You may be required to undergo an evaluation as part of your workers’ compensation case.
In California, workplace injuries and illnesses are handles through the workers’ compensation system. In California, all employers are required to carry workers’ comps insurance. If an employee is injured or becomes ill because of something related to their job, they can receive benefits without having to prove that their employer did something wrong. For this reason, workers’ comp is referred to as a no-fault system.
If you have been applied for workers’ comp benefits, you may receive a request for an Independent Medical Evaluation (IME). This might be surprising, because you probably already have your own doctor, and have been diagnosed with an injury or illness.
IMEs play a significant role in California workers’ comp cases, particularly where there is a dispute over an issue in your case. It may be used to resolve questions such as whether you can return to work, if your illness or injury is work-related, and even if you require ongoing medical treatment. A California workers’ compensation attorney can counsel you on your rights related to a request for an IME.
An IME is a type of medical exam that is typically requested by the workers’ compensation insurance company, although the Workers’ Compensation Board may also request that you undergo an IME.
This type of examination is performed by a doctor who is supposed to be neutral (not on the side of the insurance company or your side). An IME should be an objective, unbiased evaluation of your illness or injury. Unfortunately, because the doctors who perform IMEs are often chosen by and paid by the insurance company, the physician may not be truly neutral.
Before you go to your IME appointment, the doctor will review your medical records and other information about your injury or illness, such as your statements about how you got hurt or became ill. The insurance company may also submit questions for the doctor to answer, such as whether your diagnosis is correct, if your injury or illness is work-related, and when you will be able to return to work. Your workers’ compensation attorney should review any letter that the insurance company sends to the IME doctor before your appointment. This way, your lawyer can fix any mistakes in the letter and make sure that the questions that the doctor is supposed to answer are appropriate.
Importantly, when you are being evaluated in an IME, you do not have any type of doctor-patient privilege. The things that you do and say can be used against you in your workers’ comp case. For example, if you have a back injury that makes it difficult for you to move, but then you hop up onto the exam table easily, the doctor may note that in your file and opine that they believe that you are able to return to work.
During the exam, the physician will ask you questions about how the injury or illness happened, your treatment to date, and relevant medical history. They will also do a physical exam and may order tests such as bloodwork or x-rays. The doctor will then write a report with their conclusions, specifically addressing the questions asked by the insurance company.
If you have received a request for an IME, you should consult with your California workers’ compensation attorney as soon as possible. At PLBSH, we represent injured Californians in workers’ comp cases, offering compassionate, diligent counsel to each of our clients. Contact us today at (800) 435-7542 or firstname.lastname@example.org to schedule a free initial consultation.