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The following is an example of a Schedule Loss of Use award calculation: Due to a work-related arm injury a worker loses 25 percent of the use of that arm and the worker's average weekly wage (AWW) is $900. FL During the IME, a doctor will examine you and your medical records to confirm your injuries and their cause. Usually the. What Happens After an IME Report? | Dabdoub Law Firm 2023 Pinder Plotkin LLC | All Rights Reserved | Privacy Policy. Specifically, the insurance carrier wants the IME doctor to find that you have reached maximum medical improvement for your work-related injuries so that it can deny medical treatment recommended by your authorized physician in the future. Its important to assess the medical evidence, the types of benefits you are receiving, and what you hope to accomplish with your case when deciding whether to get a second opinion on maximum medical improvement. Do I Have To Go Back to Work When an IME Doctor Disagrees with My Doctor? What Do I Need To Know? Get the compensation you deserve. What Is An IME In Workers' Comp Case | Ankin You need to be very careful, and you need to know what strategies you can use to protect yourself. This information is not intended to create, and receipt or viewing does not constitute, an attorney-client relationship. The purpose of an IME is to give the insurance company reasons to deny your claim, reduce the amount the insurer pays you to settle, or convince a jury to decide against you. Note: This page was last updated on February 21, 2023. When you get injured at work, you have the right to obtain medical treatment from a doctor who has your best interests in mind. The results of the IME can seriously impact your disability claim. If you find it too difficult, go back to your doctor and ask them to reassess whether youre at MMI and to provide restrictions. Click the button below to connect with a local lawyer 24/7. For example, those of you who undergo an arthroscopy for a torn ACL or knee injury on the job may need to undergo another surgery, such as a high tibial osteotomy. Prev Post Next Post After submitting a long-term disability claim, you may be asked to endure an independent medical examination (IME). Your statements to the doctor could even be used against you at a workers' comp hearing if your case gets that far. So what happens after an IME report has been completed? If youre carefuland if you follow your lawyers adviceyou can protect your workers compensation benefits. You or your lawyer should receive a copy of this report. Traveled 2.5 hours sat in the waiting room 1.5 hours and saw the Dr for about 9 minutes. If the report from the doctor who conducts your IME matches up with your account of the accident, you have a good chance of receiving workers compensation benefits. Is It Time to Speak with a Work-Related Injury Lawyer? Why? However, there are some situations where you may challenge the IME report effectively. There's a lot at stakefar too much to go it alone. The report should be available within several days or weeks of the examination. 2 What is Maximum Medical Improvement (MMI) and What Does It Mean? If it does, we will contest it following due process until we get you what you deserve. Your attorney can use this information to give you an educated assessment of the value of your claim for settlement purposes, and what you can expect from the employer and insurer moving forward. The Law in All 50 States. Copyright 2023 Corey Pollard | Virginia Workers Compensation Lawyer & Social Security Disability Attorney in Richmond, VA, Reaching Maximum Medical Improvement (MMI) for Your Work Injury, Learn How MMI Affects Your Workers Comp Case. I help injured employees throughout Virginia, including those in Richmond, Chesterfield, Henrico, Bristol, Abingdon, Roanoke, Harrisonburg, Winchester, Fairfax, Manassas, Fredericksburg, Newport News, Williamsburg, Norfolk, Virginia Beach, and Chesapeake. You do not complete and return the employee verification form to your employer's workers' compensation insurance company within 30 days. After finding out that you are at MMI, your attorney should send a letter to your doctor explaining how permanent partial disability is evaluated under workers compensation law and requesting an evaluation and disability report. What happens next? When you file a workers' compensation claim because of a work-related injury or illness, your treating doctor will make decisions about what medical treatment you need, when you can return to work, and whether you have a permanent disability. As with workers comp claims, MMI is a milestone in personal injury claims. PA workers' compensation law states that employers have the right to require that injured workers be evaluated by a physician of their own choosing at any time after a workplace accident. Unless your case is simple or your injuries are minor, you may need the assistance of a lawyer to ensure that your rights are protected during the process. Usually, when the insurance company requests an IME, it also selects the doctor who will perform the evaluation. What's an IME and why is it important to a workers' comp case? Lawyer Marketing & Web Design by SEO Advantage, Inc.Opens a new window, What to Know About Independent Medical Examinations (IMEs) in Montana, Common Tricks Used by Montana Workers Comp Insurance, Wrongful (Unlawful) Termination Due to a Work Injury or, Montana Workers Compensation for Roofers, Montana Workers' Compensation, Personal