Michigan workers’ comp attorney discusses the independent medical examination and how to challenge biased medical reports.
Our job as workers’ comp attorneys is to protect employees hurt on-the-job. We hate giving bad news to people, but sometimes it is necessary when the insurance company is playing games. This usually starts when an independent medical examination (IME) has been scheduled. This examination is mandatory and failure to attend will result in a suspension of workers’ comp benefits. A frequent question is what happens when the IME disagrees with my doctor?
Employees who are on workers’ comp are routinely examined by a doctor selected by the insurance company. These so called “independent” medical examinations are typically used for the purpose of a cut-off. Insurance companies use the same doctors over and over because they know what to expect. Some of these doctors make careers out of testifying against disabled employees and earn millions of dollars in the process. Clients have reported that an IME can take as little as 15 minutes and the doctor barely examines them. We recommend attending the IME but having an attorney in place should workers’ comp benefits be stopped.
Unfortunately, it is common for IME doctor to find a problem is not work-related. This can happen months or years after a claim has already been paid. They use incidental findings of arthritis or degeneration to say a medical condition is from old age. It does not matter that a problem started when the workplace accident occurred or that a treating doctor believes it to be work-related. What happens when the IME disagrees with my doctor? Medical treatment is stopped immediately.
IME doctors are also notorious for saying that an employee has fully recovered and can return to work without any restrictions. This medical opinion is sometimes based upon surveillance video obtained by the insurance company through private investigators. IME disagrees with my doctor and claim disputed? Wage loss benefits are stopped.
The burden is on the disabled employee to file an Application for Mediation or Hearing. This will start a formal process where the workers’ comp case is assigned to a magistrate. It will be necessary to present medical evidence from a treating doctor to challenge the biased IME. The magistrate will make a finding regarding payment of additional medical treatment and/or wage loss benefits. Our experience shows most of these cases are eventually settled for a lump sum cash payment.
We tell our clients to use their health insurance when medical treatment is cut-off. It is critical to have evidence of continuing disability for the workers’ comp case. Employees who settle their workers’ comp case will need to reimburse the health insurance company for any money it paid out. This is never a problem because an experienced attorney can negotiate liens and make sure medical bills get covered.
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.