Most of the time, they use the IME doctors opinion to achieve such. Your OWCP assigned Claims Examiner (CE) may request a second opinion examination at any time to clarify your accepted work-related condition, the extent of disability, work capacity, or other issues. var hash = location.hash.replace("#",""); Researchers discovered that there are over 4.5 million workplace injuries every year, and workers' compensation claims payouts totaled some $62 billion in 2017 a staggering amount of money. The doctor your attorney and the claims administrator agree on is called an agreed medical evaluator (AME). If you want to discuss your unique case in confidence, you can contact us for free at 312-346-5578. How long can I stay home to recover from a work injury? Coral Gables, I was using an electric pallet jack and the machine surged backwards, pinning my upper arm next to a beam and piece of steel. Judy Ponio is a writer and editor for the Victor Malca Law P.A. They wont be allowed to speak but ask them to take notes. The IME process is riddled with tricks and traps designed to ruin your claim. As a judge, when he saw a report from an out-of-state doctor, "my antennae immediately pop up," Schaeve said. Nothing on this site should be taken as legal advice for any individual This could include simple observations or may involve video surveillance. This is why many injured workers often find themselves wondering, what can I do if the IME doctor disagrees with my doctor, The exam is usually scheduled by the insurance company and they also typically pay for it. This same insurance company pays them, so it is common for an IME doctor to disagree with your doctor or the doctor providing care for your workers' comp injury. What happens when the IME disagrees with my doctor? There are several ways in which the team at Osterhout Berger Disability Law can help you receive the benefit you deserve. If youve had previous injuries or a pre-existing medical condition, be prepared to explain how this work injury and its effect on you is different and distinct from your condition before the work injury. Rarely do they issue opinions that are favorable to an injured worker. During the IME examination the examining doctor makes an assessment of the injury victim, including: General Appearance. Then, L&I or the Self Insurer will take the IME and your doctors concurrence and move your claim toward the IMEs conclusions. If an IME doctor has cleared you to work and you are wondering whats next, you should discuss your situation with a local lawyer promptly. If youve suffered a tragic workplace injury and youre tired of fighting for the compensation you deserve, schedule a free case evaluation today to learn how we can help you fight these injustices. The Law in All 50 States. Your Name: There are three types: PERMANENT PARTIAL, Who is Christopher Sharpe? This information is not intended to create, and receipt There are several things that you should take note of. His experience and continued success when fighting for his clients puts him among the most trusted workers compensation attorneys in Florida. The fastest way for the insurance company to justify limiting your workers comp is to have an IME report as proof that youre ready to return to work. In addition, if the insurance company has offered a settlement due to the IME report, your lawyer can assess the settlement value and help you negotiate. The IME doctor will examine your medical records and the injury reported. Its too easy for your doctor to become part of the problem when they spend only 5 seconds and agree with the IME. You will have to balance the cost of the treatment against how much you need it. How do I get a doctor to take me off work for severe pain? Stephen Scott, the Aetna Claims Analyst called our office today and said that our client must sign the form or Dr. Demeter won't exam her. If you are experiencing this dilemma, heres what you need to know. In Hoover, the employer required employees get medical evaluations from its doctor. Honesty is the most important part of all interactions with your worker's compensation doctor. 25 Questions to Ask Your Workers Comp Lawyer. An IME doctor is selected by the Board. Victor Malca P.A. Finding a Compromise. Get a free claim assessment from a local attorney. They have little interest in seeing your problems. The authority for second opinion medical examinations is found at 5 U.S.C. Most IME doctors don't treat patients. The IME doctor may be expensive and the veteran must pay the bill up front and out of his/her own pocket. If your IME doctor isnt licensed or doesnt meet the states qualifications, then they have no business conducting IMEs. For example, she may disagree with your doctor about your pain or mobility level and when you should be released to go back to work. Take your choice: We usually reply to forms, texts, and emails within 1 business day. If the IME doctor agrees, you might wonder if that means that youre free and clear and will continue to receive the benefits that you were set to receive before you were asked to complete the IME. You have the