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What Not To Say To A Workers’ Comp Doctor During An IME in 2023

What Not To Say To A Workers' Comp Doctor During An IME in 2023
If you have filed a workers’ compensation claim, you may think your worries are over after filing the extensive amount of paperwork and seeing a doctor to treat your injuries.  However, many insurance companies for employer’s workers’ comp policies will request an Independent Medical Examination (IME) so that a different treatment provider can evaluate your injuries, and provide any inconsistencies that they can use to counter the cause, extent, and restrictions of your injuries from a workplace accident.  If you have been called to complete an IME, there are a few things you should know.

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What is an IME in a Workers’ Comp Case?

If you have sustained a workplace injury and are in the midst of a workers’ compensation claim, you may find yourself requested to complete an Independent Medical Examination (IME).

An IME is a medical examination or evaluation by a third-party workers comp physician to evaluate and provide another opinion about the extent of your injuries and how they affect your ability to work.

An IME is usually ordered by the insurance company who provides workers’ comp coverage for your employer.  The IME serves as a way for the insurance company in a workers’ compensation claim to assess the validity of your claims, and possibly to counter the claimed extent and effect on the wage-earning capacity of the injuries you sustained in a workplace accident.

What Kinds of Questions Will I Be Asked in a Workers’ Comp IME?

The physician conducting the IME will be provided with any medical records or documentation about your injuries.  The IME doctor will then conduct their own medical examination.  Some of the questions that may be asked during an IME include:

  • What symptoms or injuries did you notice before, during, and after the workplace accident?
  • Did you have a pre-existing condition prior to the workplace accident? Did you have symptoms from this pre-existing condition that was present at the time of the accident?  Were any injuries or symptoms of your pre-existing condition aggravated from the accident?
  • Are there any restrictions on your ability to work from your injuries? Did the accident or injury result in any permanent disability?
  • How has your injury or accident impacted your daily life? Are you able to do normal activities?
  • Do your injuries require further treatment, such as physical therapy, surgery, or specialized treatment?
  • What did your treating workers’ comp physician diagnose you with? What treatment did he or she recommend?

What Should I Say or Not Say at the IME?

You may be worried how your answers to questions at your IME will affect your workers’ comp case.  Maybe you are thinking of talking up certain symptoms or downplaying your ability to do daily activities.

First and foremost, always tell the truth!

It’s important to be completely honest at your IME and tell the truth about anything you are experiencing.  Defense teams and insurance companies make it their priority to deny or limit coverage in workers’ comp claims.

They are skilled at finding any inconsistencies in your statements and symptoms, and they may use those inconsistencies to attack your credibility.  It’s important to always tell the truth about all symptoms, prior injuries or conditions, or developments you have so that the IME physician can correctly evaluate your condition.  Your case is not doomed because of an insurance company’s interpretation of your truthful responses.

Don’t rely on the insurance company to evaluate your workers’ comp claim.  A skilled New York Workers’ Compensation attorney can help guide you through the workers’ comp process from filing a claim to obtaining the proper recovery you are owed.

If the insurance company tries to dispute your claims after an IME, an expert workers’ comp attorney can interpret the IME in your favor so that you aren’t denied what you are rightfully owed.

Let an Experienced Workers' Comp Attorney Guide You

Workers’ comp claims and the process that follows are difficult, and defense teams and insurance companies are not usually on your side.  Don’t handle this difficult process alone.  Let someone with a knowledge of New York Workers’ Compensation Law and the experience with workers’ comp claims and the court system help you navigate your next steps to make a successful case on your behalf.

If you have been injured in a workplace accident, the sooner you call a Workers’ Comp Attorney in New York, the better.  We will evaluate your medical records, the facts in your case, and the law to make sure you get everything you deserve.

Finding the Right Workers' Comp Doctor

Now that you know what you should not say to a workers’ comp doctor, you are most likely wondering how to find the right doctor to treat my work-related injuries? You will want to look for all the basics when searching for a good doctor, such as experience and licensing. Still, there are other important criteria to consider when you are searching for the right workers’ comp doctor near you. Read on to get everything you need to know to find the right doctor to treat your job-related injuries.

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Experience Treating Injured Workers

Start by confirming that you chose the right physician who has experience treating workers who were injured at work. This is a unique scenario, and working within the guidelines of workers’ compensation will adjust some of your treatment protocol. As such, the process will go much more smoothly if they already have experience dealing with workers’ comp and injured workers.

Choosing a healthcare provider with experience in this regard will also help reduce the risk of errors that could hurt your claim or your recovery process. After all, they will be familiar with the adjustments in paperwork and other differences in treating an injured worker compared to a typical patient.

Essentially, seeing a physician familiar with treating work-related injuries will likely help you get your claim more quickly and with less effort or stress on your part, as the doctor will be familiar with the various nuances of required workers’ comp documentation and treatment.

