I am seeing an IME Dr. Who is afiliated with same hospital

Asked over 1 year ago - Scranton, PA

I am seeing an IME Dr. Who is afiliated with same hospital as my neuroligist. This IME doc is surgeon at the same hopital. Will this IME doc go against my doc and say otherwise? I have read some really bad reviews on the IME from this doctor. I have to have surgery and Ins co scheduled me with an IME with the doc.

Attorney answers (5)

  1. Ryan Scott Zavodnick

    Contributor Level 6

    3

    Lawyers agree

    Answered . Without knowing who the doctor is or the specific facts of your case/injury it is difficult to provide an opinion on whether the IME doctor is likely to agree or disagree with your neurologist as to whether you require surgery and whether the surgery is related to your recognizned work injury. Although an IME stands for "Independent Medical Examination" it is the farthest thing from independent and the insurance companies frequently schedule you to be seen by a doctor who more often than not provides them with an opinion that is contrary to what your treating doctor has said, therefore, you are right in questioning whether you will get a fair opinion from the IME doctor.

    If you are not represented by an attorney you should contact one immediately, and definitely prior to the IME, to review the facts of your case and to assist you in obtaining the medical treatment that your doctor has advised you require. You may also be entitled to additional benefits that only an experienced workers' compensation attorney would recognize you are entitled to. Almost all workers' compensation attorneys will provide you with a free consultation to review your case and most work on a contingent basis, meaning you will only have to pay them should they obtain benefits for you.

  2. Richard Alan Jaffe

    Pro

    Contributor Level 13

    3

    Lawyers agree

    Answered . Without knowing the identity of the IME physician, it is unclear as to what the results of said exam will be. Although the exception to the rule, there are actually some "honest" IME physicians out there even though most of them are "hired guns" who will tell the Workers Compensation Carrier what they want to hear.

    The more important question is whether or not the Workers Compensation Carrier is even entitled to the Independent Medical Examination at this point in time.

    It has been my experience that many employers in Pennsylvania improperly controlled the medical treatment of injured workers and I typically take the position that in those instances if the employer improperly sent there employee to a "panel physician" without complying with their obligations pursuant to the Medical Cost Containment Regulations that the Workers Compensation Carrier may not be entitled to a "IME."

    if your doctor is recommending surgery and you believe it is the best course of treatment, you may want to file a prospective request for Utilization Review and force the Insurance carrier to pay for the procedure without going to the IME.

    Given the paucity of information that you have provided in your question, it is my recommendation that you immediately contact an attorney who is experienced in handling Workers Compensation Claims to determine whether or not you should attend the IME. Please note that most attorneys who handle Workers Compensation Claims will handle your case on a Contingent Fee basis and will not charge for an Initial Consultation.

  3. Joseph Benjamin D'Amico

    Contributor Level 7

    3

    Lawyers agree

    Answered . I don't trust any IME doc in Pennsylvania. The fact that the IME is in the same hospital as your treating doc might actually help in that the IME doc will know that he/she will likely run into your doc in the hallways and MAYBE that could result in a more honest IME opinion. Scranton is a place where the professionals all know each other. So I still don't trust that you will get an honest opinion, but there is hope in your case.

  4. C. Lee Anderson

    Contributor Level 3

    Answered . The fact that the IME doctor is from the same hospital more than likely increases the chances that he will support you doctor. However, there is no guarantee of this. This would be more likely if he was in the same doctor's office and not just at the same hospital. As Joe D'Amico stated above, you should not trust any IME doctor. They are paid for by the insurance company, and they know why they are being hired. Insurance companies are not in the business of paying claims. They are in the business of saving money. The best way to do that is to get a medical opinion that will result in getting you off comp. This kind of question is best addressed by an attorney who specializes in workers' compensation and who practices in your area. We can help you. We regularly handle cases in Scranton. Feel free to call one of our attorneys at MyCompLawyers.com (1-800-875-2010) to discuss the specifics of your case. We know most of the doctors who treat claimants and most of the IME doctors in your area.

  5. George Ellis Corson IV

    Pro

    Contributor Level 20

    Answered . The IME may or may not agree with the Treater, but the Insurance Company clearly wants a second opinion before they pay for the surgery/recovery/Disabilty payments arising out of the recommendation.

    We give free general concepts to be helpful, but you should give ALL your facts to a licensed Attorney in your... more

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