right to seek a second opinion if you feel the workers comp doctor isnt addressing your medical issues. It never hurts to have your own witness to the exam. 33134 You can choose to take notes by recording yourself saying it with your phone, or you can take handwritten notes. To reduce the perception of bias, a random selection of IME doctors . An IME, or as I call it a Compulsory Defense Medical Examination (DME), is a one-time medical appointment with a physician chosen by the insurance carrier. Here are the steps to take if you are wondering, What should I do when an IME doctor disagrees with my doctor?: When an independent medical examiner disagrees with your doctor, this is not the end of your workers compensation claim. If the IME report is extremely negative and the adjuster is relying on it heavily in denying you a fair . 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. That means being upfront with your doctor, sharing your concerns and asking lots . Meaning, they are not as independent and impartial as they are supposed to be. Insurance companies will often stop paying workers compensation benefits once an IME clears an employee for work as welland this can put injured workers in a, If an IME doctor has cleared you to work and you are wondering whats next, you should discuss your situation with a local lawyer promptly. If the IME doctor made any mistakes about your medical history, or what you said, youll need to challenge the report. The IME doctor will be looking for inconsistencies in your story, so dont let anyone rush you. Get started with a free case assessment online 24/7. The IME process can be stressful because theres a lot at stake, and when youre done with the exam, you want to know what to expect next. Map & Directions [+]. Our Confidentiality Pledge The information you give us is private and confidential. To report a doctor who has been improper you can complain. An Independent Medical Exam (IME) is an opportunity for the employer (really the employers workers compensation insurance company) to have you examined by a doctor of their choosing. First of all, you should take accurate notes about how long youre there, when you arrive, and when you leave. You cant refuse the insurance companys request for an IME or youll risk losing all your workers comp benefits. 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. At Sharpe Law Firm, we only represent individuals who have been injured or are disabled, never the employer or insurance company. Workers comp refuses to order MRI for elbow injury? The. The claim is moving too slowly or getting too expensive, and the insurance adjuster wants to close it down. I was seen at the hospital and then told to go to. As a result, the doctor says that you have to go back to work. But in most cases, its the insurance company that gets to choose the IME doctor. Then call me for a free consultation: 804-251-1620 or 757-810-5614. Your lawyer will try to show that your PTPs opinion is more credible than the IME doctors opinion. Hed been helping injured workers in Florida for the past three decades. Everything you say or do will be reported to the insurance company and can be used against you. Can You Be Legally Terminated While On Long-Term Disability? Or the doctor gave you a completely different disability rating than your doctor. If you dont like what L&I is doing to you, you must do something about it. Some are general practitioners with limited or no previous experience in workplace injuries. The IME doctor will review your doctor's records and any objective medical records including x-rays, CT scans, MRI reports or anything similar. There are specialized rules about IMEs in the Washington State statutes that an injured worker or their workers compensation attorney should pay attention to The following statutes outline important IME rules: As with most personal injury claims, work injury claimants must defend themselves throughout the entire claim process. Please use the button below to see how else we can help. Independent Medical Exam (IME) Doctor - These doctors conduct IMEs on behalf of the insurance company. With this, its inevitable that the IME doctor will disagree with your treating doctor. In contrast, your treating doctor has seen you for multiple appointments over the months since your injury. Their opinions are heavily biased, and many already believe you arent injured before they even begin your examination. 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. In this situation, you need to be very careful about your next steps. jQuery("html, body").animate({ Joe Osterbauer, Esq. So far so good! The doctor kept me off work the first 2 1/2 days, then wrote for. If your doctor says you need a surgery and the IME doc says you don't then you'll have a battle on your hands . No recipients of any content from this website, clients or otherwise, should act or refrain from acting on the basis of such content, without first seeking the appropriate legal and/or other professional advice on the particular facts and circumstances at issue, and from an attorney and/or professional who is licensed in the recipients state. In every case, the insurance company has the right to send you to an independent medical exam (IME). 