre already working with an attorney, you should then give those notes to your attorney. IMEs review medical records and in some cases examine the injured worker. Additionally, if you dont agree with the IME doctor, you might be able to challenge their decision if they made it based on incomplete, incorrect, or outdated information. Just because the IME doctor does not agree with the diagnosis your treating physician provided, that does not mean your case is over. FL The IME doctor will be looking for inconsistencies in your story, so dont let anyone rush you. Getting a second (and sometimes third) medical opinion can help support your claim. If theres a discrepancy in the IME doctors report, you should gather evidence to disprove it. } has over 27 years of litigation experience in Workers Compensation and Social Security Disability lawsuits. Please be sure to indicate the best answer. If you have an attorney, your attorney and the claims administrator may agree on a doctor without going through the state system used to pick a QME. There might also be an arbitrator, who will decide whether the IME doctor or your doctor is more credible. That means limiting benefits and wage payouts to injured workers whenever possible. The nurse may present herself as your advocate who is acting in your best interests. The IME doctor will review your doctor's records and any objective medical records including x-rays, CT scans, MRI reports or anything similar. Get your doctor to write a helpful report outlining their disagreement with the incorrect IME findings and conclusions, including their own findings and conclusions. But that doesnt mean you cant challenge their opinion. Because of their financial interests, some doctors may order unnecessary or questionable tests or medical treatments hoping the insurance company will pay for them. Depending on where you live, this may be a doctor of your own choosing, or it may be a doctor who has been pre-selected by your employer. Make sure to include evidence to prove your claim. console.log("hash::"+hash); How do I get a doctor to take me off work for severe pain? Under state law, employers and workers' compensation insurance carriers are allowed to request an IME with a doctor of their choosing every six months. var hash = location.hash.replace("#",""); You should prepare yourself for two basic scenarios: the IME doctor agrees with your doctor or disagrees with your doctor. At Osterbauer Law Firm, we have a strong belief in the relationship between our lawyers and our clients. Categories Independent Medical Examinations In this case, the "independent third party" refers to the IME doctor. But its not unheard of for employers and insurance companies to use it to discredit your claim. , Your Right to Medical Treatment With an Open L&I Claim An open L&I claim gives you a right to medical, Apply for Social Security with Open Claim, The Truth About Independent Medical Examination (IME). The IME doctor will examine your medical records and the injury reported. If the IME doctor agrees with your doctor and supports your injury claims being related to the wreck caused by the defendant insured with that insurance company behind all of this, then the IME doctor would not be involved in the case any further. My husband felt a sudden snap in his arm while working. To do so, IME exams are scheduled with doctors who will help them manage a claim. They told me it was just a bad ankle sprain. Most attorneys offer a free consultation and most states limit legal fees for workers comp cases. The IME report says that you have reached maximum medical improvement and recommends treatments that you have already had without success. state agency. If the IME doctor agrees with your doctor in terms of the treatment that youre 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. IME stands for "Independent Medical Exam." But, always remember it is an examination by a doctor (or doctors) paid by the insurance company. Some other details to note include how long you were in the waiting room, if there were any other patients waiting with you, details about any paperwork you were asked to fill out, what questions the doctor asked you, your general impressions, any information that the doctor shared with you, and anything unusual that you noticed. How Long Does A Social Security Disability Review Take? behalf if necessary. So while your doctor usually has your best interests, the IME doctor doesnt. You need to be careful when you leave the doctors office where your IME evaluation is done. As a judge, when he saw a report from an out-of-state doctor, "my antennae immediately pop up," Schaeve said. An IME doctor will evaluate your medical history and your current medical state to determine the severity of your disability or medical condition, the treatment you need and your ability to continue working. Workers' compensation benefits you can receive based on your injury, either an Agreed Medical Evaluator (AME) or a Qualified Medical Evaluator. Make the request in writing and send a copy of your request to your states workers comp board. Several circumstances may cause the insurance company to request that you submit to an Independent Medical Examination (IME). Why? Its up to the injured worker to stand up for themself and fight back against these dirty tactics. Try Avvo Advisor at instant.avvo.com if you want to speak directly with myself or another attorney right away. If your case is taken to court, the judge will most likely believe the IME doctor more than you or your treating doctor. They: People in charge of your claim and the insurance company to request that you reached... They told me it was just a bad ankle sprain agree with the diagnosis treating! Work for severe pain employee rights and privileges are recognized by our past clients across South Florida: an medical. 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