It isn’t required but the insurance company may want it before they settle. Since settlement can only occur if both sides agree and they won’t settle without it, then for all intents and purposes you need to undergo the IME. But be sure you have consulted with a certified workers compensation attorney before considering any settlement.
Full Answer
Why would a Workers’ Compensation judge order an Ime?
In some cases, a workers’ compensation judge may order an IME if they believe it will resolve a medical dispute between you and the insurance carrier. Although insurance companies claim they pick independent doctors to conduct IMEs, this is a fallacy.
When will workers comp offer a settlement for my case?
When Will Workers Comp Offer a Settlement? When a worker gets injured on the job site, among the first (and most popular) questions asked is: When will workers comp offer a settlement? The usual timeline for settling a workers compensation case is 12-24 months, with the average case settling in about 16 months.
Do injured employees have to show up for an Ime?
Yes, injured employees who are ordered to undergo an IME must show up, or risk losing their workers compensation benefits. Though workers compensation rules vary from state-to-state, all of them allow for a “second opinion” on the status of an injured worker. In many cases, that “second opinion” is an IME.
What is a workers’ comp independent medical examination (IME)?
If the employee submits a workers’ comp claim, the employer’s insurance company may ask the injured worker to have an independent medical examination (IME). A doctor chosen by the insurance company will perform the examination.
What is the purpose of an IME?
An IME is an independent medical evaluation that is used to resolve questions about your medical condition for purposes of a workers' comp claim. States have different rules on who chooses the doctor to perform the IME. In some states, the insurance company picks the doctor.
What is the difference between IME and Qme?
An AME physician is usually a QME, but does not have to be one. In California, an Independent Medical Evaluation (IME) is an exam by a physician involving an injury that is not work-related.
How long does it take to get an IME report back in Pennsylvania?
Generally, the IME report is sent to the insurance company within 30 days or so of the examination. That does not mean that you or your workers' compensation attorney will receive it right away though. If the case is in litigation on a contested Claim Petition, your attorney should get the report pretty quickly.
How do you dress for an IME?
While you don't need to dress up for an IME, it's a good idea to come freshly showered and well-groomed, wearing clean and appropriate clothing. Bring someone with you. If you are nervous, see if you can get a friend or relative to come with you to your IME appointment.
How long after Qme is settlement?
Generally the QME gets the report back to you within 30 days. You then use that report, assuming you are at Maximum Medical Improvement, to get a settlement. This isn't something you should do on your own, having representation is important...
What does a Qme look for?
A workers' compensation adjuster may request that you see a QME if there is a question as to an element of your injury such as the extent of your injuries, the extent of any resulting disability, or the likely cost of treatment.
What should you not say in an IME?
What Not to Say to the Independent Medical Examination DoctorDo not ask the physician for a diagnosis. ... Do not exaggerate the symptoms of your injuries or occupational illness. ... Avoid saying more than you should.
What happens after an IME in PA?
After the doctor has conducted the IME, they'll write a report detailing the results. It will address concerns noted by the insurance company, such as whether you can perform certain activities.
What is the purpose of an IME quizlet?
What is the purpose of IME? To confirm that an individual is permanently disabled.
What can I expect from IME?
What should I expect from the IME? The IME doctor will likely begin by asking you general questions about your injury, the work-related incident that led to the injury, and your medical history. The doctor may also conduct some exams and tests to assess your injury.
What do you say in an IME?
First and foremost, always tell the truth! It's important to be completely honest at your IME and tell the truth about anything you are experiencing. Defense teams and insurance companies make it their priority to deny or limit coverage in workers' comp claims.
How do you pass a disability physical exam?
1:008:04Seven tips for a Social Security disability medical exam - YouTubeYouTubeStart of suggested clipEnd of suggested clipSo one key step to doing that is not going to the exam. Alone bring an advocate a loved one a spouseMoreSo one key step to doing that is not going to the exam. Alone bring an advocate a loved one a spouse have the advocate take notes write down each move that the doctor. Makes.
What happens during a QME exam?