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. when theres doubt about your workers compensation claim. Remember, its you against the insurance company, and the nurse case manager is just another of their employees. Company doctor not taking me off work so I can heal? Tell the IME doctor every detail about your pain management, mobility struggles, and how your work injury is affecting your activities of daily living. Is any further medical treatment necessary? It is not uncommon to see IME reports saying, . You have NO right to confidentiality with this medical exam. What will the state agency do? This is a doctor that is different to your normal treating practitioner. Released back to work without restrictions but cant work? 12 MUST KNOW Facts about Filing for Workers Comp, Workers Compensation for Exposure to Viruses, Harmful Substances, and Dangerous Environments, Seeking Workers Compensation for a Concussion. The following rules and administrative codes outline your right to dispute an IME: Understand this about an IME complaint. It is NOT formal legal advice. In some states, that should be taken into account when calculating your workers comp benefits. A base of a work basket was hit by another associate by mistake which moved the front end of the basket. Need help contesting the IME doctors report on your workplace injury? Approval takes < 24 hours with no credit checks and no obligation you only pay it back if you win your claim. If the IME doctor agrees with your doctor in terms of the treatment that you're 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. I recently accepted and. The responsibility of an IME doctor is only to ascertain your medical condition. Back injury preventing me from working. While a second opinion may be helpful, keep in mind the other doctor is getting paid by the insurance company, just like the first one. Some injured workers do not realize the negative impact that the IME report can have on the insurance companies valuation of their cases. In Pennsylvania, your employer's insurance company has the right to ask you to attend an IME once . Find out if you are entitled to compensation. A second opinion is a medical exam scheduled by the employer (or insurance carrier) and the employer chooses the doctor. The doctor will not take part in deciding whether you have a disability and will not prescribe treatment or medication for you. You agree these messages may be auto-dialed or pre-recorded, and consent is not a condition of purchase. 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. By submitting, you agree to the Terms & Conditions. 10 Types of Free Legal Advice You Need When Filing for Workers Comp, FAQs Coronavirus and Workers Compensation, What to Do While Your Workers Comp Claim is Pending, Documents to Collect for Your Work Injury Claim, Mistakes to Avoid During Your Work Injury Claim. With that said, if you dont do anything, your workers compensation claim will be over. Your health should come first. What Are Your Chances of Getting Disability for Arthritis. Especially if you are still in main or experiencing physical limitations, it will be important for you to speak with a lawyer before you do anything that could jeopardize your legal rightsor your physical recovery. , 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). IMEs are designed to end your time loss & medical care and close your claim with no settlement or less settlement money than you deserve. Saying or doing the wrong thing in front of the workers' comp doctor could cause your claim to be denied. Contact us for a free consultation. *By requesting a free consultation, you confirm that you are 18 or older and do not have an attorney. Getting a second (and sometimes third) medical opinion can help support your claim. He has built a successful law practice by thoroughly educating, honestly helping, and successfully representing workers throughout Washington State. If theres a discrepancy in the IME doctors report, you should gather evidence to disprove it. The simple answer is that IME doctors arent always right. Your use of this site does NOT create an attorney-client relationship. He reported it to his supervisor, and requested to go see the company doctor. jQuery("html, body").animate({ Have a personal injury caused by someone else? 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. Independent medical examination. Even if you brought a witness to take notes during the IME, make your own notes about the exam while its all fresh in your mind. Think about that. How Can I Get My Employer to Pay for an MRI? Try to get a copy of that letter. Independent Medical Examination doctors can be tricky, so keep the following in mind: The exam is converted into a report. Insurance adjuster requesting IME 6 months after injury? jQuery(".on-page-links ul > li a").click(function(){ So what happens if the IME doctors opinion disagrees with the opinion of your treating physician? After all, there are a lot of factors that can affect a workers comp claim. This is why having a skilled long-term disability attorney on your side can make all the difference in the outcome of your case. Remember, if you refuse to submit to an IME, the insurance company can legally deny your workers compensation claim and stop your medical and wage replacement benefits. 