If you sustain a work injury, you may receive a letter from your employer requesting you appear for an Independent Medical Examination (“IME”). Under the Workers’ Compensation Act, employers may, and often do, request their injured employees to submit to a physical examination by an appropriate healthcare provider or other expert. Because this is a regular practice in Workers’ Compensation cases, we thought we would shed some light on how this may look if you ever find yourself in this situation.
You will get a letter in the mail with a place and time of your IME appointment. You should know that the IME doctor is being paid by your employer and/or the insurance company. The date, time and place of the IME are dictated by the employer and/or insurance company, however, the appointment must be at a reasonable time and place. It is not unusual for our clients to move or relocate. That is ok. If, for example, you decide to move permanently to Florida after sustaining a work injury, the Court will not force you to travel back to Pennsylvania to attend a local IME. If the employer wants you examined by an expert, they need to schedule it with a doctor closer to where you live. Additionally, if you do not drive or have other means of transportation, the employer’s insurance company has to set up and pay for your transportation to and from the IME appointment.
There are some cases when an injured worker could be subject to multiple IMEs as a result of the type of injury suffered. For example, you sustained a shoulder injury and developed PTSD after slamming into the steering wheel during a serious motor vehicle accident. Because there is physical and mental component to your injury, the employer could request you submit to an orthopedic and psychological IME. A different example is if you suffer a concussion and neck injury after falling off scaffolding on a construction site. In that case, your employer could send you to a neurologist for the concussion and orthopedist for the neck.
These IMEs are very important and should be taken seriously. If you do not show up to the scheduled appointment, the employer can file a Petition for Physical Examination with the court. If that happens, a Workers’ Compensation Judge will conduct a hearing, which will likely result in the Judge issuing a court Order compelling your appearance at the next scheduled IME. If you miss the court-ordered IME without reasonable cause or excuse, the employer can file another petition, asking the Judge to stop your compensation benefits until you submit to the requested examination, which could be financially devastating. You may ask, what is a “reasonable cause or excuse?” That question is left entirely to the discretion of Workers’ Compensation Judge handling your case. We can tell you that reasons such as no ride, you thought it was a different day, or you were out of town visiting family, are not looked upon sympathetically in front of a Judge.
When you get to your IME appointment, know that the IME doctor will not render any treatment or create a physician/patient relationship with you. He or she is examining you for the sole purpose of authoring an IME report at the request of the employer and/or insurance company. The IME doctor will probably have your medical records, diagnostic studies and other documents that have been exchanged between your attorney and defense counsel during the course of litigation. When the appointment begins, the doctor will take a history, asking you various questions related to the work injury and treatment you have received to date. The doctor will ask you about your prior medical history and any injuries you suffered before the work injury. It will feel like an interview and it is important to give an honest and accurate description of your prior medical history, post-injury treatment and current complaints. They will then conduct a physical examination, asking you to perform different physical tasks to test your physical capabilities. The entirety of the examination can last anywhere between 15 minutes to an hour, depending on that particular doctor’s procedure.
Within a few weeks, that doctor will issue an IME report that will be circulated to the attorneys and yourself for review. In the vast majority of cases we handle, IME doctors’ opinions fall into two categories. 1) You did not sustain a work-related injury; or 2) there was a work-related injury, but you are fully recovered and able to return to your full-duty job as of the date of the IME. These outcomes are somewhat predictable since the doctor is being paid by the employer/insurance company and the best way to earn future business is to write a report that can be used by them to go to court. That being said, it is also not highly unusual for the IME doctor to acknowledge an ongoing injury but release our clients to perform some form of modified work. Regardless of the outcome of the IME report, do not panic. This is just one opinion and the Judges do realize this. Your doctor(s) will have the opportunity of having their opinions heard too.
A huge advantage to hiring a lawyer is our ability to cross-examine the IME doctor. At some point during litigation, the IME doctor will present for a deposition. At that time, the employer’s attorney will ask the IME doctor questions about their one-time examination, their IME report, and the doctor’s opinion related to your injury and capacity to work. The doctor is then subjected to cross-examination, allowing your attorney to question each and every aspect of the doctor’s examination, including how much he/she was paid to conduct the IME and how much they are being paid for their deposition testimony. We also like to know the number of IMEs that a particular doctor performs within a specific time frame. Our goal is to show the Workers’ Compensation Judge that this doctor is biased and lacks credibility in making their opinions. This is done by bringing to light the fact the IME doctor saw you one time for the sole purpose of creating an IME report favorable for the employer. We always argue that the Judge should reject the IME opinions and accept the opinions of your treating doctor(s). We always point out that their intimate familiarity with your condition after numerous office visits should be viewed as the more credible opinion.
Call us. The consultation is free. We are here to help you obtain and keep the benefits you rightfully deserve.
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