They will examine you and all your medical records to determine the extent of your work-related injury. They will decide if you have any permanent disability and what future medical care you may need. It is important that the doctor has all your medical records.
What is the next step after a QME?
What Happens Once the QME Report is Completed? The QME should send copies of the report to you, your attorney, the claims administrator, and the Division of Workers' Compensation Disability Evaluation Unit (DEU). The DEU should issue a rating of your injury within 20 days.
What happens at QME?
What Does the QME Do? The QME will receive a complete copy of your medical records from the insurance provider. The QME will then take a history of your injury and do a physical examination.
What happens after seeing a QME?
Settlement After QME & What Happens After QME Report The QME has 30 days from your examination to issue a medical report. If you have an attorney, the QME will send a copy of the report to your lawyer and the claims administrator.
Why do insurance companies ask for an IME?
An IME helps in resolving doubts about your medical condition. Usually, it’s the insurance company that asks for an independent examination. They do this when they disagree with a decision your treating doctor made or the general treatment course. This happens especially when the doctor recommends an expensive procedure or surgery.
How Will an Independent Medical Examination Affect Your Work Comp Case?
After the conclusion of the IME, the doctor will write a report on what they believe your medical condition is. The report will also clarify the disputed issues and answer questions raised by the insurance company. Either you or your lawyer will then receive a copy.
Who Chooses the Doctor for an Independent Medical Examination?
Ordinarily, an IME is supposed to be an objective assessment of your medical condition. It is supposed to cover the treatment you need and whether you’ll be able to work in the future. However, the objectivity of these results depends on who chooses your doctor.
What to do if you notice a factual mistake in your IME?
However, if you notice a factual mistake with the report, you should write a statement to the insurer and the doctor. Also, support it with your medical records, and get your workers’ compensation lawyer involved. Your lawyer will protect your interest, file an objection, schedule a deposition to question the doctor, or request another examination.
How to combat work comp?
You can combat these by requesting a different independent evaluation or getting your work comp lawyer involved. Also, an attorney is used to dealing with insurance companies and can detect when they are acting in bad faith. The lawyer would also protect your rights during the entire process.
Does IME affect workers comp?
The IME result usually has a significant impact on your workers’ comp case. This is because workers’ compensation judges and commissioners see IME doctors as experts. They also see them as more objective than treating physicians and place tremendous value on their reports.
How long does it take for an IME to be issued?
As a result, a doctor’s report could take anywhere from a few days to a few weeks to be issued.
What happens if your IME doctor disagrees with your doctor's opinion?
If the IME doctor disagrees with your doctor’s opinion or of your medical condition, your workers’ compensation benefits can be affected. Having an experienced workers’ compensation lawyer guide you through this process can be very beneficial in determining your rights with practical legal advice.
When are IMEs Conducted?
Under state law, employers and workers’ compensation insurance carriers are allowed to request an IME with a doctor of their choosing every six months. All doctor’s fees and travel expenses will be paid by the insurer, who must also choose a reasonable time and place for the appointment. Patients are also allowed to ask a friend or relative to accompany them, although they are not allowed to record or tape the exam without the doctor’s permission.
What is IME report?
IME reports carry a substantial amount of legal weight, as they are often used as evidence at subsequent workers’ compensation hearings to establish an employee’s degree of permanent disability or how much he or she should receive in benefits.
What happens when you get injured at work?
When employees are injured at work, they typically go to their usual treating doctor who will make decisions about the course of medical action, and whether returning to work is an option. However, there sometimes can be disputes in a workers’ compensation case, and your employer’s insurance company may ask that an independent medical examination ...
What does it mean when an employee has reached maximum medical improvement?
Whether the employee has reached maximum medical improvement, which means that he or she is not expected to make further progress, even with additional treatment.
Can an employer stop paying workers compensation in PA?
Because attendance is mandated by state law, employers are allowed to stop issuing benefits to an injured worker if he or she fails to attend the examination without justification.
Why do workers compensation judges order an IME?
