Workers’ Comp Independent Medical Examination (IME): All You Need to Know
If you have been injured on the job in Maryland, your employer may ask you to submit to an independent medical examination (IME) before approving you for workers’ comp benefits. The so-called purpose of an IME is to have a neutral medical professional confirm the nature and cause of your injuries. However, employers and insurers also use IMEs to justify denying your claim. And unfortunately, workers’ compensation insurers are more inclined to trust a third-party doctor than you or the physician supervising your treatment.
So, can you do anything to improve your chances of a favorable IME report? An experienced workers’ comp lawyer can explain what to expect before your appointment and advise on the best way to respond to questions from the doctor.
Trollinger Law LLC is a proven workers’ compensation law firm in Waldorf, serving clients in Charles Country and Southern Maryland. If you sustained a workplace injury or suffer from an occupational disease, our attorneys can prepare you for the IME and strengthen your case for maximum benefits. Call or contact us now for a free consultation.
What is a Workers’ Compensation IME?
An IME is a physical examination performed by a third-party doctor after an employee sustains a job injury. The results are intended to reassure the insurer that an employee’s injuries are work-related and as severe as the worker claims.
Why Do I Need an Independent Medical Exam?
Generally speaking, an IME is not for your benefit. It is for your employer and their workers’ compensation provider. If they suspect your injuries are not work-related or not as severe as you say, they will request an IME to gather independent evidence. An employer or insurance company might also order an IME if they do not want to pay your claim and are looking for a way to discredit your case.
Am I Required to Attend an IME by Workers’ Comp Law?
If your employer’s workers’ compensation policy requires you to attend an IME, you have to go. And because most workers’ compensation policies contain language that compels employees to attend an IME if requested, the chances are good that you are legally obligated to go. If you do not attend your IME, your workers’ compensation claim will likely be denied.
Preparing for a Workers’ Comp IME
Here are a few key steps to take to prepare for your workers’ comp IME:
- Find out why you need the IME. If you have been asked to undergo an IME as part of a workers’ comp claim, the insurance company likely sent a letter to the doctor with questions or concerns about your condition. Ask to see the letter to ensure the information is accurate and the insurance company’s questions are legitimate. Submit your request in writing so that you have a record of it.
- Review your medical history. The doctor performing your IME will likely have your relevant medical records, but it’s wise to review your medical history anyway. Consider any prior injuries or illnesses that may have affected your current workplace injury. When discussing your medical history, be straightforward without exaggerating or downplaying your injuries.
- Explain how the injury or illness happened. Details matter in an IME, so take time to thoroughly review how you got hurt or became sick. Rehearsing your account of the accident or illness can help you stay consistent and avoid potentially damaging mistakes.
- Go over your symptoms and course of treatment. You do not want inconsistencies between the symptoms you described to your treating physician and what you say in an IME. Reviewing your past and present symptoms can help you stay consistent during the exam. Providing an overview of the treatment you have already received is also helpful, even if the doctor performing the exam has your medical records.
- Dress neatly and professionally. Your appearance should not affect the outcome of your exam, but look presentable anyway. Bring any devices or equipment you need as part of your treatment, such as a sling or crutches.
- Be on time. Lateness will not start the IME off on the right foot.
- Bring a trusted friend or relative. If possible, it is a good idea to have someone else in the exam room with you. While they shouldn’t say anything during the exam, they can take notes and provide emotional support.
What Do Doctors Look for During an IME?
An IME is not just another doctor’s appointment. The physician performing the exam is looking for answers to specific questions or concerns raised by the insurance company, such as:
- Signs of deception or fraud
- Proof that the injury or illness is work-related
- Whether your condition is as severe as you say
- If your injury or illness prevents you from working
- Whether further treatment is necessary
- Whether you have any pre-existing conditions
- What treatment you may need in the future
- Whether the treatment you are currently receiving is appropriate
After the exam, the IME doctor will submit a report to the insurance company offering a medical opinion about your injuries and whether you have a valid workers’ comp claim.
What to Do During the Exam
What you do during an IME is even more important than how to prepare for it. Here are a few IME tips to keep in mind:
- Answer the doctor’s questions honestly. Never exaggerate or underplay your injuries.
- Be polite.
- Be upfront about your past and current symptoms.
- Clarify how a prior condition may affect your current injury or illness.
Honesty always matters when it comes to an independent medical examination. If the doctor suspects any deception, you could undermine your claim.
Next Steps After the IME
The next steps after a workers’ comp IME depend on what the doctor says in their report. If the IME doctor agrees with your doctor, your claim will likely be approved, and you should start receiving workers’ comp benefits. But if the IME doctor’s report disputes your statements, you could face a claim denial. A workers’ comp lawyer can discuss your options to appeal an unfavorable workers’ comp decision.
Talk to a Workers’ Compensation Attorney First
You deserve financial support if you suffer from a work injury or occupational illness. An independent medical examination could threaten your ability to collect the workers’ compensation you deserve. Protect your claim by talking to a Maryland workers’ comp attorney before an IME. Call or contact Trollinger Law LLC for a free case review.