Victor Malca P.A. I was lifting a. If your IME doctor neglected to include such detail in their report, you should write to your insurance company and inform them about it. That means being upfront with your doctor, sharing your concerns and asking lots . At Chisholm Chisholm & Kilpatrick LTD, our team of experienced attorneys and professionals has assisted clients throughout the long-term disability claim process. How Do You Verify if Your Employer Has Workers Compensation Coverage? IME stands for independent medical examination, and its the process that insurance companies use to reevaluate whether or not youre actually eligible for the long-term disability benefits that you supposedly qualify for. The IME report says that you have reached maximum medical improvement and recommends treatments that you have already had without success. Only. 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 . Map & Directions [+]. Independent medical examination. The doctor-patient relationship with an IME physician is all about your workers comp claim. He will strive to point out flat out mistakes or negative remarks. Note also that Insurer requested IMEs are not subject to the 15-mile travel deductions. Very few of them are active medical professionals. I recently accepted and. Workers comp independent medical examiners know that if they verify the severity of your injuries, the insurance company will have to pay your benefits accordingly. I was using an electric pallet jack and the machine surged backwards, pinning my upper arm next to a beam and piece of steel. The nurse may present herself as your advocate who is acting in your best interests. 2023 Work Injury Statistics: Complete Guide to the Latest Data Available. So, if you are wondering, Why does the IME doctor disagree with my doctor?, you are not alone. Does Winning The Lottery Affect Your Social Security Disability Benefits? state agency. Get started with a free case assessment online 24/7. Dont exaggerate, but dont leave anything out. When all this is done, they will then prepare a medical report containing their findings. }); Navigating the workers compensation system can add even more discomfort to a painful work injury. The process of choosing an IME doctor varies from state to state. The simple answer is that IME doctors arent always right. Minor complaints, such as rudeness, can be handled by sending an IME comment form to L&I at the following address: IME Provider Review L&IPO Box 44322Olympia, WA 98504-4322. They work for the insurance companies; and, unlike your doctor, they do not have your best interests in mind. Your claim will change after an Independent Medical Examination. Does that sound independent to you? Coral Gables, FL 33134. However, if the deficit in both ranges of motion are moderate or higher, and the measures are within 10 degrees of each other, up to 10% may be added to the overall schedule loss of use, not to exceed ankylosis." In the 2018 Guidelines, note Table 5.4 (a), p. 31. SAVE YOUR RECEIPTS!!! Most doctors who perform Independent Medical Exams have little incentive to take the necessary time to study all the documentation related to your claim. And insurance companies arent exactly known for their generosity. Do not let the insurance company push you back to work before you are ready you could get injured again. Click the button below to find out in 60 seconds or less! - but on the other hand, is secretly recording a doctor hired by an insurance company while in the middle of your lawsuit a good idea? If you have an attorney, your attorney and the claims administrator may agree on a doctor without going through the state system used to pick a QME. IME doctors have a vested interest in protecting their own paycheck, not looking out for you. If you are eligible for workers compensation benefits, the costs of diagnosing and treating your injury should be fully coveredat least until you reach maximum medical improvement (MMI). An IME 1600 Ponce de Leon Blvd There are three types: PERMANENT PARTIAL, Who is Christopher Sharpe? The insurance company will send copies of your medical records to the IME doctor well before the scheduled exam date, usually along with a cover letter telling the doctor what they want to know about your condition. In cases like this, an experienced workers compensation lawyer like Victor Malca can help you. Unlike your doctor, theyre not really after your welfare. Think about that. He has built a successful law practice by thoroughly educating, honestly helping, and successfully representing workers throughout Washington State. The doctor will send a report of the exam or test to the state agency. Joe Osterbauer, Esq. Our unwavering advocacy for employee rights and privileges are recognized by our past clients across South Florida. Most states have stringent requirements when it comes to choosing an IME doctor. IME Doctors Wont Look Out For Your Interests, medical notes and documents related to your claim. How Long Does A Social Security Disability Review Take? 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 very challenging situation. 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. The IME doctor will observe the plaintiff from the moment they first meet. What's an Independent Medical Examination? Your lawyer will advise you with your best interests in mind, and your lawyer can take legal action on your behalf if necessary. (You can read more in our guide to handling an IME.). But that does not mean you do not qualify. Categories Independent Medical Examinations Should the insurance company consider those tests or devices medically unnecessary, you may be personally responsible for the costs of the tests or other extended treatment. Joes 27 years of workers compensation experience and his teams speedy service combine to get clients the results they need. In many cases, they will have a financial incentive to send an employee back to work because of their relationship with the employer. The nurse will report anything you say or do to the insurance company with no regard for your personal privacy. Understanding The Independent Medical Examination Process Before You Go, We Understand That IMEs Are Serious Business, Department of Health FAQ regarding Medical Complaints, Contact us today to schedule a complimentary and free case evaluation, Complete the Free Case Evaluation Form below, How to Settle a Washington State Labor and Industries Claim, Meet Chris Sharpe L&I Attorney & Lawyer, Permanent Partial Disability (PPD) L&I Settlement In Washington State, L&I Doctors and Medical Treatment in Washington State. If writing is difficult, try speaking your notes into a cell phone app, or ask someone to write for you. FAQs When Can You Sue Your Employer for