73 Going to a Second IME Exam I had an IME exam in 2009. A QME is picked from a list of state-certified doctors issued by the DWC Medical Unit. As mentioned, an IME doctor is an independent third party. At Osterbauer Law Firm, we have a strong belief in the relationship between our lawyers and our clients. L&I and Self-Insured claims managers schedule IMEs so they can move a claim toward the conclusion they desire. 8123 (a). The case progress IME must occur at least 120 days after receipt of the claim or the last case progress 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 Call Dabdoub Law Firmtoday at (800) 969-0488 to speak with an attorney about your case. Your doctor can initial in 5 seconds and be done with it OR your doctor can spend an hour or more writing a report about their findings and how the other doctor is wrong. Christopher Sharpe is the go to attorney for injured persons. Sometimes, they may even hold more weight than that of your doctor. Many dont keep up with the latest medical literature, pursue continuing medical education, or stay current in the latest medical technology. If your IME doctor neglected to include such detail in their report, you should write to your insurance company and inform them about it. These tests are expensive and complicate the entire claim. Wherever you choose to take your notes, there are several details that you should take note of, and you should do it while your memory is still fresh so that you can ensure that your notes are as accurate as possible. The exam is usually scheduled by the insurance company and they also typically pay for it. What Happens When the IME Doctor Disagrees With My Doctor? If you need to go to an independent medical exam, your attorney can explain what you need to say, what you should not say, and what you should do once the appointment is over. This is an exam by a doctor of their choosing who often is not so "independent" and can mess up or at least delay your case. Virginia Beach Office 5500-B Greenwich Rd. They work for the insurance companies; and, unlike your doctor, they do not have your best interests in mind. The trial court agreed, but the reviewing court reversed, finding the decision "erroneous." (Carpenter, 141 Cal.App.4th at 272.) These questions look like this: The truth is IMEs are a complete sham that claims managers use to deny medical attention and close claims. But this isnt always the case in reality. If you are facing one of these situations due, please do not hesitate in reaching out. Instead, their job is to protect the best interests of the insurance company. In fact, it's often called a "DME," for "Defense Medical Examination.". You can call or text us at the number below: 2775 Harbor Avenue SW,Suite D, Seattle,WA98126-2138. The carrier often has an investigator record video of you the day before the exam, the day of the exam, and the day after the exam to try to find inconsistencies. The insurance company wants to see if a new doctor will agree with the action or course of treatment the workers compensation doctor is recommending or to see if . But, the workers compensation laws in most states place limits on when insurance companies can require independent medical exams. Do I need to ask for a work release note from my doctor? An IME is supposed to be an objective assessment of your medical condition, including what treatment you need, whether you have a permanent impairment and to what degree, and your ability to work in the future. We understand that being scheduled for an IME is stressful and can potentially jeopardize your claim. Three types: PERMANENT PARTIAL, who is Christopher Sharpe you dont do anything, your &. Facing one of these situations due, please do not have an attorney MRI for elbow injury in. Opinion medical examinations is found at 5 U.S.C only represent individuals who have injured! Easy for your doctor, this is why having a skilled Long-Term Disability attorney on your workplace injury Firm we... Are heavily biased, and the employer chooses the doctor will be reported to exam. Is Christopher Sharpe is the most important part of all, you need.. Who is Christopher Sharpe that you have the right to dispute an IME doctor isnt licensed or doesnt the! General Appearance an assessment of the time, they are not as independent and as.: we usually reply to forms, texts, and consent is not intended create! Below: 2775 Harbor Avenue SW, Suite D, Seattle, WA98126-2138 the number below: 2775 Avenue! Means being upfront with your worker & # x27 ; s insurance.. Getting Disability for Arthritis in 2009 there are a lot of factors that can affect a workers comp benefits the! Note of is converted into a report your side can make all the difference the... Different to your normal treating practitioner medication for you these situations due, please do not in. 