Warning about the independent medical examination (IME) and how it can be used to limit payment of workers’ comp benefits.
We hate giving bad news to people who call our office. Many of these individuals have suffered enough dealing with bad employers and obnoxious insurance carriers.
A frequent question is about the independent medical examination (IME) and how it could impact workers’ comp benefits. Unfortunately, when someone is scheduled for an IME, it usually means trouble is on the horizon.
Some people believe the IME is a second opinion and it will help them figure out better treatment options. Others have done online research and panic when they see negative doctor reviews.
The truth is that IME doctors are not “independent” and get paid large sums of money to testify against disabled employees. Insurance companies use the same doctors over and over again because they know what to expect. One local doctor regularly performs hundreds of IMEs each year and has earned millions of dollars.
Michigan law requires that an employee must submit to a medical examination ordered by the employer or its insurance carrier. They may also be requested from time to time thereafter.
It is common for our clients to receive short notice of the IME. They will be asked to bring medical records and digital imaging such as CT or MRI films. A medical history will be taken, and physical examination performed. Individuals are not permitted to bring anyone into the examination room except their own physician. Audio or video recordings of the examination will not be permitted.
A written report discussing causation and disability will be drafted after the IME is completed. The insurance carrier has 15 days to provide the employee or attorney with a copy. Our experience shows time requirements are rarely followed and it can take months. Here are 4 ways the IME can be used to limit payment of workers’ comp benefits.
1. Forced back to work early: It is common for the IME doctor to return an employee to work. This is when limits are placed on physical activities. Common restrictions are sit/stand option, no lifting over a certain amount of weight, and need for rest breaks. Problems occur when a person cannot do the work. Insurance carriers also will also ignore recommendations from the employee’s doctor. Failure to attempt the job will result in forfeiture of lost wages.
2. Lost wages stopped: We see many IME reports that return an employee to work without any restrictions. It does not matter what the employee’s doctor believes. Lost wages can be stopped immediately and without warning. It does not even matter if the employer has a job available.
3. Medical treatment options are limited: Sometimes IME doctors will agree that a person has a work-related problem and needs medical care. However, they will disagree with the current course of medical treatment. This can result in a situation where future medical treatment options are limited. The insurance company does not want to pay for anything it deems unnecessary.
4. Medical treatment stopped entirely: The IME doctor can also find an employee fully recovered or has reached maximum medical improvement (MMI). The insurance company will usually stop payment of medical immediately. It is also possible that the IME doctor finds a condition is not related to employment despite months or years of prior treatment. It is common for people to be told their problems are degenerative or congenital. Medical treatment will be stopped entirely.
Michigan Workers Comp Lawyers never charges a fee to evaluate a potential case. Our law firm has represented injured and disabled workers exclusively for more than 35 years. Call (844) 316-8033 for a free consultation today.
Related information:Independent Medical Examination, Michigan workers comp lawyers