Experienced In Treating Your Type of Injuries

You should also confirm that you chose a medical provider who has experience treating your type of injury. Remember that workers’ compensation covers a long list of different injuries. Statistics from 2010 to 2014 from one of the workers’ compensation insurance carriers found that handling objects and materials accounted for 32% of claims. Another 16% of claims involved slips, falls, or trips. There can also be injuries from colliding with objects, accidents involving tools, overuse injuries, and more.

Given the range of work-related injuries, there is no guarantee that the first doctor you find will have experience dealing with situations like yours. Take the time to ask and confirm. Remember that while doctors cover everything in medical school, you want the person treating you to have used their knowledge recently and regularly. This will increase the chances of them spotting all the problems early on and selecting and following through with an effective treatment.

Accepts Workers' Compensation Insurance

It should go without saying, but you should always confirm that you find a physician near you accepts workers’ compensation insurance. This is important because you need to be sure that you will not be on the hook to pay for treatments at the end of your case. The unexpected expense could add significantly to your stress.

A key part of this is that the provider should accept the appropriate workers’ compensation fee schedule. Some doctors may prefer other payment schedules, and they are entitled to this. However, you do not want to choose them to treat your workers’ comp injuries. With more than 900,000 workers’ compensation injuries and illnesses in 2018 alone, you should have no problem finding a doctor that meets this requirement.

Properly Licensed and Certified

Also, ensure that your chosen doctor is properly licensed. This is important for multiple reasons, including ensuring you get accurate, helpful treatment and that the insurance company will cover their services.

Your workers’ compensation insurance is unlikely to cover any treatment by an unlicensed doctor. Additionally, without licensing, you are at risk of the doctor cutting corners in the treatment process or simply not using the latest medical knowledge and the highest level of skill.

You should go a step further than just looking at general licensing. You also want to ensure that you select physician is certified or authorized by the proper Workers’ Compensation authorities.  For example, if you live in New York State, you want to make sure that your doctor is authorized by the Workers’ Compensation Board (WCB) to treat injured workers.

Find the right specialist. This specialization will ensure that your doctor has a well-rounded knowledge of your injury, including the best and most recent medical treatment and procedures. For example, suppose you suffered a broken bone. In that case, you should contact an orthopedist. If you are suffering from headaches, a good neurologist should be able to help you. This goes back to the previous point of experience in treating your specific type of injury. Seeing the right specialist will result in better outcomes in your recovery.

Availability of Appointments

Before choosing your doctor, do not forget to confirm that they have appointments readily available. It can be daunting to switch in the middle of a workers’ compensation claim, so you would want to make sure that physician has the availability to schedule your appointments.

Most clinics will have some wait, but you should try your best to choose one with appointments available within several weeks. This will let you begin treatment and help ensure you can schedule your next appointment at the previous one, instead of having to plan months in advance

Proximity

If you were injured in the job, chances are you have to go for physical therapy or other treatments two to three times a week. Make sure you find a medical office that is close to your home or office.

Ask if your doctor offers telemedicine services. This way, you will be able to call in and get a consultation over the phone of you are unable to make it to the clinic.

Your Comfort Level

Do not forget to consider your overall comfort level with the doctor that you choose to treat with. Look around when you get to the doctor’s office – is it clean? Are there any other patients in the waiting room? Is the doctor’s staff complaining? Listen to your gut. You want to be able to trust them. Luckily, by paying attention to the other considerations we mentioned, you should find a doctor you trust and are comfortable with.

Being Part of a Multispecialty Team

You should try to choose a physician who is just one part of a multispecialty team for the best experience. For common musculoskeletal injuries, the team could include a neurologist, an orthopedist, a physical therapist, a chiropractor, and a pain management specialist. This way, you get all the care you need in a single location and with excellent communication between all medical specialists. Both of those points are very important.

By getting all the care you need in a single location, you will not have to waste time traveling to multiple offices or getting medical reports from numerous clinics. You will likely be able to schedule appointments with all specialists with the help of one receptionist, saving you time and letting you plan out your entire treatment. There is also the convenience associated with being familiar with the doctor’s office.

Besides, the communication among the medical team is also very important. A multispecialty team likely has a great deal of experience working together, including procedures to communicate with each other clearly. This will make it easier for you. You will not have to relay messages between specialists or wait days to communicate with each other. Instead, messages between your various specialists will likely take minutes or hours, at the most. This should result in shorter gaps before the required treatment and quicker healing.

Get Help Now

Now that you know how to find a good workers’ comp doctor, it’s time for you to make an appointment and get on the way to recovery.

If you need help find an experienced workers’ compensation physician, call 1-800-897-8440 today. We will help you find the right doctor near you and schedule your appointment.

 

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