Oftentimes, I recommend that my Workers' Compensation clients have an IME, or independent medical examination. You may be wondering if this would be a good idea for your case. In this article, I'll try to review the general pros and cons of having an IME to help you decide if this is something that you think your Workers' Compensation case could benefit from.
What is an IME?
An IME is a medical examination conducted by someone other than your treating doctor. It is a fancy way of saying "second opinion". In most Workers' Compensation cases, the doctors who treat you are selected and paid for by your employer's insurance company. These doctors may rely on the insurance companies to send them to repeat business, so they may be hesitant to fully treat or evaluate your condition.
The IME is conducted by a doctor selected and compensated by your side of the case. At my office, it is our practice to pay for the costs up front so that no money or co-pays have to come out of our client's pocket. Because of this, sometimes the IME is also called the Claimant's Medical Examination.
We begin the process by selecting the most appropriate doctor for our client's injury. We use specialists in orthopedics, back injuries, brain injury, plastic surgery, or other fields depending on our client's injury. Once a doctor is chosen, we will make an appointment for our client, and submit the relevant medical records
You should consider an IME if your case involves the following:
- Any back or spinal cord injury
- If you have pain that hasn't been treated
- Broken or shattered bone
- A head or brain injury
- A scar or any permanent disfigurement
- Any injury requiring surgery
What Is the Process of an IME?
A week or two after your examination the physician will prepare a written report and send it to your attorney's office. You can obtain a copy from your attorney who will review the report and then, as appropriate, share it with the insurance company. If a hearing is required in your case, the report can be provided to the Commissioner, who will be deciding your case.
Every doctor who provides an assessment for Workers' Compensation purposes should be using the same medical standards (now called the American Medical Association Guides to the Evaluation of Permanent Impairment in the 6th edition). However, there can be major differences between the ultimate conclusion of the physician selected and paid for by the insurance company vs. independent physicians. These results can sometimes call for double or triple the amount of compensation that you are entitled to.
What Are the Drawbacks?
First, there is the cost. Most physicians will charge between $750-$1,000 for the examination and report. Second, sometimes the best medical specialist to conduct your examination will be located out of town for you, and you may have to travel for the appointment. You should know though in nearly every case with serious injuries the benefits of an IME outweigh the drawbacks.