How To Beat An Ime Exam
When a worker in Pennsylvania is injured on the job, one of the beginning things they should exercise is seek medical attention. Medical intendance may involve immediate treatment past a staff nurse or a trip to an emergency room. More serious injuries may require more intensive medical procedures.
If the injury is non serious enough to atomic number 82 to firsthand hospitalization, the worker must report their injury to their employer or to their supervisor within 120 days. In reality, the sooner a worker reports an injury, the amend. If the worker was properly served with re-create of the Employer's listing of network physicians, the worker must then select a physician from the panel of six doctors chosen by the employer for the first 90 days of treatment. After 90 days, the injured employee may apply their own dr., although they need to notify their employer's insurance company that they are switching doctors.
If the employee submits a workers' comp claim, the employer'due south insurance visitor may ask the injured worker to have an independent medical examination (IME). A physician chosen past the insurance company volition perform the exam.
Since an IME plays a critical function in determining whether an injured worker receives compensation, it's crucial for them to speak with an experienced workers' bounty lawyer before the IME who can help them empathise their legal obligations and rights.
What Is an Contained Medical Exam (IME)?
If you lot've been injured on the task and asked to undergo an IME, the first thing you demand to understand almost the examination is that information technology'southward not independent. A md called and paid past the insurance visitor examines yous. They so requite the insurance visitor their opinion virtually your injury. The doctor'southward opinion includes the cause of your injury, your disability, your ability to piece of work and whatsoever futurity medical treatments you may require.
Your employer'due south insurance company will typically asking an IME if it disagrees with your own doctor's diagnosis, peculiarly if this diagnosis recommends extensive medical treatment, surgery or if it says you accept suffered a permanent disability.
In some cases, a workers' bounty judge may order an IME if they believe it will resolve a medical dispute between you and the insurance carrier.
Although insurance companies claim they pick independent doctors to conduct IMEs, this is a fallacy. Remember, these doctors are called past the insurance company, who then pays them for their IME report. Many of these doctors are semi-retired. Most any doctor in Pennsylvania can be certified to perform IMEs provided they maintain a minimum clinical practice4 and their medical license is current.
Many, but not all, of the doctors who perform an IME see information technology as a cash moo-cow. They realize that if they do non provide the insurance companies with medical reports that contradict an injured employee's workers' comp merits, they will not be asked to perform any more than examinations. Insurance companies shop for IME doctors who they know are probable to give them the results they want. To protect yourself, you need to talk to an experienced workers' compensation lawyer before you attend an IME.
What to Expect from an IME
You will receive a notification from the insurance visitor about who will perform the IME and the time and the identify of the examination. Under Pennsylvania law, you are required to attend.
An IME is not like a regular dr. visit. Information technology is often quite curt. There is no md-patient human relationship or confidentiality, then anything that you say to the doctor tin can brand its style into the written report.
How To Prepare for An IME
Before you lot nourish an IME, there are several things that you can do to feel more confident and relaxed:
- Review your entire medical history. Include whatever past injuries.
- Review the details of your workplace accident and how information technology happened.
- Think about the ways that you were injured, including all parts of your body that were hurt.
- Consider how the pain from these injuries affects your daily activities. It's important to be specific. Describe the way the pain affects you throughout the day. It may brand it hard for you to get out of bed in the morning or difficult for you to go to sleep at night.
- Gear up a complete listing of all medications related to your workplace injury.
- Think most how these injuries take changed your life. What are you no longer able to exercise? How has information technology afflicted your family and your friends? Has it changed your relationship with your coworkers?
- Equally chiefly, it is perfectly OK, and expected, to be clear about activities that exercise Not hurt, or activities that yous CAN practice, or can exercise in moderation. Practice Non exaggerate, most doctor's know it when they run into it.
Write out the answers to these questions. Get over information technology ii or three times before you nourish the test. Don't take the answers with y'all, or else you will expect too rehearsed. Reviewing the summary before your visit will assist you requite precise answers and set y'all for any probing questions.
What Happens During an IME
It'due south of import to remember that you are non asked to attend an IME to receive a second opinion about your injuries. The purpose of an IME is for the insurance company to get together information from an adept to make up one's mind whether to award or deny yous workers' compensation benefits. An IME does not constitute whatever form of medical handling. Even if an IME doctor gives you advice nigh how to treat your injuries, yous are not obliged to follow information technology.
Under Pennsylvania constabulary, an insurance company can but ask y'all to submit to an IME twice a twelvemonth. The dr. performing the IME volition receive all relevant medical information before the examination. The insurance visitor oft includes a letter that requests the md to examine you for a specific reason:
- Accept you been properly diagnosed by your doctor?
