I WAS SCHEDULED FOR AN INDEPENDENT MEDICAL EXAMINATION, FOR MY WORK ACCIDENT, NOW WHAT?
You might be freaking out when you hear you were not only deposed—but you are now being scheduled for a workers’ compensation independent medical examination (“IME”) by the workers’ compensation insurance carrier. This can be a nerve-wracking experience and the stakes are high at these examinations; that’s why it is important to know how IMEs work and what to expect during your IME examination. The results of these IMES play an important part in your claim and in some cases, can be the primary basis of a judge’s decision on whether or not to grant or deny your benefits.
WHAT IS AN IME?
With that being said, you may ask what exactly happens at my IME and why do I need to go. Put simply, an IME is an “impartial” medical examination and assessment that is conducted when there is a dispute (whether it be related to wages or medical treatment and recommendations) arising from your workers’ compensation claim. The exam is performed by a licensed medical practitioner at the request of either party (you or the insurance company) and the right to choose the IME doctor lies with the person who made the request. Sometimes, you may have to attend two IMEs, if you and the insurance company both elected to use an IME.
PLEASE, TELL ME MORE ABOUT IMES!
So, you went to your IME scheduled by the workers’ compensation insurance carrier and didn’t like the doctor or he didn’t treat you fairly (surprise!). The good news is that an IME can only opine as to what medical treatment you may need (or don’t need) and whether or not you may work (and what kind of work you can do, for how long, etc). In other words, and IME can only make recommendations and your examination with this workers’ compensation insurance carrier IME is just that, an examination. They cannot treat you and you will likely not have to see them again throughout your case.
Also, regardless of which party elected to use their IME, the IME doctor should only give an opinion within their area of expertise. In other words, if your IME doctor is a licensed orthopedist, their opinion is only valid in so much as it pertains to your orthopedic injury. For example, some clients may have various issues stemming from their work accident (orthopedic treatment, neurological treatment, and psychological treatment), but if a party elects to use an IME for orthopedic purposes, they cannot render an opinion as to any neurological and/or psychological conditions.
Also, very important to remember is that both parties are only entitled to one IME per accident and not per specialty. For example, in the example given above, if a person is receiving orthopedic treatment, neurological treatment, and psychological treatment, and one party elects to use an IME, it can only be either for the orthopedic treatment, neurological treatment, and psychological treatment—not all of the above!
IS MY IME DOCTOR TRULY INDEPENDENT?
If you are ever scheduled for an IME by the workers’ compensation insurance carrier, it is important to remind the IMEs aren’t really that “independent” or subjection. Since the workers’ compensation insurance carrier is allowed to choose their “independent” doctor, they often try to exploit injured workers during the examination for their own gain. For example, let’s say there is a dispute as to whether or not your back injury is “pre-existing” rather than work-related. Let’s further say the workers’ compensation insurance carrier elected to use their IME to prove your back injury is pre-existing, and the information received at this examination, could be used on front of the judge who may or may not agree with them. This is why it is imperative for an injured worker to know their rights under the Florida Workers’ Compensation System (AKA “Workmens Compensation”) so as not to prejudice or harm their case.
Once the workers’ compensation insurance carrier has notified you, through your workers’ compensation attorney, that you are scheduled for an IME, there are other key points to keep in mind. To attend an IME, the workers’ compensation insurance carrier must notify you of your examination in writing at least seven days prior to the examination date. If, for whatever reason, you are not able to attend the examination on the date it was scheduled for, you must inform the workers’ compensation insurance carrier at least 24 hours beforehand (however, some doctors may require more notice). Any failure to appear at your examination without a valid reason may prevent you from receiving further compensation and the workers’ compensation insurance carrier can charge you 50% of the cancellation or no-show fee (ouch!).
IME DOCTOR SELECTION.
Another key point to remember, is that per the Florida Workers’ Compensation Statutes, once you attend an IME, you must inform the opposing party of your choice within fifteen (15) days from the date of your examination. This point is crucial and failure to do so can render any results of your IME invalid—which means any results and opinions rendered as a result of your IME would be inadmissible. This is vital and can have tremendous impact on your case. That’s why it is important to speak with an experienced Florida workers’ compensation attorney who knows the law and can protect and fight for you.
WHO IS GOING TO PAY FOR MY IME?
You may now be saying, okay, okay, I am going to the IME but asking yourself, who will pay for this examination? According to Florida Workers’ Compensation Statutes, the IME costs shall be paid by the party who requested the IME. This includes any and all doctor’s fees, charges for medical/diagnostic tests, and other relevant costs. You may now be thinking “wow that sounds expensive!” However, at Pena Law Group, P.A., we pay for all your costs associated with attending an IME, should we be the ones to select one. There is another good thing, which is if we prevail against the workers’ compensation insurance carrier after you’ve had your IME, the examination itself and all related expenses shall be paid for by the workers’ compensation insurance carrier.
HOW DO I BEST PREPARE FOR MY IME?
The first step is to know why you are there! Why did your attorney or why did the workers’ compensation insurance carrier send you to this examination? What exactly is being denied or what are they contesting? With this being said, you need to make sure you have a solid understanding of the timeline of events leading up to your IME.
A few important things to know are: When and how did your accident happen? When did you start experiencing symptoms? What medical treatment have you received? How much time have you missed from work? What are your current physical limitations and symptoms you’re experiencing? Also, if you’ve had any prior accidents (whether work-related or a car accident), be sure to also mention this to the IME doctor and when the problems related to any potential prior accident resolved. Also—very important—know that you may be watched or even followed as you go to your IME.
HOW DO I CONDUCT MYSELF AT THIS IME?
Try to arrive to your IME early. Once you’re there, be polite and respectful to the doctor and the staff (even if you’re not happy to be there!). If you’re asked to fill out any questionnaire, be honest! However, it is always best to consult with your lawyer before your IME so you know if a question on the questionnaire may be potentially intrusive or irrelevant. Nonetheless, a safe approach is to answer relevant questions about your injury, medical treatment, and current limitations (but, keep it brief!).
HOW SHOULD I CONDUCT MYSELF DURING THE IME?
First off, be truthful. While it may be potentially difficult, try not to exaggerate any symptoms or limitations you may have. For example, if the IME doctor asks how you’re feeling, don’t say “terrible, I can’t even walk.” In most instances, the second half of this statement is not true. You have to remember an IME hired by the workers’ compensation insurance carrier is looking for any and all ways to diminish your credibility but if you’re honest, it will be harder for them to say you’re trying to “milk your comp claim.”
Next, be consistent. The IME doctor may ask you many questions and it is important that all your answers match all your prior medical records, accident reports, and any statements you may have given. However, if you notice the doctor asking you the same questions repeatedly, then the IME doctor likely does not believe you and is looking to trip you up. At that point, you can kindly tell the doctor you have answered this question.
Lastly, since the IME doctor is not your treating physician, there is no doctor-patient confidentiality—which means anything you say during your exam will be related to the workers’ compensation insurance carrier! Therefore, don’t volunteer information and don’t ask for advice. Remember the IME doctor is just there to assess your condition and given an opinion on the issues in dispute.
ABOUT THE AUTHOR-ASHLEY C. PENA, ESQ.- FLORIDA WORKERS’ COMPENSATION & PERSONAL INJURY ATTORNEY
Ashley C. Pena, Esq. has many years of litigation experience in Florida Workers Compensation and personal injury lawsuits. Mrs. Pena is a zealous advocate for her clients and will always fight for their rights. She offers free consultations and speaks Spanish. Call today to see how Pena Law Group, P.A. has helped countless individuals fight “the big guys” throughout the State of Florida and see how we can help you today.