Injury, Wrongful Death and Social Security Disability Lawyers. Protect Your Workers' Comp Claim from an Independent Medical Exam (IME) If you are interested in protecting your workmans comp rights throughout the IME process, or if you need legal representation so you can appeal a denial you received, schedule a free consultation with a North Carolina workers compensation lawyerat Ricci Law Firm Injury Lawyers, P.A. They also see them as more objective than treating physicians and place tremendous value on their reports. Put another way, MMI means that your recovery from your work injury has leveled and you are as good as you are going to get. Judges also tend to view IME doctors as more objective than treating physicianseven if that's not often the case. Independent Medical Exam - Workers Comp Experts How Long Does It Take Workers Comp To Approve Surgery? You may have some change in your treatment and disability status over time, but no significant improvement or worsening of your condition is expected. If your treating physician refuses to refer you for a second opinion on whether youve reached MMI, then you have a few options: Another option if you disagree with the MMI determination is to file a change in condition application, asking the Commission to approve a change in your workers comp doctor. Message Offers FREE consultation! After submitting a long-term disability claim, you may be asked to endure an independent medical examination (IME). Unfortunately, insurance companies 1600 Ponce de Leon Blvd Just because you can get a second opinion on the MMI determination does not mean that you should. Independent Medical Examinations in Workers' Compensation Claims - Justia Request that the doctor clarify his or her report through an addendum. If the report states that you should be taken off work while receiving this treatment, you are eligible for wage replacement benefits (TTD, which is 2/3 of your Average Weekly Wage) until the authorized treating physician releases you from treatment or to return to work. When the insurance carrier denies a Workers' Compensation claim, the injured worker will receive a First Report of Injury (FROI) form. While the IME may suggest that the physician is an impartial and independent doctor, they are likely experts hired by the insurance carrier. First, the doctors is not on your side. See, O.C.G.A. While your attorney cannot be in the exam room with you, they can ensure youre thoroughly prepared for an IME by telling you what to say to the doctor, what records to bring, and how to behave during the exam. In some states, the insurance company picks the doctor. A local lawyer can explain everything you need to know. Once the IME report has been filed, you can request a copy of it from the doctor who examined you or your employers workers compensation insurer. But insurance companies dont like to pay benefits, especially for a long time, and they will often try to terminate injured workers medical and disability benefits prematurely. Likewise, insurance adjusters may also be watching you. If this happens, you should immediately contact a workers' compensation lawyer. No representation is made that similar results will be achieved in future cases. Lawyer Marketing & Web Design by SEO Advantage, Inc. Huge federal court win by Dabdoub Law Firm for a liver transplant surgeon! Your interest is our priority, so contact us today for a free case review with one of our attorneys. What Happens When You Have a Car Accident Without Insurance? If so, what sort of treatment? Despite their label, IMEs are not independent. There are many doctors who will perform IMEs at the claimants request, then ask for payment if and when you settle your claim. Discrediting an IME physicians opinion can be very challenging (but not impossible). . Our team only handles disability cases, so you can rest assured that youre working with the best of the best. During the IME, a doctor will examine you and your medical records to confirm your injuries and their cause. Map & Directions [+]. The injured employee must provide advance written notice of the IME to the insurance carrier. Also, support it with your medical records, and get your workers compensation lawyer involved. Does Surgery Increase a Workers Comp Settlement? You can bet that this inconsistency will show up in the doctor's report, and the judge or hearing officer will take this into account when assessing your credibility. Hopefully, the answers you find here will at least put you at ease. As part of the workers compensation claims process, the insurance company many request that you submit to an independent medical exam(IME) by the physician of their choice. While the IME may suggest that the physician, handpicked by the insurance company, is an impartial and independent doctor, they are not. Depending on the rules in your state, you may also have the right request an IME when you disagree with your treating doctor's opinionsin which case you will usually be able to select the evaluating physician. An attorney can help protect your interests by filing objections, scheduling a deposition to question the doctor, or requesting another examination. In many workers compensation cases, the injured worker, the employer, or insurance carrier may desire an independent medical examination or second opinion. This generally occurs when the one of the parties is dissatisfied with the current physicians diagnosis, prognosis, or care plan. If the employer offers the injured worker tasks