In some workers’ compensation cases, the injured employee, employer, or the employer’s insurance company may request an independent medical examination or IME. Essentially, this is a second opinion.
Usually, an IME exam for workers’ comp is requested if one of the parties isn’t satisfied with the diagnosis, prognosis, or care plan provided by the chosen physician.
What Is the IME Process in Georgia?
According to the Georgia Workers’ Compensation Act, an employer and the employer’s workers’ compensation insurance provider can request an IME for an injured worker. Even though the IME may state that the physician, who is selected by the insurance provider, is impartial and “independent,” they really aren’t. In fact, these are doctors who are often known for being hostile toward injured workers and being skeptical regarding the work injuries they have experienced.
If you are like most people, you probably wonder what happens during the IME. During this, there may be physical exams, psychiatric exams, and testing. It’s necessary for the employer or the insurance carrier the employer uses to provide an employee with written notice of the IME 10 days before it is scheduled and pay for the worker’s travel costs. There is no limit on how many IMEs the insurance company or employer can request during a case.
What Does the Doctor Look for During an IME?
The IME doctor will review all the relevant and related medical records that are connected to the injury or illness you suffered at work. During the exam, they will consider other factors, too. These include:
During your IME, the doctor will watch everything you do. They will evaluate how you look, how you act, and what you have trouble (or don’t have trouble) doing. They will also consider factors like how you are dressed. Their goal is to find signs that your injury isn’t as severe as you believe it was.
Signs of Deception
The doctor will also be looking for any potential signs that you are trying to deceive them. This could be done by exaggerating your injuries or acting differently in the waiting room and exam room. This is all information that will be reported to the insurance company.
Sometimes the insurance company will browse your social media posts to see if statements you made there are different than what you have told your doctor. You may also be under surveillance before and after your IME exam to see if what you tell the doctor is consistent with your daily activities.
The IME doctor will likely request that you undergo several tests to see how much pain you are in. The results of these tests will be provided to the insurance company.
How Does IME Affect a Workers’ Comp Settlement?
You may wonder what happens after a workers’ comp IME. After an IME is requested by your employer or insurance company, a report will be provided by the doctor. It’s important to look out for IME doctor tricks. The fact is, these doctors often receive financial incentives to provide these evaluations, which means they are only going to report something if it benefits the insurance company.
Because of this, it’s important to have a workers’ compensation attorney protecting your rights.
In many cases, the IME physician will state that the injured employee has fully recovered, even if they still require treatment or surgery. Also, IME physicians may claim that a worker can return to heavy-duty work, even if the treating physician has recommended that this not happen yet.
Can Your IME Report Impact Your Workers’ Compensation Benefits?
You probably want to know if your workers’ comp benefits will be cut off after an IME if it is unfavorable.
This depends. It’s important to make sure that your attorney gets a copy of the report provided by the IME doctor so they can challenge findings that aren’t aligned with what the treating physician has said or that seem to be inaccurate.
Some of the situations where you will likely need your attorney to challenge an IME report include:
- The report contains inaccurate information about your health and history. It’s possible to send a letter to the insurance company that points out any false information on the report and request clarification or addendum. If there is evidence that supports your claim, like documentation from a prior appointment, be sure to submit that, too. Your attorney will be able to address any IME mistakes in court.
- The IME is used to limit the workers’ compensation benefits you receive. It’s possible for your attorney to fight this decision by going to court.
- The physician who conducted the IME was not qualified. An IME doctor has to have the proper qualifications to conduct this evaluation. If they don’t, then your lawyer can challenge the findings of your report.
While these circumstances and situations don’t always occur, it’s important to know what you can do to fight IME findings that are inaccurate. Having an experienced workers’ compensation lawyer will help you have the guidance and insight needed in these situations.
Protecting Your Rights Before, During, and After an IME Exam in Georgia
Do you know what the next step after IME is? Do you know how to protect your rights to workers’ compensation benefits? If not, hiring a workers’ compensation attorney in Georgia who is familiar with these laws is essential. Our legal team has handled cases like these for years. We will help protect your rights to compensation and challenge any element of the IME report that is inaccurate or flawed in any way.
The first step in this process is to get in touch with our legal team by calling (478) 742-3381. We can review your case and situation and help you recover the compensation you deserve for your work-related illness or injury. We are here to help, so give us a call as soon as the IME is requested. We aggressively fight for our clients’ rights.
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