Most workers qualify for workers compensation benefits if they are injured or develop an occupational disease. Benefits from workers compensation vary by state but generally cover medical expenses arising from the workplace injury as well as some portion of lost income. 

If you’ve been injured on the job, 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. It’s important to know what to expect from an independent medical exam to protect your rights and your claim. Don’t hesitate to reach out to a workers compensation lawyer to discuss your case and get help with your claim.

What is an Independent Medical Exam?

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. The doctor who conducts the exam will be chosen by your employer’s insurance company. Workers compensation doctors are attempting to answer questions like, is currently recommended treatment or testing really necessary?, will you be able to return to work, when and under what restrictions? 

The doctor is supposed to be a neutral party, but implicit bias could be going on. In other words, likely 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 may be an inherent benefit for the doctor’s opinion to somewhat benefit the insurance company.

Independent Medical Exams Do Not Fall Under Doctor-Patient Confidentiality

It’s important to note that during an independent medical 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. In other words, things you say or do in the doctor’s office may be used against you or during legal proceedings in your workers’ compensation case. 

Tips to Remember for Your IME

Be honest without exaggerating or downplaying.

While it’s tempting to exaggerate your symptoms and injuries, doing so can have negative consequences down the line. If the insurance company believes you are lying, it can put your workers’ comp benefits at risk. Tell the truth about your symptoms, prior injuries and conditions in a factual manner. 

On the flip side, downplaying your injuries and thinking you’ll tough it out won’t help you in the long run, either. Injuries and chronic conditions can’t heal without proper time to recover.

Be clear and precise.

Make sure to describe the demands of your position in a clear way and describe in what ways your injury is limiting your ability to perform the job. You should also tell your workers comp doctor about any concerns you have with returning to work. If you return to work too early or accept a light duty job, you could be putting yourself at risk. 

Be positive and punctual.

Express your desire to get well and make sure to keep a positive attitude throughout the appointment. Don’t speak negatively about your employer. It's also important to show up on-time -- even early -- for your appointments. If you continually miss appointments, that could be grounds for denial of benefits. Remember that notes and visit summaries will be used as evidence for approval or denial of claims.

What If You Disagree with the Results of Your IME?

If you disagree with the results of your independent medical exam, 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. 

Get Help from Brandon J. Broderick, Workers Compensation Lawyers

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. Contact us today for a free consultation.

Posted by: Brandon J. Bro…
Date: Wed, 03/30/2022 - 19:50

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