What To Know About “Independent” Medical Examinations

by | Apr 24, 2023 | Firm News

After a workplace injury, the steps you take can define the quality of the outcome of your workers’ compensation claim. One of these important steps likely is your “independent” medical evaluation (IME), which the insurance company can use to deny cases and halt the kind of compensation you are owed.

In any claim for worker’s compensation benefits, a work comp carrier may require that an injured worker attend an “independent” (or adverse) medical evaluation.  Importantly, the IME doctor is not your doctor.  This is a doctor chosen by the insurance company.  By law, the injured worker is required to attend the appointment.  The doctor can be used to determine whether an injury is work-related, the extent of disability, or the necessity or type of treatment (like a proposed surgery).  IMEs can happen at reasonable intervals, generally every six months if required.

At Domer Law, S.C., our Wisconsin lawyers are committed to helping clients recover from their injuries while pursuing the outcomes they deserve in their cases. While trying to protect their best interests, we encourage our clients to know what to do and what to avoid while attending their IME.

The Things You Should Do

When attending your IME, it is important to what is necessary to protect your best interests, including:

  • Show up on time for your appointment. Being late for your IME can mean missing out on the appointment entirely, and the doctor may not get an accurate understanding of your condition by the time you can get to your next appointment.  (Please note that if you do miss the appointment, the insurance company cannot charge you a no show fee).
  • Stay truthful about your incident. When the doctor asks about your accident, be sure you describe only the truth of what happened without any embellishments or exaggerations. Explain your symptoms and pain levels since the work injury.
  • Follow your doctor’s orders. Failing to follow a specified treatment plan can result in accusations that you made your original injuries worse, which can cost you the outcome you deserve.
  • You can bring an observer to the appointment, as long as they do not interfere with the appointment.  The observer can be a spouse, partner, child, medical provider/physician, or even a friend.  It is best to notify the IME company that an observer will be present before the appointment.
  • You can audio record the examination if not obtrusive and disclosed to the IME physician before the appointment.

These are a few steps anyone should follow in their IME, there are also steps you need to avoid while at your IME.

What To Avoid At Your Appointment

When at your appointment, it is important to remember not to do anything unnecessary, such as:

  • Do not argue with the doctor. While it is fine to make your side of things clear, do not get into a serious argument. If the IME agrees with the treating physician, generally your work comp benefits can condition.
  • Do not lie about your condition. This should go without saying.  Your IME is not a time to underplay how hurt you are. If you think you are experiencing a consequence to your accident, do not keep it to yourself at your IME.
  • Do not discuss outside issues with anyone at the IME appointment. Talking about finances, your legal situation or anything about your insurance can come back to haunt you in your compensation claim.
  • Be aware of surveillance.  The work comp insurance company knows the date and time of the IME appointment. Generally, there will be video surveillance of you going from your house to and from the IME location.  Be on the lookout.

When at your IME, the best thing you can do is to keep your priorities set on your IME and get through your appointment. If you need more information about any aspect of your case, we can offer you the guidance you are looking for.

IME Reports (and more)

An injured worker is entitled to the IME report when it is completed.  However, there is no official timeframe on when the IME physician has to complete the report.  If the IME physician denies any aspect of your worker’s compensation claim, you have the right to dispute that IME report with the opinion from your own treating physician.  You can bring an application for hearing to overturn the IME opinion.

Also, if you refuse to submit to an IME examination, the work comp carrier has the ability to suspend your compensation.  Thus, even if the injured worker is incredibly angry that they have to attend the appointment, a refusal to attend can impact benefits legally.

Let Us Help You Through Your Claim

If you are ready to meet with someone you can depend on in your workers’ compensation claim, now is the best time to reach out to our Milwaukee office. Call us at 414-279-2647 or more information about any aspect of your case to schedule your initial consultation today.



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