- Is a work-related incident or job-related exposure to toxic chemicals responsible for your medical condition?
- Volition y'all crave additional medical treatment?
- Do you have a partial or permanent disability?
- When will you be able to return to work and will you need any medical restrictions when you do?
As yous can see, an IME plays a vital function in determining the effect of your workers' bounty claim.
What The Doctor Looks For
While an IME medico volition review all the relevant medical records connected to your work-related injury, they will also consider several other factors during the exam including:
1. Your Full general Appearance
The doctor will watch everything that y'all practice non but during your IME, but also before and subsequently you leave their office. How do you expect when y'all walk into the office? Is it different from the mode that you walk into the test room or when you lot walk beyond the parking lot? Do you have difficulty getting on the examination table or do you bound right up on information technology? How did you wearing apparel?
Basically, the doctor is watching for annihilation that volition give them clues that they believe are relevant to your work-related injury.
2. Deception
An IME physician looks particularly difficult for signs of deception. If you exaggerate your injuries or if you act differently in the waiting room than you do in the test room, the doctor will report that to the insurance company. Sometimes, the insurance company will look at your social media posts to see if your statements tot he dr. are dissimilar from the activities that yous or your friends post on line. Or, yous could be under surveillance earlier and afterwards an IME exam, again to see if your statements to the doctors are consequent with your daily activities.
three. Review of Medical Records
The IME doctor will review your doctor'southward records and any objective medical records including ten-rays, CT scans, MRI reports or anything similar. This will assistance them determine if there are any "objective" signs of an injury related to your workplace accident. The doctor will then evaluate if the mode you describe your injuries matches the evidence from your medical reports.
4. The Examination
An IME doctor volition normally ask yous to perform a series of tests that provide some indication of the amount of pain, sensitivity and discomfort you lot experience. The doc may ask y'all to perform several tests affecting the injured area to see if your reports of pain are consistent.
5. Past Medical History
The medico may ask yous questions about your past medical history, including any accidents or injuries that happened before your piece of work-related incident or afterward. The doc will also question you about your lifestyle.
During an IME the doc is on the lookout for any reason to tell the insurance company that you lot are not injured as severely as yous merits to be.
Tips for Your Contained Medical Test
Hither are some tips to follow in preparation of and during your IME:
- Prepare an outline to help you give consistent answers to the doctor'southward questions.
- You are non required to bulldoze yourself to your date. If y'all have difficulty driving and a family unit member or friend cannot bring yous, the insurance company volition usually provide transportation.
- Effort to arrive at least fifteen minutes early for the test. If yous go far late for any reason, this will be reported by the doctor.
- Dress neatly and professionally.
- Provide an authentic description of your job and your duties.
- Remember, you are nether observation by the doctor and their staff from the moment yous arrive in the parking lot until the moment you leave. If you run from your automobile to the function building or do so after you leave only when yous're in the exam room you lot limp, this will be noted by the md.
- Remember that you may be nether surveillance before and after the IME exam.
- If you are asked to sign or fill out any forms during an IME visit, inquire for copies. Many doctors do not keep copies of these cases. You may demand to go on your ain for a future workers' bounty claim.
- Record your impressions as before long as possible after the exam. Write down how yous think it went, the questions asked and the behavior of the medico and their staff. Having a tape of what happened may help your workers' compensation attorney argue that the physician was antagonistic confronting you lot from the beginning.
How Can an IME Impact My Workers' Comp Instance?
An IME physician does not owe yous a duty of intendance. An IME dr. wants to brand extra money by traveling to unlike cities to examine injured workers and testify for the insurance visitor that hired them. They are often paid about $thou for the test and a written study. They are usually paid effectually $3000 to bear witness against you lot in court for the insurance visitor. In our stance, in that location is a clear fiscal incentive for the medico to say something that favors the insurance company. That is, they get paid a lot of boosted money when they testify against an injured worker. They only testify when they say something that favors the insurance company.
IME physicians commonly say that an injured worker is fully recovered from a work injury even while the worker is even so treating or needs surgery. IME physicians frequently say that an injured worker should render to heavy work that the treating physician has recommended against.
What Happens After a Workers' Comp IME
Afterwards the physician has conducted the IME, they'll write a report detailing the results. It will address concerns noted by the insurance company, such as whether you lot tin perform certain activities. If the insurance company plans whatever legal action, your lawyer will receive a re-create of this study, as volition the judge if your case goes to courtroom.
Ofttimes, judges give the opinions of the IME doctor significant weight, and sometimes more than than those from the treating physician. IME doctors are supposed to exist independent and objective, but that's non always the case. However, we always advise our clients to be honest during the IME and perform the tests to the best of their ability.
