Workers’ compensation benefits can require the cooperation of several parties in Nevada. Besides the insurance company of your employer, you may have to visit multiple doctors. Independent medical examinations (IMEs) may be ordered by insurance companies in addition to your treating physician.
IMEs are theoretically performed by third-party doctors who are neutral. Examiners are often chosen by insurance companies. You might already feel that the odds are stacked against you, so you should know what to expect and how to prepare for success.
The Medical Exam
A third-party physician will perform your independent medical exam, which confirms that you have the medical condition that is the basis for your workers’ comp claim. Basically, it’s a second opinion. Normally the insurance company orders this exam; however, you can ask for one yourself. In the exam, your medical records will be reviewed, and you can learn more about your condition.
Reasons an IME Might Be Ordered
The insurance company may request another medical exam because your treatment is expensive, and they are challenging the diagnosis or treatment. An IME might also be ordered if long-term disability and the inability to work is involved. The independent exam may be ordered as a potential cost-saving measure. The insurer benefits if your third-party physician says your injury or condition is not as severe as previously asserted.
Some injured workers ask for an independent medical exam themselves if they don’t agree with the previous doctor’s recommendations. For example, the recovery timeline suggested by the previous doctor is wrong in your opinion.
What You Should Do Before your Exam
Being prepared before going to your exam can make things run smoothly. The following can help:
- Request copies of your documentation and look it over so you can discuss it. If the information has errors, tell the physician.
- List the important information such as the location and time your injury occurred and severity and frequency of your symptoms. Keeping a small notebook with this information written down beforehand may be helpful.
- Because anything you say can be reported to the insurance company, keep the conversation focused on your work injury and symptoms.
- Be honest and polite. The physician has your medical findings in front of them. If you exaggerate your symptoms or condition, this inconsistency can go against you. So can rudeness. Remember, it can affect the report the physician files.
What Happens During Your Exam
The physician will look over your medical records before you arrive. You will be asked about your work injury and how it happened. Diagnostic tools may be used to evaluate your condition. The physician might also ask questions about when the accident occurred and what you were told by the previous doctor, including recovery time and treatment.
After the Workers’ Comp Exam
Afterward, the physician writes their report for the insurance company. The report will be used to determine your benefits and decide whether to disallow or approve the claim.
Disputing the Results
If you disagree with the results reported in your IME, you can dispute them. For example, if the physician says a pre-existing condition was responsible for your workplace injury, you can dispute the report. Enlisting the help of a lawyer who specializes in workers’ compensation claims improves your chances of obtaining compensation. For example, a workers’ comp attorney can use expert testimony to dispute the claim that your injury was due to a preexisting condition.
Jay Short: Nevada Attorney for Workers’ Compensation
If you have been injured at work or while performing company business and are looking for help, contact Jay Short – Attorney at Law. Providing fair compensation for injured workers is our sole focus, and it’s our mission to protect workers. We offer free consultations all day and night at (775) 786-2006. Please feel free to contact us online as well.