In some cases, a workers’ compensation judge may order an IME if they believe it will resolve a medical dispute between you and the insurance carrier.
What is an IME in workers comp?
If the employee submits a workers’ comp claim, the employer’s insurance company may ask the injured worker to have an independent medical examination (IME). A doctor chosen by the insurance company will perform the examination.
What Is an Independent Medical Exam (IME)?
If you’ve been injured on the job and asked to undergo an IME, the first thing you need to understand about the examination is that it’s not independent. A doctor chosen and paid by the insurance company examines you. They then give the insurance company their opinion about your injury. The doctor’s opinion includes the cause of your injury, your disability, your ability to work and any future medical treatments you may require.
How Will an Unfavorable IME Impact My PA Workers’ Comp Case?
You, or your lawyer, can challenge the findings of an IME, such as when:
Why Am I Required to Attend an IME?
Here is what you need to know: If you refuse to attend an IME, the insurance company may hire a lawyer to take you to court to stop your benefits. Your benefits should not be stopped without a hearing.
What Should I Tell the Doctor During an IME?
If there is one good piece of advice about speaking to a doctor during an IME it’s stick to the facts:
How often do you have to submit an IME in Pennsylvania?
Under Pennsylvania law, an insurance company can only ask you to submit to an IME twice a year. The doctor performing the IME will receive all relevant medical information before the examination.
Who requests an IME?
However, in the last few years, the worker’s attorney is just as likely to request an IME and for exactly the same reason: they disagree with the treating doctor.
Where do you go for workers comp?
A survey of workers comp rules for all 50 states shows that in 23 states, you must go to the doctor or clinic designated by your employer or insurance carrier for initial treatment. In 24 states, you can be seen by a doctor of your choice, but in some cases, only for the first visit, then you must go to the one designated by your employer or insurance carrier.
What Happens at an IME?
The first thing you should know about an Independent Medical Examination is that you are not the IME doctor’s patient. This doctor is not there to provide medical treatment for your injury. The doctor is there to obtain contradictory information on behalf of whomever hired him/her.
How to verify IME findings?
Verify IME findings by meeting with your physician: Schedule an appointment with your own physician the same day as the IME to compare findings.
What is the responsibility of an IME physician?
That said, the IME physician has a responsibility to act in a professional manner. When you come in the examining room, the doctor should have reviewed your medical records, looked at x-rays or MRI tests, seen the medications prescribed – basically know you as well as any doctor can know a patient they are seeing for the first time.
How many IMEs per year for neck and back injuries?
And in many states, the laws allow for two IMEs per year for each injured body part.
How long does it take to get an IME?
Don’t agree to any written tests or visits to another doctor’s office for further examinations. IMEs usually take around 30 minutes, but could be over in 10 minutes. Make a note of how much time was spent. There is only so much “history” an examining doctor can absorb from one meeting with a patient.
What Happens During the IME?
Before the Independent Medical Examination the insurance company will send the IME doctor your medical records, diagnostic reports, and other documents it has obtained through the workers comp discovery process.
Who Chooses the IME Doctor?
In most cases the insurance company selects the physician who will conduct the Independent Medical Examination, without seeking input from your attorney.
What is an Independent Medical Examination (IME), also called a Defense Medical Examination (DME)?
An IME is a one-time medical evaluation conducted by a physician with whom you have no treating relationship and have likely never seen or heard of before.
When Will the IME Take Place?
The insurance company may ask you to attend an Independent Medical Examination at any time after your work injury and the filing of a claim.
How Will the Defense Medical Examination Report Affect My Case?
The Independent Medical Examiner’s report can play an important role in your workers comp case .
Why Do I Have to Go to an Independent Medical Examination?
When you seek monetary damages or workers compensation benefits for your mental or physical condition, the insurance company or other party defending the case may have a doctor of its own choice examine you.
What Happens if I Refuse to Attend the IME?
Refusing to attend the workers compensation Independent Medical Examination puts your lifetime medical benefits , wage loss payments, including temporary total disability and temporary partial disability, and permanent partial disability benefits at risk.