How Will an Unfavorable IME Impact My PA Workers' Comp Case?
Y'all, or your lawyer, tin can claiming the findings of an IME, such as when:
- An IME includes information about your health history that's wrong: You can transport a letter to the insurance company pointing out the simulated information and asking for an addendum or description. If you have evidence to back up your bespeak, such as documentation from a previous appointment, submit that too. If you lot accept a lawyer, he or she can accost the IME mistakes in Courtroom.
- An IME is used to limit your workers' bounty benefits: Your lawyer tin fight this in Courtroom.
- The physician conducting the IME is not qualified: In PA, an IME doc must have a license from the Commonwealth and be in agile clinical practice at least 20 hours each week. They also must accept certification from an American Board of Medical Specialities-certified board. Those are the minimum qualifications. Our lawyers often inquiry the doctor and his or her specialty to diminish the weight of their opinions if they are not entirely qualified.
While these instances exercise non occur every time, you should investigate ways to fight the IME if you feel that it'due south inaccurate. An experienced workers' bounty attorney can offering the insight and guidance you need in this case.
Must I Attend an IME Exam in Pennsylvania?
Yes. If y'all decline to become to an IME, your insurance company may file a petition to stop any workers' comp benefits you receive. They tin too request an order from a approximate to force you to attend.
Why Am I Required to Attend an IME?
Here is what you demand to know: If you refuse to attend an IME, the insurance company may hire a lawyer to take you to courtroom to stop your benefits. Your benefits should not exist stopped without a hearing.
You are obligated to attend an IME up to twice per year and then long as the test is at a reasonable identify and time. That is, they cannot make yous travel hundreds of miles or appear for the test at midnight. If you have an IME and have a question about how far y'all must go from your area, feel free to call the states. The answer commonly depends upon where you lot live and how rural the surface area is from major medical centers.
A notice of an IME oftentimes asks you to drive around and collect all of your medical records and films. Y'all are non required to do that. Your only requirement is to appear at the identify and fourth dimension of the exam and cooperate. You may ask for the insurance visitor to provide transportation. Even so, practice not discuss your case, daily activities or medical condition with the driver.
Y'all may provide your own transportation and asking mileage reimbursement for travel. If y'all lose time from piece of work for the examination, you may ask for wage loss benefits for losing wages to attend the exam. On the solar day of the exam, you lot may be under surveillance before or afterwards the exam.
What Should I Tell the Doc During an IME?
If there is one good piece of advice about speaking to a doctor during an IME it'due south stick to the facts:
- Be straightforward in your answers simply simply answer the question asked.
- Do not exaggerate. Do not overemphasize your injuries during the test.
- Do not be chatty with the doctor. Practice not express joy a lot or fissure jokes. Be pleasant but not overly friendly. Remember, as prissy a person every bit the dr. may be, they are non there to aid your workers' compensation example.
- If possible, give yeah or no answers to questions.
- Practise non give lengthy answers to questions. Only respond what yous are asked.
- Do non try to seem smarter than the doctor past talking almost what you lot learned about your injury online.
- If the doc asks y'all well-nigh whatever previous injuries be honest in your answers. If they do non ask, do non mention them.
- Do non talk about personal issues such equally your marriage, bug with your employer, or plans for retirement. They accept nothing to do with an IME.
- Do not discuss your workers' compensation claim with the doctor other than the medical data required.
Tin I Bring Someone with Me to My IME?
In some cases, you may. You can bring a friend or family fellow member to the exam location with you, and you may need someone to drive yous home. Whether the physician permits that person to enter the exam is up to their discretion. You should enquire what the policy is ahead of time so that you don't face any unpleasant surprises when yous arrive at the IME.
Should I Talk to an Attorney before an IME?
Contact Us for Complimentary Consultation
If yous have an IME scheduled, you should consult with an experienced workers' comp chaser. In our decades of experience in representing injured workers, an IME is usually scheduled by the insurance company with the hope and intent of denying medical treatment or starting a lawsuit against you to stop or lower your workers' comp benefits. Our attorneys will listen to yous closely to acquire most your medical situation and provide advice to you that is specific to your situation and specific to the detail IME md. We have dealt with hundreds of the IME doctors over the past several decades of representing injured workers.
If you would like to speak to i of the experienced workers' compensation attorneys at Frommer D'Amico to learn more about your legal rights or for legal advice, schedule a free consultation. You can reach u.s.a. at 717-400-g or visit our contact us page. Provide some details well-nigh your situation and your contact data and a member of our squad volition get back to you as soon as possible.
If yous have questions nigh the IME, please contact us today.
Updated: 1/22/2020
Source: https://mycomplawyers.com/what-is-an-ime/
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