Preparing for an Independent Medical Examination
Our firm fights for injured workers in Brooklyn, Queens and throughout New York
If you have been injured in a workplace accident in New York, you are eligible to receive workers’ compensation benefits. However, employers and insurance companies routinely challenge claims. For example, they may question the seriousness of your injuries or argue that they were pre-existing.
The insurance company can’t tell you which doctor will provide treatment for your injuries. However, they can request an independent medical examination (IME). This will be performed by a medical professional authorized by the New York State Workers Compensation Board and hired by the insurance company.
Injured workers need to be prepared for the IME process, and our workers’ compensation lawyers are prepared to help. Remember, this article is general information, not legal advice on your specific situation. The best thing you can do to prepare for an independent medical examination is to speak with an experienced New York workers’ compensation attorney as soon as possible.
What to know about the IME process
The professional who will conduct your IME is called “independent,” but again, they are hired and paid by the insurance company, so the term “independent” is misleading. The insurance company is not concerned about your health. They have hired this doctor because they are looking for a reason to deny your claim for benefits or reduce their payments in some way.
You may be required to undergo an IME requested by the insurance company in order to remain eligible for workers’ compensation benefits. However, you also have several rights:
- The insurance company must give you at least 8 days’ notice before an IME.
- The examination must take place in a location that is reasonably convenient for you.
- The report must be sent to the injured worker and the insurance company within 10 days of the examination – and mailed to both parties at the same time.
- You have the right to bring a witness to the examination.
- You have the right to have your examination recorded (audio or video).
When you go to your IME appointment, the doctor will review your medical records. You may be asked some questions. The doctor may also conduct a physical examination of your injuries and/or run some tests. An IME typically does not take very long.
Here are some things you should know before your appointment to help you prepare:
Remember this examination was requested by the insurance company.
The doctor who examines you may be kind and the office may have a comfortable atmosphere. But keep in mind that it was the insurance company that asked for this examination. Their goal is to minimize your injuries so they can limit your benefits. Keep your focus on answering any questions accurately but succinctly. Don’t offer any information.
Be aware that the evaluation begins as soon as you arrive.
The doctor will examine you to determine the extent of your injury. But the doctor will also notice how you are walking, if you are having trouble with any type of movement, and whether you appear to be in physical discomfort. Don’t exaggerate any difficulty you are having. But keep in mind that you are being evaluated during the entire time that you are in the office.
Answer questions honestly.
The doctor may ask you about the pain you are experiencing or any limitations your injury has brought. Insurance companies have been known to hire private investigators to watch injured workers out in public to see if they are exaggerating any limitations. Whether they do that in your case or not, your best approach is always to answer honestly.
Review the report with your lawyer.
Following the IME, the doctor will complete a report and send it out to both parties. The insurance company will use this report to make a determination on your benefits. It’s always best to review the report with your attorney to understand how it could affect your claim.
There are several reasons why an insurance company may deny your claim after they read the IME report. The IME doctor may have determined that your injury is not serious enough to qualify for benefits or to require specific types of treatment that your treating doctor has recommended. The doctor may conclude that you are capable of returning to work – even if you are still experiencing discomfort or pain. It is also possible for the IME to find that your injury was pre-existing.
But even if the IME report does not support your claim for benefits, you still have options.
How a workers’ compensation attorney can help
An experienced lawyer can help you prepare for the IME by giving you more information about the process and going over the types of questions that you are likely to be asked. Your attorney can also review the completed report and advise you on the next steps to take.
If your claim for benefits is denied, you have the right to dispute the denial in a hearing before a workers’ compensation judge. A lawyer can investigate your work injury and examine your medical records to build a strong case for why you should receive benefits. Your lawyer can represent you at the hearing,
If the judge rules on the side of the insurance company, a lawyer can help you file an appeal of that decision to the Workers’ Compensation Board. There are also additional appeals that your lawyer can help you pursue, if necessary.
Fighting for workers in Brooklyn, Queens, and beyond
New York workers’ compensation law is very complex and highly technical. There are also deadlines and standards that need to be met when filing a claim for benefits. The experienced attorneys at Pasternack Tilker Ziegler Walsh Stanton & Romano LLP have a thorough knowledge of state laws affecting injured workers and are very familiar with how the system works.
Our attorneys understand how an injury can affect workers and their families and are determined to get the best outcome possible. We put in the time and resources needed to move your workers’ compensation claims forward. Our firm has recovered millions for clients through settlements and awards.
If you were injured on the job in Brooklyn, Queens, or anywhere in New York, we’re ready to fight for you. Contact us to schedule a free case evaluation.
Click here to download a PDF of this article, “Preparing for an Independent Medical Examination.”