If you suffered injuries on the job and receive workers’ comp benefits, the insurer may require an objective medical review, an independent medical exam, or IME. An IME is an impartial medical evaluation by a doctor other than your treating physician. Your employer or the insurer selects this doctor to offer an opinion about the nature and extent of your injuries.
An experienced workers’ comp attorney in New York can assist in all aspects of your work comp case, including answering questions about what an IME is in a workers’ comp case and the IME evaluation process.
What Is an IME in Workers’ Compensation?
An IME is necessary in many workers’ compensation cases in New York. An IME aims to obtain an objective opinion about your injuries, including whether surgery or further medical treatment is necessary. At an IME appointment, you can expect an in-depth physical exam and interview by the doctor. They will also carefully examine your medical records and evaluate your complete medical history before determining whether your injury occurred at work or existed before.
Please read more about the medical history here: Why Your Medical History Prior to Your Work Accident Is So Important
If the doctor concludes you didn’t get injured at work, their report will indicate that your employer was not responsible for your workplace injury. In other words, your injuries were not due to your job duties. This highlights why it is critical to have a knowledgeable workers’ comp attorney who can prepare you for the workers’ comp medical review. They will advise you about what to say at an IME to ensure you accurately communicate your medical history. You can trust your lawyer to assist you throughout the process to help you receive the benefits you deserve.
How an IME Can Affect Your Workers’ Comp Claim
Because the employer and their insurer choose and pay the IME doctor, it is not unusual for them to issue an IME report in favor of workers’ compensation. Sometimes, a workers’ comp claim is denied after an IME because an unfavorable report is issued despite the existence of medical records that support your workplace injury report. In other words, your treating doctor and the IME doctor have conflicting opinions about the extent of your injuries and how they occurred. This may require a second opinion, as explained below.
Although you may be nervous about the IME, you must submit to it if requested in your case. Why? Failure to do so could result in your workers’ compensation benefits being terminated. At Fusco, Brandenstein & Rada, P.C., we understand how stressful an IME can be and that you might worry about terminating your benefits. We can help you prepare for an IME so you know what to expect and are ready to fully and completely answer the IME doctor’s questions.
Tips for Preparing for an IME
If you receive an IME scheduling notice, you will understandably want to know what happens at an IME and the role of the IME doctor.
The doctor performs a physical exam at the IME while discussing with you how the work injury occurred. During the appointment, you can expect the IME doctor to ask about your symptoms and the pain you experienced after the accident that caused your injuries. They will also question you about your medical history, including any other injuries you have suffered (whether at work or outside of work). These questions are appropriate because, as the doctor evaluates your work injury, they can investigate whether you have suffered a similar injury. For example, if you sustained a neck injury at work, the doctor will review your medical records to see if you have complained of neck pain in the past or were in a car accident or other incident in which you injured your neck.
An IME differs from a traditional medical appointment because it doesn’t establish a doctor-patient relationship. Because your employer (or their insurer) selects the IME doctor to conduct the examination, the doctor may disclose the otherwise confidential information you share during the IME.
At Fusco, Brandenstein & Rada, P.C., we can help you through the IME process, including offering tips for the appointment. We understand this process may be confusing, and you may be unsure how the IME may impact your workers’ comp benefits decision.
What Does an IME workers’ comp Conflict Mean for Your Case?
It is possible for the IME doctor’s opinion to conflict with your treating doctor’s evaluation of your injuries. If the doctors disagree about the extent and causation of your work injury, a dispute can arise that could potentially impact your work comp benefits. Specifically, the work comp insurer may exclusively rely on the IME’s doctor’s opinion to deny or reduce your benefits.
Because a conflicting IME opinion can harm your case, it is essential to have an experienced workers’ compensation lawyer who can advocate on your behalf. For example, they may discover a basis to argue that the information you reported to your treating physician, which your relevant medical records reflect, does not truly conflict with the information you provided to the IME doctor. In other words, the purported inconsistencies should not affect your eligibility for benefits because they are not direct contradictions.
When Should You Seek A Second Opinion?
You may need a second opinion if a dispute arises between the IME report and your treating physician’s opinion. For example, suppose the IME doctor indicates you have reached maximum medical improvement, but your doctor recommends surgery. In that case, another opinion may be necessary so the parties can further evaluate your current physical status and whether workers’ comp would cover the surgery (if required).
Contact a New York Workers’ Compensation Attorney Today
At Fusco, Brandenstein & Rada, P.C., we know how difficult it can be to obtain the necessary workers’ comp benefits you need after you have been hurt on the job. With a workers’ comp attorney in New York from our firm on your side, you can be confident you have an advocate fighting for the benefits you deserve.
Our team is here to help you understand your rights and take the first step toward securing the necessary benefits. If you need assistance with an IME and workers’ comp settlement, contact us today at 516-496-0400 to speak to an attorney in a free, confidential consultation.
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