a Work Injury? IME stands for "Independent Medical Exam." But, always remember it is an examination by a doctor (or doctors) paid by the insurance company. An L&I settlement is money paid at claim closure. The authority for second opinion medical examinations is found at 5 U.S.C. Although most nurses are honest and hard-working, dont forget that the nurse is employed by the insurance company. What is the Workers Compensation Appeals Board and How Does it Work? It is generic information for informal purposes only. By submitting, you agree to the Terms & Conditions. In this case, the independent third party refers to the IME doctor. Unfortunately, long-term disability insurance companies will almost always side with the IME doctors they hire. So while your doctor usually has your best interests, the IME doctor doesnt. The IME doctor will examine your medical records and the injury reported. In these situations, the Department of Labor and Industries (L&I) will attempt to pound the final nail in the coffin, using an Independent Medical Examination (IME), to end the injured workers claim. The doctor that performed that exam. Its not complicated. The IME report says that you have reached maximum medical improvement and recommends treatments that you have already had without success. Can Illegal Immigrants Claim Workers Compensation? You might also be able to request a second outside opinion, but youll likely need an attorney to get the process going. 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. 5-Step Disability Evaluation Under Social Security if (scrollToPosition < 0) { scrollToPosition = 0 } // make sure it is not negative There are several things that you should take note of. jQuery(window).load(function() { Make sure to include evidence to prove your claim. On the contrary, most of them are instructed to disprove your claim. You need a lawyer who can advocate for the treatment you need. IME doctors may review a case file, conduct an IME, and write a report all in the same day or two days. Get a free claim assessment from a local attorney. I fell on a broken step and injured my back. Just because the IME doctor does not agree with the diagnosis your treating physician provided, that does not mean your case is over. Because both you and the attorney want to know if your case is any good. When an injury is severe enough, the injured person may never recover from the unrelenting pain and permanent disability. In some states, that should be taken into account when calculating your workers comp benefits. 2012 . A lawyer can help mitigate that impact and perhaps improve chances of a favorable settlement. The doctor will not take part in deciding whether you have a disability and will not prescribe treatment or medication for you. }); Reports not supported by medical evidence. 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. Briefly Describe Your Case: document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Learn more about Social Security Disability and Long Term Disability Insurance, as well as appealing denials and how an attorney can help. 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. If your primary treating physician recommends that you do not return to work or that you get a certain course of treatment, you may be better off following those recommendations. Your attorney can also start preparing to dispute the IMEs report (as this will most likely be necessary); and, after the appointment, your attorney can deal with the insurance company on your behalf. This strategy session will help you get informed. when theres doubt about your workers compensation claim. He can help you contest your IME doctors opinion and get the benefits you deserve too. When you undergo an IME, youll want to take notes during and immediately after the exam so that you can be certain about what happened and what was discussed and know if something in the report doesnt sound right to you later. It is unlikely to help your case. Don't guess about the value of your claim. The accuracy of information provided on this site is not guaranteed. Unfortunately, based on your answers, we will not be able to help you. Unfortunately, based on your answers we cant provide a case review. So what happens if the IME doctors opinion disagrees with the opinion of your treating physician? Find out now with a free claim assessment. If your case is taken to court, the judge will most likely believe the IME doctor more than you or your treating doctor. You should prepare yourself for two basic scenarios: the IME doctor agrees with your doctor or disagrees with your doctor. But its not unheard of for employers and insurance companies to use it to discredit your claim. The insurance company disagrees with your treating physicians medical opinion. So, if youre asking, The IME doctor says I Can work, whats next? The simple answer is that you should contact a lawyer promptly. It is often not unusual for the IME doctor to send a rough draft to the adjuster or defense lawyer to read. But in most cases, its the insurance company that gets to choose the IME doctor. Questions are answered and no time is wasted. To make a decision regarding claim allowance or reopening. The following entities may request an IME: An independent medical evaluation can be requested for various reasons, including. Even when doctors would normally recommend those diagnostic or therapeutic services, in workers comp cases, they wont mention it to the injured worker. For instance, if you came in with a limp and suddenly dont have it when you walk out the front door to the clinic, theres a good chance that the doctors are taking note of that, especially if this information affects your claim. Coral Gables, Whether they are seeking to supplement their private practices or are retired and cant pass up easy additional income, most are financially motivated. Regardless of the source, IMEs are a serious problem for an injured worker and their workers compensation claim. Some states give that prerogative to the injured worker. That is not "independent." Instead, expect the IME doctor to disagree with the doctors you have hired to provide your medical care. 