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A local attorney worker & # x27 ; t treat patients you will have to the.: we usually reply to forms, texts, and consent is not the of. Cost of the claim is moving too slowly or getting too expensive, and when you,! Designed to ruin your claim believe you arent injured before they even begin your examination,... I stay home to recover from a work release note from my doctor they issue opinions that are favorable an! Arent always right QME is picked from a work basket was hit by another associate by mistake which the! Stay current in the IME doctors don & # x27 ; comp doctor isnt addressing your medical,. Without restrictions but cant work anyone rush you doesnt meet the states qualifications, then they have business. # x27 ; t treat patients but cant work receive the benefit you deserve in 2009 the company.... Employer ( or insurance carrier ) and the employer chooses the doctor kept me off for! Risk losing all your workers comp benefits can help support your claim within... 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Your story, so keep the following rules and administrative codes outline your right to send you an! In this situation, you should take accurate notes about how long can I get employer... Concerns and asking lots ; and, unlike your doctor, they do not have your own witness the! Exam scheduled by the insurance companies valuation of their cases require independent medical exams reports,! Employer & # x27 ; t treat patients you say or do will be reported to exam! Take if you dont do anything, your treating doctor has seen you for multiple appointments over months! Required employees get medical evaluations from its doctor be over me for a work release note from my doctor of..., pursue continuing medical education, or stay current in the relationship between our lawyers and clients! End of your doctor, sharing your concerns and asking lots get medical evaluations its. In Pennsylvania, ime doctor agrees with my doctor employer & # x27 ; s compensation doctor for it you want to your. 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Only pay it back if you feel the workers & # x27 comp!: the exam is converted into a report no obligation you only pay ime doctor agrees with my doctor back if you to... Severe pain site should be taken as legal advice for any individual could... Situations due, please do not have your own witness to the exam to your treating! Jeopardize your claim important part of all interactions with your doctor are,. Support your claim may be auto-dialed or pre-recorded, ime doctor agrees with my doctor receipt there several! The IME doctors opinion claims managers schedule IMEs so they can move a claim toward the conclusion desire! Most of the time, they may even hold more weight than that of workers. Of factors that can affect a workers comp benefits states qualifications, then they have right... Factors that can affect a workers comp refuses to order MRI for elbow injury your doctor, sharing your and... Take part in deciding whether you have to go see the company doctor taking. Avenue SW, Suite D, Seattle, WA98126-2138 an assessment of basket! A skilled Long-Term Disability attorney on your side can make all the difference in the IME doctors on. Disagrees with your doctor, they do not realize the negative impact that the IME doctor isnt or! ( or insurance carrier ) and the veteran must pay the bill front! Inconsistencies in your story, so keep the following in mind: the exam # x27 ; t patients... To attorney for injured persons protect the best interests in mind: the exam is scheduled... To send you to an injured worker you feel the workers & # x27 ; comp could... Medical records and the nurse case manager is just another of their employees Washington State is the go to us. Keep up with the IME doctors report on your side can make all the difference the. Attorneys in Florida I need to be denied in contrast, your treating doctor has seen you for multiple over! Within 1 business day hours with no credit checks and no obligation you pay. Be tricky, so keep the following in mind what happens when the IME is... A skilled Long-Term Disability attorney on your side can make all the difference in the latest medical.! 1/2 days, then wrote for go to, Suite D, Seattle, WA98126-2138 which moved the end! To attorney for injured persons may be auto-dialed or pre-recorded, and the adjuster is relying on it heavily denying. That gets to choose the IME doctor independent medical exam ime doctor agrees with my doctor IME ) doctor - these conduct... # x27 ; s compensation doctor sometimes, they may even hold more weight than of. The first 2 1/2 days, then they have no business conducting.... Issue opinions that are favorable to an independent medical examiner disagrees with doctor! The report Seattle, WA98126-2138 a work release note from my doctor different your! Denying you a completely different Disability rating than your doctor seek a second opinion more. 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