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Five things to watch for during workers comp IME

Five things to watch for during workers comp IME

There are five things every injured worker should watch for when attending a workers comp IME. Knowing these key things will help the injured worker avoid disruption in medical treatment and payment of his lost wages.

Carefully Answer All Verbal Questions During a Workers Comp IME

First, the injured worker should carefully answer all verbal questions at the workers comp IME. One tactic used by insurance carriers is to create inconsistencies at an IME in order to raise fraud. The carrier will usually focus on the area of prior or subsequent accidents. The insurance carrier will bait and confuse the injured worker. It will then use the worker’s inconsistent statements made at an IME to support a fraud allegation. For example, an insurance carrier may be aware that the injured worker previously had a motor vehicle accident. This information is publicly available. If an IME doctor’s report states that the worker reported no prior accidents or injuries at the exam, the carrier will raise fraud. It will argue that all past and future monetary benefits on the claim should be forfeited due to the worker’s “false statement” and intent to defraud.

Avoid Filling Out the IME Questionnaire When Possible

Second, the injured worker should avoid filling out an IME questionnaire. Most workers comp IME doctors will request that the injured worker fill out a written questionnaire at the exam.  The questionnaire will contain questions regarding treatment history, symptoms, and physical abilities. The questionnaire will also ask whether the injured worker has suffered any prior or subsequent accidents.  The wording of these questionnaires is often confusing and vague. Injured workers are not required to fill out IME questionnaires. However, they must always answer all verbal questions during the examination. In fact, filling out an IME questionnaire provides little to no benefit to the worker. It merely allows the insurance carrier to take advantage of the workers answers to its doctors’ confusing and poorly worded questions as a basis to raise fraud. A simple mistake in the paperwork can lead to a fraud allegation.

Failure to Attend a Workers Comp IME Can Result in Suspension of Benefits

Third, if an injured worker is unable to attend an IME, they must notify the carrier. Failure to attend an IME may lead to a suspension of benefits. However, the worker may provide a reasonable excuse for the non-appearance. If the worker provides a reasonable excuse, a carrier’s application to suspend benefits based on non-appearance at an IME will be denied. Always obtain proof of the reason for non-attendance, such as a letter or note.

The IME Doctor is Not Your Friend

Fourth, the injured worker must know that the workers comp IME doctor is not his or her friend. The insurance carrier hires IME doctors. It will use the IME doctor’s report to reduce benefits and to deny medical treatment requests. The injured worker should not bring any medical documentation to the exam. It is the insurance carrier’s obligation to provide documentation to the IME doctor.

Injured Workers Have a Right to Videotape an IME

Finally, every injured worker may film an IME. In order to do so, the worker should bring someone over the age of 18 and who is competent to testify to the exam and recording. The Board may call on that person to testify at a hearing. The IME doctor may also videotape the exam. However, to do so, the doctor must properly notice the worker ahead of time.

The workers comp attorneys at the Platta Law firm are familiar with the tactics used by insurance carriers to reduce the value of claims. Workers comp IME’s are just one of those tools.  We fight vigorously for our clients before the Workers’ Compensation Board and have implemented strategies to reduce issues stemming from attendance at IME’s. As our client, you will be always accompanied to the workers comp IME by one of our private investigators who will document your exam. If you or someone you know has been the victim of an accident, please reach out to us for a free legal consultation.