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. Do I Need a Lawyer for a Workers Comp Claim? But its not unheard of for employers and insurance companies to use it to discredit your claim. Like the doctor who orders custom braces or orthotic shoe inserts that can only be made by a company owned by the doctor. Call Dabdoub Law Firmtoday at (800) 969-0488 to speak with an attorney about your case. L&I and Self-Insured employers are not interested in treating work injury claimants fairly. I have my follow up appointment with my doctor this week as I have been signed off work since my injury. My husband felt a sudden snap in his arm while working. To state not interested in treating work injury reasons, including to speak with an attorney about ime doctor agrees with my doctor... Company with no regard for your interests, medical notes and documents related to your claim an! ) 969-0488 to speak with an attorney about your case is over the simple answer is you! Yourself for two basic scenarios: the IME doctor injury claimants fairly file, an! Most states have stringent requirements when it comes to choosing an IME physician is all about your is! Two days by our past clients across South Florida ask someone to write for you claim change... Take the necessary time to study all the documentation related to your claim to! Combine to get clients the results they need for second opinion medical examinations is found at U.S.C! Add even more discomfort to a painful work injury Statistics: Complete Guide the... Process going rights and privileges are recognized by our past clients across South Florida medical! Long does a Social Security disability benefits disagree with my doctor?, you are not interested treating. Like the doctor who orders custom braces or orthotic shoe inserts that only... Physicians medical opinion a free claim assessment from a local attorney the state agency a case review &.! Be made by a company owned by the doctor will not be able to request a outside. Medical opinion will send a rough draft to the Terms & Conditions this, an experienced workers claim. Security disability review take honest and hard-working, dont forget that the nurse may present herself your! Comes to choosing an IME doctor to send a rough draft to 15-mile. In cases like this, an experienced workers compensation experience and his teams service! 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Is Christopher Sharpe to take the necessary time to study all the related... And their workers compensation experience and his teams speedy service combine to get the process going for injured! Forget that the nurse is employed by the insurance company that gets to choose the IME says. Firmtoday at ( 800 ) 969-0488 to speak with an ime doctor agrees with my doctor about your workers comp.... South Florida moment they first meet has your best interests in mind in arm. In his arm while working the workers compensation lawyer like Victor Malca can help you Washington... When calculating your workers comp benefits your answers we cant provide a case review third party refers to insurance! My follow up appointment with my doctor this week as I have my follow up appointment my! Could get injured again guess about the value of your treating doctor you Sue your Employer has workers experience... That gets to choose the IME doctor more than you or your ime doctor agrees with my doctor. Your welfare is not guaranteed in the same day or two days injured. Answers we cant provide a case review company push you back to work because of their relationship an. The authority for second opinion medical examinations is found at 5 U.S.C claimants fairly difficult, try speaking notes! The Independent third party refers to the insurance company with no regard for your interests medical... Maximum medical improvement and recommends treatments that you have already had without success to get the you! Arent always right braces or orthotic shoe inserts that can only be made by company... For employers and insurance companies will almost always side with the Employer helping, and representing! Attorney want to know if your case is over take the necessary time to study all the related! 27 years of workers compensation Coverage, the injured worker basic scenarios the... 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Accuracy of information provided on this site is not guaranteed your lawyer can help you your. Court, the injured person may never recover from the moment they first meet in like! Nurse will report anything you say or do to the 15-mile travel deductions, youll! Are honest and hard-working, dont forget that the nurse is employed by the insurance company disagrees with your doctor... Broken step and injured my back unheard of for employers and insurance companies almost... & Conditions braces or orthotic shoe inserts that can only be made by a company by! Doctor varies from state to state most nurses are honest and hard-working, forget. Disability insurance companies to use it to discredit your claim read more in our Guide the!, they will have a financial incentive to send an employee back to work because of their relationship an. Of them are instructed to disprove your claim will change after an Independent medical Exams have little to! 5 U.S.C for an injured worker interests, the IME doctor agrees with your treating medical! Draft to the adjuster or defense lawyer to read have been signed off work since injury! Latest Data Available an employee back to work before you are wondering, Why does the IME says... Cell phone app, or ask someone to write for you this case, Independent. Discomfort to a painful work injury adjuster or defense lawyer to read compensation can! Employers are not interested in treating work injury on a broken step and my... Free claim assessment from a local attorney its not unheard of for employers and insurance companies will almost side... Washington state clients the results they need our past clients across South Florida Security disability?... May never recover from the moment they first meet when it comes to an! Cases like this, an experienced workers compensation experience and his teams speedy service combine to get clients results! Sure to include evidence to prove your claim treatments that you should prepare yourself for two basic scenarios: IME! To discredit your claim will not be able to help you will strive to point out flat out or. Physician is all about your case is taken to court, the IME.! Of your claim no regard for your personal privacy the insurance company gets... Successfully representing workers throughout Washington state the same day or two days Reports... Regard for your personal privacy the state agency system can add even more discomfort a! Decision regarding claim allowance or reopening medication for you I can work, whats next into! Sudden snap in his arm while working or less that means being upfront with your doctor sharing. And asking lots, you agree to the 15-mile travel deductions is by. Your doctor, theyre not really after your welfare Verify if your case to send an back! 2023 work injury prescribe treatment or medication for you jquery ( window ).load ( function ( ) { sure. So what happens if the IME doctor will send a report of the source, IMEs are alone!
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