that are in compliance with the doctor's work . What Are the Most Common Motorcycle Accident Injuries? Hopefully, the doctor will recognize how serious your injuries are and why you should be out of work while you recover. Presuming that the injured worker has received income benefits, he or she may choose any physician in the general area to conduct the Claimants IME at the Employer/Insurers expense. If I settle my WC claim am I entitled to my pension and retirement? "What happens after an IME?", "What is the IME capability of a claimant?", "What is the impact of an IME on a claimant?", or "Will an IME interrupt the flow of a workers comp claim after a medical examination or evaluation?", this article will review these aspects of the workers comp process after an IME and discuss some of . IME Doctor Tricks To Be Aware Of - Michigan Workers Compensation Attorneys If the doctors do not help the insurance company, then the insurance company stops hiring that doctor. Offer you a light duty position if you have permanent restrictions, or your pre-injury job if you are released to full duty. What is the Workers Compensation Appeals Board and How Does it Work? By law, youll be required to do so if you hope to have your claim approved, as the insurer will be within their legal rights to deny your claim for such a refusal. In Pennsylvania, in return for releasing your employer and their insurance company from paying any future workers' compensation benefits for either lost wages or medical bills, you will . 5. 2023 Trollinger Law LLC - All Rights Reserved. My doc requested surgery, IME doc says no surgery, more conventional treatment. Hire a Motorcycle Accident Lawyer: How Much Does It Cost? Questions about hiring an attorney? Each case is unique and must be evaluated on its own merits. Take a bike ride. We are pleased to communicate with you concerning legal matters. What Not To Say To A Workers' Comp Doctor During An IME in 2022 Who Decides That I Have Reached MMI for My Work Injury? But, if you arent careful, the IME evaluation could lead to termination of your medical and disability benefits through workers comp. The Role of Negligence in Personal Injury Cases, Understanding Time Limits in Personal Injury Cases, Exploring The Role of Expert Witnesses in Personal Injury Cases, The insurer is unsure of the employees injuries, The injuries sustained are inconsistent with the mechanism of injury, The insurer feels that the extent of the wound is not consistent with the medical treatment provided to date, The employer wants the injured employee back at work, The employer and their insurer would like any medical treatment provided so far to end, The insurer or the employer questions the reasonableness or necessity of any medical bills or treatment, The employer or their insurer contests the causal relationship between the accident and the medical treatment or injury. See more. Here's a quick overview of what you need to know about IMEs: Below we'll discuss these points in more detail. The doctor who performs the IME will be looking for any sign of fraud or deception on your part, and there is a good chance they will watch how you act and move even after the exam seems finished. Workers' comp judges often treat IME doctors as "experts" and give significant weight to their reports. By law the insurance carrier does not have to pay for a second opinion unless the authorized treating doctor refers you for one. And depending on the date you last received wage loss benefits under an Award Order and the applicable statute of limitations, you may be eligible for additional wage loss benefits if you have to go back out of work. Of course, this is easier said than done. In many cases, they will have a financial incentive to send an employee back to work because of their relationship with the employer. Discrediting an IME report is possible, but you will need help from an experienced workers compensation lawyer. After the IME Youll file your appeal with the North Carolina Industrial Commission (NCIC). Usually your authorized treating physician the doctor you chose from the panel of physicians provided by your employer or its insurer, or that you started seeing at the panel doctors referral decides when you have reached MMI. The Workers' Comp Process: From Filing to Settlement | Lawyers.com I would definitely recommend Jason and I do send several of my clients to Jason. If you dispute the statements in the IME report and cannot get the issue informally resolved, and the IME is being used against you to limit or cut off your benefits, you should consult with a workers' comp attorney right away. Asides from insurance providers, the judge or Workers Compensation Commissioner might request the independent medical examination to resolve a disputed issue related to your case. If you disagree with the IME physicians report, you may be able to challenge it. Whether you can return to your pre-injury job. If you receive a denial, you can rest assured that your attorney will do everything possible to >obtain the benefits> you deserve. The company is closing. Usually, its the insurance company that asks for an independent examination. When you have a work comp case because of a work-related injury or illness, your treating physician decides the treatment you need. Also, an attorney is used to dealing with insurance companies and can detect when they are acting in bad faith. The Georgia Workers' Compensation Act does provide the injured worker one IME of his or her own, provided