An independent medical examination has been scheduled by my workers compensation insurance adjuster. What do I need to know about the workers compensation independent medical examination? Do I prepare for the workers comp IME? Will the IME doctor ask me questions? Is the IME doctor a real second opinion?
The IME doctor is not there to give you a second opinion. He is not going to give you medical advice or treatment.
The reason the insurance adjuster is sending you to the IME doctor is for the benefit of the insurance company, not you. Usually, the IME report opinions simply permit the insurance company to deny medical treatment and deny workers compensation benefits.
Generally, the IME doctor will not do anything invasive or painful to the patient. In fact, IME physical examinations are notoriously short and superficial. There are exceptions, but most IME doctors seem to have written their reports with little regard to the physical exam or other medical records. With a low back injury, the IME doctor will test for what are known as Waddell signs, which he will use to support his opinion that the patient is not as injured as claimed. He will also do some basic neurological or orthopedic tests to determine if the worker’s subjective complaints or symptoms are consistent with the objective diagnostic tests and treating doctor diagnosis.
The IME doctor is entitled to ask questions about the injured worker’s relevant medical condition and treatment. The IME doctor can ask about the accident or job duties over time that caused the work-related injury. It is important to answer directly and honestly. The injured worker (or his/her attorney’s) personal opinions or thought processes are not fair game.
As a general rule, avoid expressing anything in terms of “always” or “never.” For example, if one tells the IME doctor he or she can never carry the groceries or shovel snow anymore, the insurance company may have the worker followed to get surveillance video of the worker carrying groceries or shoveling snow. Similarly, although there are such cases, generally statements that one is always in constant pain, or pain is 10/10 on a pain scale, are met with skepticism by judges. Honesty is the best policy. It is best not to exaggerate, but also not to minimize.
The IME doctor’s opinions, and the insurance company denial of the claim, is not the last word. An experienced worker’s compensation attorney can review the IME report as well as the other medical records and make a determination of best the course to follow. The attorneys and paralegals at [nap_names id=”FIRM-NAME-1″] are familiar with most of the IME doctors working Wisconsin workers compensation claims.