Workers' Compensation
Written by: Bruce L. Weider | 7.01.2024

Don't Let the Doctor Derail You: How IME Doctors Can Impact Your Workers' Comp Claim

Being injured on the job can be a stressful and overwhelming experience. You're likely dealing with pain, lost wages, and mountains of paperwork. On top of that, you might be scheduled for an Independent Medical Examination (IME). While it may sound objective, IMEs arranged by insurance companies can significantly impact your workers' compensation claim.

This blog will explain what IMEs are, how they can weaken your case, and what steps you can take to protect yourself.

What is an Independent Medical Examination (IME)?

An Independent Medical Examination (IME) is a medical evaluation arranged by the insurance company after a worker files a workers' compensation claim. The doctor performing the IME is supposed to be a neutral third party who wasn't involved in your initial treatment. However, there can be an inherent conflict of interest, as the insurance company pays the doctor's fees. 

The goal of the IME is to assess your medical condition and determine how it relates to your work injury. This assessment can significantly impact your claim. The IME doctor will review your medical records, conduct a physical examination, and ask you questions about your symptoms and limitations. Based on this evaluation, the doctor will write a report that will be used by the insurance company to decide on your claim. 

It's crucial to understand that while IMEs are intended to be objective, they can sometimes be used by insurance companies to challenge the severity of your injuries, limit your recommended treatment, or even deny your claim altogether.

How Insurance Companies Use IMEs

Insurance companies wield IMEs as a strategic tool to potentially minimize their payout on your workers' compensation claim. Here's a deeper dive into their tactics:

  • Challenging Injury Severity: The IME doctor might downplay the extent of your injuries. They could use phrases like "subjective complaints" to dismiss your pain description or claim your limitations are exaggerated. This could lead to a lower compensation amount for your injury.
  • Limiting Treatment Options: The IME doctor might disagree with your treating physician's recommendations for further treatment, such as physical therapy or surgery. This can significantly hinder your recovery and potentially force you back to work before you're fully healed.
  • Denial by Disassociation: In some cases, the IME doctor might find no clear connection between your work activities and your current condition. This tactic, often used for repetitive stress injuries or those with a delayed onset, can lead to a complete denial of your claim.
  • Shifting Blame: The IME doctor might try to link your pain to a pre-existing condition you had before the work injury. While pre-existing conditions don't automatically disqualify your claim, they can be used by the insurance company to argue that the work injury only aggravated a pre-existing issue, potentially reducing your compensation.

It's important to be aware of these tactics and take steps to protect yourself during the IME process.

How IME Doctors Can Weaken Your Workers' Comp Claim

Beyond simply downplaying your injury's severity, IME doctors have a number of techniques they might use to weaken your workers' comp claim. 

One tactic involves focusing on the examination itself. They might rush through the appointment, leaving you feeling unheard and the evaluation incomplete. This raises doubts about the accuracy of their assessment. 

Another tactic centers around your pain description. They might use dismissive language or focus on inconsistencies between your current statements and past medical records. For instance, if you mentioned occasional back pain during a previous doctor's visit for an unrelated issue, the IME doctor might use that to downplay your current, work-related back pain. 

They might also delve into pre-existing conditions, attempting to connect your current limitations to those old issues rather than the work injury. This can significantly reduce the amount of compensation you receive. 

In some cases, the IME doctor might misinterpret your medical records entirely. It's crucial to carefully review these records beforehand and ensure they accurately reflect your condition and its timeline.

By being aware of these tactics and staying prepared, you can minimize the risk of the IME doctor weakening your rightful workers' compensation claim.

How to Prepare for an IME While Protecting Your Rights

  • Consult with a Workers' Comp Attorney: An attorney can advise you on your rights and how to best prepare for the IME.
  • Gather your medical records: Bring all documentation related to your injury, including doctor's reports, test results, and treatment plans.
  • Write down your symptoms: Document your pain level, limitations, and how the injury affects your daily life.
  • Be honest and consistent: Answer the doctor's questions honestly but avoid exaggerating your symptoms.
  • Don't discuss pre-existing conditions unless directly asked: Focus on how the work injury caused your current limitations.
  • Bring someone with you: Having a trusted friend or family member present can be helpful and provide a second witness.

What to Do if You Disagree with the IME Report?

If you disagree with the IME doctor's findings, don't stay silent. Here's what you can do:

  • Contact your Workers' Comp attorney immediately. They can review the IME report and identify any discrepancies or inaccuracies. For instance, if the report downplays your pain while you have documented complaints in your medical records, your attorney can highlight this inconsistency.
  • Gather any evidence that contradicts the IME report. This could include witness statements from colleagues who saw your injury occur, detailed pain journals you've kept, or prior medical records demonstrating a lack of pre-existing conditions.
  • Request a formal review of the IME report. Your attorney can help you navigate this process and present your case to the insurance company for reconsideration.
  • Be prepared to fight for your rights. If the insurance company continues to deny your claim based on the disputed IME report, your attorney can guide you through the appeals process or even take legal action to ensure you receive fair compensation.

Remember, you have rights throughout the workers' compensation process. By taking action and seeking legal guidance, you can challenge the IME report and increase your chances of a successful claim outcome.

Consider Legal Support

A Workers' Comp attorney can be a valuable asset throughout the entire workers' compensation process, especially when dealing with IMEs. They can advise you on your rights and how to prepare for the IME and help you gather and organize your medical records. Worker’s Comp attorneys can review the IME report and identify any discrepancies as well as advocate for you and ensure your claim is fairly evaluated.

Contact Us Today!

If you've been injured on the job and are facing an IME, don't hesitate to contact The Law Offices of Bruce L. Weider, PC. Our experienced Workers' Comp attorneys understand the challenges of IMEs and can guide you through the process. We'll fight for the compensation you deserve. Call us today at (734) 485-0535 or visit our website to schedule a consultation. We're here to help!

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If you are in need of a workers' compensation attorney, contact us today. We have a track record of success in helping injured workers obtain the compensation they deserve. We understand the challenges that injured workers face, and we are dedicated to providing compassionate and effective legal representation from start to finish.

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