If you’ve filed a workers’ compensation audit claim, you'll be asked to attend an examination with a doctor aside from your treating physician. These exams, which are called independent medical examinations (IMEs) in most states, can have a big impact on the result of your case. So it’s important that you simply steel oneself against the IME, know what to expect, and follow a couple of simple guidelines for your conduct during the exam itself.
What Is an Independent Medical Examination?
An IME is conducted by a physician who will give an expert opinion about any disputes in your workers’ compensation case. Most often, your employer’s insurance firm requests an IME (and selects the examining physician when it disagrees together with your workers’ comp treating doctor about whether your injury or illness is work-related, whether any medical treatment (such as surgery) is actually necessary and appropriate, if and once you can return to figure, and whether you've got any permanent disability.
In some states, the workers’ compensation agency may order an IME, otherwise, you could also be ready to request one. You may need to attend several IMEs during your case. (To learn more about the choice of IME physicians, what happens during the exam, and the way you'll counter the IME doctor’s report, see what's an Independent Medical Examination and the way Will It Affects My Workers' Compensation Case?)
What Should You Do Before the Exam?
Learn what the insurance firm has told and asked the IME doctor. The adjuster for your employer or its insurer may write a letter to the IME doctor describing your injury or illness, summarizing the medical treatment you’ve already received, and asking specific questions on your medical condition that are at issue. This letter frames the problems that the IME physician will address. You should ask to review this letter before time, in order that you'll correct any mistakes about the facts of your case and confirm that the questions are appropriate. If possible, make your request in writing and file a replica with the office of the state workers’ compensation agency where your claim was filed.
Be familiar with your medical history. The IME doctor will likely have all of your relevant medical records, including records of previous injuries to an equivalent a part of the body that was suffering from the recent workplace injury or illness. The examiner will ask you about all of these things, so take the time to review your medical history. Don’t attempt to conceal any previous injuries or downplay them, but do means how your current condition is different than it had been within the past, as a result of the recent workplace injury or illness.
Review how the accident happened. The physician will ask you in detail about how the injury happened. Although workers’ compensation may be a no-fault system, the examiner will want to form sure that the accident is actually associated with your job. Also, the IME doctor could also be trying to find inconsistencies in your story. Keep your answers brief, and confirm they’re according to what you've got reported within the past (for example, in any accident reports or ER visits). Any changes in your story may be used as evidence that you are not telling the truth, so don’t be afraid to point out any inaccuracies in the reports.
Be familiar with your course of treatment. You will probably even be asked about your treatment history for this injury, so look over your notes and records to review the tests, surgeries, or other procedures or treatment you’ve received so far. This is not a memory test, so if you can’t remember a specific date or medication, that’s fine. But you ought to have a public knowledge about what medical treatment you've got received and when.
Review your current symptoms. It is important to let the examiner know whether you're still experiencing pain, limitations, or other symptoms. Are you experiencing headaches or pain? Are you having difficulty together with your everyday activities, like walking, grooming, or sleeping? You will be asked intimately about your current symptoms and limitations, so confirm to incorporate everything, regardless of how minor it seems at the time.
Dress appropriately. Present yourself in a manner consistent with your injury. For example, if you've got an ankle injury, you almost certainly shouldn’t show up to the exam in high heels. Also, you ought to wear or bring any devices you would like for your injury, like crutches, dark sunglasses, or a sling. If you tell the doctor that you need to wear dark glasses all of the time because of constant headaches and you don’t wear them to the exam, you might lose credibility.
Plan to arrive early. If you miss your appointment time, you'll face consequences, like having your benefits suspended. Make sure you give yourself plenty of time to get to your appointment.
Plan to bring a friend. You should decide to bring a trusted friend or relative with you to the exam. This person shouldn't speak during the exam but may take notes, provide you with emotional support, and act as a witness to the exam.
What Should You Do At the Exam?
Be polite. Even if the IME doctor has been hired by the insurance firm or workers’ comp agency, you ought to still be polite and respectful. Don’t assume the examiner is out to get you. Even if the doctor is a smaller amount than friendly, responding belligerently can only hurt you.
Be honest and don’t exaggerate your symptoms. IME physicians will often conduct tests or use other methods to assist them to determine how honest you’re being about your symptoms. They even have years of experience examining injured people to work out if they're accurately reporting their pain or limitations. If you’re caught exaggerating your symptoms, you will lose credibility and may have difficulty getting the benefits you deserve. However, while you should avoid exaggeration, you also shouldn’t downplay your pain or symptoms to seem more credible. Just be honest, thorough, and accurate about what you’re experiencing.
Be honest about your limitations. Likewise, you ought to be completely honest if you’re asked about activities you'll and can't do as a result of your injury. For example, don’t claim that you simply can’t drive anywhere if you’ve driven since your injury. It is possible that the insurance firm has taken video surveillance of you over the last several months. You’ll lose credibility if you’ve said you can’t drive but there’s a video that shows you driving. Instead, if you're still having trouble driving, explain that you simply can only drive short distances.
Distinguish your previous injuries. If you’ve had a previous injury to an equivalent part, your employer and its insurance firm likely will question whether your symptoms are thanks to the previous injury and not your workplace injury. Accordingly, it is important for you to explain how this injury is different. For example, if the sooner injury healed several years ago and you haven’t experienced any pain or symptoms a few times, tell the doctor that. Or, if you're experiencing new symptoms, more pain, or additional limitations thanks to this new injury, confirm to explain them.
What Should You Do After the Exam?
If you or a friend weren’t able to take notes during the exam, take a moment to write down what you remember about how long it lasted, what the doctor asked you, what tests the doctor performed, and so on. Remember that you simply could also be under surveillance leaving the office, so don’t do anything inconsistent together with your injuries or what you said at the exam.
The IME doctor will write a report after the exam, and you or your attorney should receive a replica. Read it carefully and convey up any factual mistakes about your medical record or treatment. If you don’t have a lawyer, this is often the time you ought to consult an experienced workers’ comp attorney. Depending on the laws in your state, your lawyer could also be ready to request another IME with a special doctor to counter the primary examiner’s opinion. Your attorney can also file objections, conduct a deposition to ask questions of the primary examiner, and use all of the opposite available workers’ comp procedures for shielding your rights.