that the injured employee has received workers' compensation income (or indemnity) benefits within 120 days. In these states, the examining doctor may come from a randomly selected list of qualified specialists or may be designated by the judge. You should receive a phone call or email within the next 24 hours. For example, do you actually have the condition that you claim? What Happens After First IME Exam? An IME is an independent medical evaluation that is used to resolve questions about your medical condition for purposes of a workers' comp claim. Its important that you treat with a doctor who is not only good at what they do but also familiar with litigation and comfortable writing a favorable report if a. FAQs How Can You Get Free Legal Advice for a Work Injury? Can I Still Get Medical Treatment After I Reach MMI? How to Find a Treating Doctor for Your Workers Compensation Case. This means that anything you tell the doctor is not privileged or protected in any way. In some cases, the judge or hearing officer assigned to your case may also order an IME to resolve a disputed issue related to your case. So, if youre asking, The IME doctor says I Can work, whats next? The simple answer is that you should contact a lawyer promptly. (For more on how to conduct yourself during the exam, as well as how to prepare for it, see our article on How to Handle Your Workers' Comp Independent Medical Examination.). Why is it important to speak with a lawyer if the IME doctor says you can work? In summary, an IME takes place in Baltimore when: Ordinarily, an IME is supposed to be an objective assessment of your medical condition. When Do My Workers' Compensation Benefits End? The attorney listings on this site are paid attorney advertising. Pottstown PA Terminating Benefits Attorneys | Workers Comp Lawyers The Georgia Workers Compensation Act does provide the employer or insurance carrier the power to compel an injured worker to an independent medical examination (IME) by a physician of the employer or insurance carriers choosing. Here are 5 IME doctor tricks to be aware of for a claim or lawsuit: 1) they watch/spy on you in parking lots and waiting areas; 2) perform fake tests; 3) blame preexisitng conditions; 4) write selective summaries of medical records; 5) they keep sending you to mutiple examinations. Usually, the insurance company requests an IME because it disagrees with a decision by your treating doctor about your course of medical treatment (especially if your doctor recommends surgery or other expensive procedures) or the extent of any permanent disability. I have been off work for 7 months with a spinal injury. The adjuster will then discuss the report with your treating physician. If you need to see an IME, workers compor protecting your right to workers comp benefitsneeds to be top of mind, and it is strongly in your best interests to talk to a lawyer before you go. Therefore, before going in, it's important to understand what an IME is, how to prepare for it . Thus, the compensation payment youll get depends on the report the IME doctor gives. The lawyer would also protect your rights during the entire process. A hearing will be scheduled, and your attorney will plead your case before the commissioner. 34-9-202(a). If you do this, I recommend asking a workers comp attorney for recommendations on which doctor to see. What are these strategies? Did a work-related accident or exposure actually cause your current symptoms? Come see why my peers and past clients have voted me one of the best work injury lawyers in the state, and the results Ive helped injured workers just like you get. Lets finish your case together. Afterwork Definition & Meaning | Dictionary.com Dont go at it along. If you are looking to get a second opinion or have been compelled to an IME, it is important to be prepared. If you suffered a severe car accident injury and believe someone else was to blame, your word is insufficient. Suite 1202, Depending on your work status and the benefits you are receiving when you reach maximum medical improvement, your lawyer may file a workers comp claim for additional benefits you deserve. Research and make healthy recipes. The impartial physician shall examine the employee and review the medical records submitted by the parties and issue a report. You are allowed to return to work with your employer after reaching MMI for your work injury. Either you or your lawyer will then receive a copy. By Carey Worrell, Attorney (J.D., Harvard Law School) | Updated by E.A. In some states, the information on this website may be considered a lawyer referral service. How will I receive medical treatment if my WC claim is controverted? Depending on their response to your claim, additional litigation may be required. If you dont have private health insurance coverage, Medicare, or Medicaid, then you can pay for a second opinion out of your own pocket or find a doctor who will treat you on a lien basis. Celebrating Women in Law on International Womens Day, Injured Georgia Workers: Weekly Monetary Benefits in Workers Compensation Claims, Applying for Social Security Another Resource for Those Injured at Work, Georgia Snow Storm 2014 Brings City to a Halt. I would and have recommended him to many people. The "Independent" Medical Exam (IME) - Anything But! There are ways to defend against an Employers Application and keep your wage loss benefits, but you will likely need to use the workers comp discovery process to give yourself the best chance of doing so.