If you’ve been injured on the job in New Jersey, your employer or its insurer may refer you to a doctor of its choosing for an independent medical examination in order to qualify for workers' compensation benefits. While you may receive ongoing medical care from your own primary or specialist caregivers, an independent medical exam is like a second opinion for the insurance company. It’s important to know how an independent medical exam works and what you can do if the second opinion is not one that favors your case.
Independent Medical Exam Doctors
The doctor to conduct the exam will be chosen by your employer’s insurance company. The doctor is supposed to be a neutral party, but, it’s likely that you are not the only patient the insurance company has asked this doctor to examine. So, whether or not the bias may be intentional, there is an inherent benefit for the doctor’s opinion to somewhat benefit the insurance company.
What Records Will the IME Doctor Have Access to?
The doctor performing the IME will normally receive all information relevant to your claim prior to meeting with you. He or she usually receives your injury report as well as any medical records regarding your current condition and how you’re being treated. It’s also likely that the insurance company will send along a list of questions that they’d like answered and any points about your condition or treatment that they feel are being dealt with incorrectly. Questions may include:
- Is the original diagnosis correct?
- Is the condition undoubtedly related to a workplace accident or injury?
- Is currently recommended treatment or testing really necessary?
- Will you be able to return to work? When? Under restrictions?
- Is there a permanent disability?
What to Expect at an Independent Medical Exam
Request access to the information the insurance company sends to the IME doctor. It may give you an idea of what the doctor will be looking for during the exam. And, take the time to make sure you have a clear understanding of your own case as well as how and when everything happened. If the doctor has questions for you, you should be able to answer them quickly and honestly. Lastly, plan to arrive early for your appointment. If you’re late and miss your exam, you run the risk of having your benefits suspended.
It’s also worth noting that during this exam there is no expectation of the normal doctor-patient relationship. This means that nothing you say to each other falls under doctor-patient confidentiality. Things you say or do in the doctor’s office may be used during legal proceedings in your workers’ compensation case. Its important to be honest but avoid the temptation to exaggerate. Make sure to be consistent in your answers as well as clear and precise when describing your current limitations at work.
Can You Dispute the IME’s Findings?
If you disagree with the doctor or insurance company, your best course of action is to contact an experienced workers’ compensation attorney. A lawyer will be able to help you protect your rights and benefits by filing formal objections, scheduling a deposition to question the doctor on the matter, or possibly requesting another examination with a different doctor.
At Brandon J. Broderick, Attorney at Law, we are dedicated to assisting clients throughout New Jersey and New York with their workers’ compensation cases. We have years of experience and the extensive resources you need to secure a fair case result. Filing a workers compensation claim does not mean you will be compensated fairly. We are dedicated to helping clients with their cases and secure a fair result. Contact us today for a free consultation.