Minnesota Workers Compensation IMEs

Following a work injury, your employer or Worker’s Compensation insurer may dispute the severity of your medical condition. They may ask you to undergo an independent medical examination. An independent medical examination is not exactly what it is called. In fact, it is an adverse medical examination. The doctor you will be seeing for the adverse medical exam is hired by the insurance company. Sometimes, the doctor that they hire will be one of their “hired doctors” that they use in such cases. These doctors often find nothing wrong with people or little wrong with people with great consistency – certain doctors more than others. On the other hand, sometimes they send you to doctors that are somewhat honest and they may even end up supporting your claim. Talk to a Minnesota work injury lawyer if you have not already.

Why am I being asked to go to the adverse or independent medical examination?

In cases of work-related injuries, the insurance company has a right to request that you be examined by a doctor of their choosing to determine the extent and validity of your injuries. This doctor who is examining you is not your treating doctor and is only doing so for the insurance company. Their bill will be paid by the insurance company. Again, they will not be treating you nor are they obligated to tell you what their findings and recommendations are at the time of your examination. Sometimes these appointments can be cold and unfriendly as the doctors are unwilling to provide much information if any at all. Obviously, this is very different than our typical experience with doctors and physicians. Please keep in mind that it is fine for you to be slightly apprehensive, but it is imperative that you cooperate and be truthful with the doctor.

What does an independent medical examination include?

In my experience, most of my clients spend more time in the waiting room than actually with the doctor. Regardless, the doctor will look to ask you questions concerning how you were hurt, your medical history, your medical treatment and how you are feeling. It is important that you are honest with the doctor but makes sure you have thought about the question before you answer it. It may be a good day but you had pain the day before, so it is important that you state with specificity when and how long you have had symptoms.

The doctor will also be doing an examination. It is important that you tell the doctor where you are having pain and problems. Once you get to the examination, the doctor or staff member will take your history. This will consist of questions regarding what medical treatment or injuries you have had in the past. The doctor will then examine you and question you regarding your injuries and the history.

Please keep in mind that during the examination that you do not have to volunteer any information. You do not need to discuss settlement of your case as that has nothing to do with your examination.

When Do I get the Results of the Independent Medical Examination

Following the exanimation, the doctor will write a report to the insurance company describing his examination findings and opinions. They will send you or your attorney a copy. At times, the findings are consistent with the treating physicians regarding continued treatment and benefits owed for your physical condition. However, this is rare. Remember, they are working for the insurer. Once you have the report, it will give you an idea of the course of future litigation. I encourage that you bring a copy to your treating physician for comment.

Lastly, keep track of any mileage related expenses incurred from the examination. You should then forward them to the insurance company for reimbursement.

When will an Independent Medical Examination be Scheduled in my Case?

All examinations are scheduled at various times. In a workers’ compensation claim such as yours, the insurance company is obligated to set an examination within 120 days following the filing of the Claim Petition. Usually, they will want to take your deposition prior to the adverse examination so they can provide the doctor with not only your previous medical records but also your testimony as to previous injuries and the injury in question. Those adverse examinations are typically scheduled no later than 6 to 14 months from the date of the injury. A repeat examination can also be scheduled if one has been performed in the past. The examination is to be done within 150 miles of your residence but in some situations, it may be expanded to further distances.

Is an Independent Medical Examiner “my” doctor?

No, the doctor is not your doctor but is hired by the insurance company. A healthcare provider directs and coordinates medical care for you, while an IME does not provide care.  Many of these doctors doing IMEs this is their only job or most of their practice. In other words, their livelihood is based on whether the insurance company continues to send them work. They are not required keep confidences and most likely will include what you tell them into their report for the insurance company.

Can I miss or skip my Examination?

Not if you can avoid it. Obviously, illnesses and emergencies come up but it is important that you attend the examination. If you cannot attend you must let the insurer or your attorney know right away. The insurance company may look to discontinue your benefits if you miss the exam and has the right to charge you for the doctor’s time. Sometimes, this can be as high as $1,500.00.

Who can I bring with to my examination? QRC? Family Member? Doctor?

In many situations, you may be allowed to bring a family member into the examination room if the physician allows it. However, under the workers’ compensation act the only person that must be allowed into the examination is your treating physician. Unfortunately, most treating physicians either won’t or can’t attend the examination. Again, most IMEs will allow a family member to be in attendance.

Who will pay my mileage or loss wages when I attend the examination?

The employer and insurer are to pay “reasonable travel expenses” incurred by you in attending the examination including mileage, parking, and, if necessary, lodging and meals. The employer shall also pay you for any lost wages resulting from attendance at the examination. You will want to make sure to put those together after your examination. If you are needing an advancement before your examination you will need to discuss that with the adjuster or your attorney.

What are some tips for when I meet with an adverse or Independent Medical Examiner?

• Make sure you wear a watch and time the amount of time that the doctor is actually in your physical presence. There are a number of adverse doctors who spend only five to eight minutes in doing adverse examinations, no matter how complicated the case. Make sure you are accurate about the time the doctor spends with you.
• Make sure that you are very careful and precise about what you tell the adverse medical doctor. He will be taking notes and anything you say may be used in the case.
• Make sure you get across to the doctor doing the adverse medical examination, all of your symptoms and complaints. Do not let the adverse doctor cut you off.
• If you have any history of prior problems, be honest about it and make sure you tell the doctor when he asks about that. In these cases, all your medical records and background comes to the surface sooner or later. Thus, not telling of any prior difficulties with your problem will only make you look bad and harm your case.
• Be polite to the doctor and do not argue with him.
• Be absolutely honest in answering all questions asked by the doctor. This is true regarding his examination of you as well. For example, I had one case where part of the examination involved a pin prick type test for numbness of a man’s arm. He lied about having numbness and the doctor re-checked him and caught him. That does not help the case. Similarly, in a low back injury case, straight leg raising to test leg nerve pressure can be done sitting and lying down. In past cases, some clients have complained of pain with very little movement of the leg when lying down, but when tested sitting they do not complain.
• If you have had symptoms in the past concerning your injury which has improved at the time you see the adverse doctor, make sure you tell the doctor about the symptoms in the past as well. This may be very important in that some symptoms traditionally reoccur after a period of remission. Good and bad days and good and bad periods often occur in orthopedic injury cases.When you are done with your adverse medical examination, make written notes about the examination, what the doctor did, what type of testing he did and, especially, what he said to you.
• Do not be overly worried about the adverse medical examination. It is just one other procedure person must go through to get your case resolved. Sometimes it actually helps the resolution of the case.

Who should I speak with prior to my adverse independent medical examination?

If you are being scheduled for an IME it would be beneficial to talk to a Minnesota workers compensation lawyer to discuss your options. Things can move quickly after an IME especially if the workers’ compensation insurer has grounds to discontinue or stop paying wage loss benefits. Also, you may have already been waiting for treatment that has been recommended, and if the IME disagrees, you may be waiting even longer to get it approved. Sitting down and discussing your case with a Minnesota work injury lawyer can go a long way to setting the groundwork to get your benefits approved. 

Jerry Sisk is a Minnesota workers compensation attorney who has handled hundreds of workers’ compensation cases. If you have questions or want to have Jerry review your case for free call 855-354-2667 or fill out the contact form below.

Photo by Tobias van Schneider on Unsplash