What Is a Workers’ Compensation Independent Medical Exam?

When an accident happens, the injury victim usually sees an ER doctor or a family doctor. After the initial exam, workers are required to see doctors that their employer recommends for an independent medical exam, or IME. Employers are supposed to provide a list of three doctors for each type of practice. This includes specialists such as pain management doctors in addition to family physicians. During the course of their recovery, employees may see a doctor of their own choosing:

• If the employer doesn’t provide a panel of three doctors
• There is a mutual agreement
• The worker pays for his/her own doctors out of his/her pocket
• The treating doctors aren’t helping the worker and the worker’s compensation Judge approves a change

Often, a private doctor will agree to defer payment until the workers’ compensation case is resolved.

Why an IME may be required

Employers and their insurance companies want employees to return to work so they can stop paying wage checks and medical bills. One strategy they often use is to contest your doctor’s findings by demanding that you be evaluated by an independent doctor. The independent doctor usually looks for reasons why you should return to work or why your benefits should be reduced or eliminated.

The employer will likely ask that an IME doctor review the following findings:

• A finding of permanent disability
• A finding that you can’t work with any restrictions
• A finding that you can’t work until your injuries have healed
• A finding of the worker’s degree or medical impairment

The employer generally has the right to request that the worker undergo an IME. The worker’s compensation judge  then is required to decide which doctor they find credible – your doctor or the doctor who conducted the IME. For this reason, it is crucial that workers review what happens at an IME and how to prepare for it – with an experienced Tennessee workers’ compensation lawyer.

Sometimes, the hearing officer may request an IME to help resolve a dispute. The worker can also request an IME if the company doctors aren’t helping the worker get better.

The rules for who chooses the IME doctor and how are set forth in the Tennessee Workers’ Compensation Law.

What steps to take if the IME is requested by the employer or the employer’s insurance company

The IME doctor will usually ask to review your medical records and any related documents before or after the examination. The insurance company for the employer may specifically ask that the doctor review:

• Your medical diagnosis
• The possibility that you had a pre-existing condition
• Whether additional medical tests are required
• The possibility that some other event caused your injuries
• Your need for continued medical treatment
• When you can be expected to return to work
• What restrictions could help you return to work

Workers should understand that the rules of doctor/patient confidentiality may not apply. This means workers should be careful not to say anything that can be used against them.

The exam will include an oral history and a physical exam. The exam will normally explore your ability to do job-related tasks such as sitting, standing, gripping, bending, lifting, moving, and other activities.

How your workers’ compensation can respond to the IME doctor’s report

An experienced Tennessee workers’ compensation lawyer will ask to review the employer’s requests so that corrections and explanations can be made.  The lawyer will also have a chance to review the IME doctor’s findings with the treating doctors. The treating doctor can respond to any medical findings in the IME report. The response can point out factual mistakes and incorrect medical conclusions.

Your lawyer may also request that your treating doctor answer questions in a deposition. Depositions can help clarify your medical condition.

Your lawyer will normally explain to the worker’s compensation judge that the treating doctor’s findings are more reliable because the treating doctor sees you on a regular basis as opposed to a 20-minute exam. The authorized treating doctor has a presumption of correctness in Tennessee.

Employers and their insurance companies will do everything they can to cut off your worker’s compensation benefits. You need an experienced Tennessee work injury lawyer on your side. At Wagner & Wagner Attorneys at Law, our attorneys have been fighting for injured employees for injury victims since 1945. We represent clients in Chattanooga and Cleveland, TN, in North Georgia, and all surrounding counties. Phone us today at 423-756-7923 or fill out our contact form to speak with a respected attorney.