August 8, 2022 | Personal Injury
When a workplace injury occurs, the injured employee should be able to recover complete compensation for their medical expenses as well as some portion of their lost wages. However, it is not uncommon for there to be a dispute between the injured worker and their employer or the workers’ compensation insurance carrier. Sometimes this dispute revolves around how the injury occurred or the severity of the injury. Sometimes, workers are required to undergo an independent medical examination (IME) to verify the severity of an injury or confirm how much medical treatment is needed.
There are a variety of reasons why an employer or an insurance carrier would dispute a work injury claim. In some cases, there is a dispute about whether or not there is an injury at all, but that is not the most common dispute that occurs. Some of the most common workers’ compensation claim disputes arise due to:
Regardless of why there is a dispute between a person and their employer or the insurance carrier, they may be asked to undergo a medical examination with another doctor who is supposed to be neutral. This is called an independent medical examination. These examinations can significantly affect how much compensation a person receives for their workers’ compensation case. The IME is supposed to resolve any questions or discrepancies related to the workplace injury and the ongoing medical care.
The IME doctor will review the relevant medical records and perform an examination on the injury victim. They will then write a report that is turned over to the insurance carrier, who will then make a final determination about how to proceed forward with the claim.
If an individual disagrees with the findings of the IME report or the decision made by the insurance carrier, they or their personal injury attorney can challenge their report.
Before the independent medical examination, any medical records related to the workplace injury and other documents related to the incident will be sent to the IME doctor. This doctor may or may not go over all these records before they conduct an examination.
In many cases, the insurance carrier will write a letter to the doctor explaining the case and the treatment thus far (from their perspective). The insurance carrier will ask the doctor to determine whether or not your condition has been correctly diagnosed, whether or not the workplace incident was the actual cause of the injury symptoms, whether you are currently undergoing the correct treatment, and when you will be able to return to work. The insurance carrier will also want to know whether or not there is a permanent disability and to what extent any disability affects the claimant’s life.
Injury victims should ask to review any documentation sent to the IME doctor by the insurance carrier so they can correct any factual mistakes and ensure that the questions asked by the insurance carrier or appropriate for the case.
