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I just had an IME exam, L&I requested. Can I protest if I disagree with IME decision?

Kent, WA |

Well it went kind a rough, I did not have a chance to explain all my symptoms and pain because the doctor were interrupting me and did not let me finish explaining my self. The other doctor did the physical exam and he was also rude and joking allot.He did the exam too fast, was rough on me, the physical exam should not cause me any harm or pain discomfort, this is what the letter said: But this doctor did this to me, force and twist my injured hands hard way too much, I felt lot's of pain and discomfort. I told him that and he just ignores everything. Don't want to listen to my complaints at all, "He is saying I am not your doctor, I am not here to treat you, you will tell your doctor your symptoms" I had a witness with me at that exam. What to expect from these IME? Thank you.

Attorney Answers 5

Posted

You can protest the IME. However, I would talk to an attorney to ensure you have all your facts covered. Get a statement, in writing from your witness, and prepare your statement as well. You can complain to L&I before a decision is reached by the IME doctor or you can wait until you see the reports contents. I am of the mind that you immediately send in your statement and your witnesses statement. Then if the exam is favorable, you do not have to worry about it. It also gives more validity to your complaints latter on.

This answer in no way creates an attorney client relationship between the parties. If you would like to seek our representation please contact our office and set up an appointment.

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Asker

Posted

Thank you Drew for quick response and your best answer.

Drew D Dalton

Drew D Dalton

Posted

You are welcome. I am glad I could help.

Asker

Posted

Hi Drew, Do you think maybe it would be better to complain to L&I after I receive IME report? Because if I do this before they might write something bad against me and my claim. Thank you for your help and advise.

Posted

This is the nature of L&I exams. It is a wake up call for many honest and seriously injured workers when they find out that these exams are not independent, are not kind or gentle, and are performed by doctors who are trained to limit or end care, reject conditions, and limit or stop necessary and reasonable benefits. I am sorry to hear about your experience. If you, like so many, were not treated fairly, then excercise your rights as Drew suggested. Have your doctor correct the exam findings and conclusions, complain to the DLI and share your experience with others online. Learn more about the system. Knowledge is power.

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Asker

Posted

Thank you so much Patrick got your advise. Also, can I protest if I disagree with IME report if it will be negative when I will receive it from DLI? Thank you for your help. :)

Patrick Arthur Palace

Patrick Arthur Palace

Posted

You can't "protest" as we use that word. It's used to fight orders. But you can disagree, and you should. So should your doctor.

Asker

Posted

How do I disagree? And where at? Do I need to report my decision to DLI that I disagree? And what the DLI say about my disagreement? Thank you for your help sir.

Patrick Arthur Palace

Patrick Arthur Palace

Posted

You should write your claims manager.

Asker

Posted

Okay, sounds good. Thank you for advise.

Patrick Arthur Palace

Patrick Arthur Palace

Posted

My pleasure. Happy to help.

Asker

Posted

Dear Patrick Palace, I do have another question and was wonder if you can give me am answer? Earlier, you said that I should write my claim manager about to disagree with decision. Can I write my claim manager after when I will receive report from IME? If I do this earlier, this decision will reflect on my report and the IME doctors might write something bad against me? Please let me know your thoughts. Thank you sir, Kind regards,

Posted

Generally the Department or self-insured employer will send a copy of the IME report to your attending physician [AP] and ask the AP no concur. Be sure to contact your AP right away and ask your AP to not respond until the AP reviews the IME report with you. Your AP also has the right to schedule you with a consulting doctor of the AP's choice pursuant to WAC 296-20-051.

This would be a good time to contact a competent local workers' compensation attorney for a free initial consultation.

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Posted

In addition to the excellent advice I see here already, you may also choose to forward your and your witness' statements to the Department's IME Quality Assurance representative. It is her job to make sure that IMEs are doing their job. This may not solve your individual problem, but if enough injured workers complain about the same IMEs, action may be taken. I am sorry that this happened to you; I only wish I could say I was surprised. Your letter may be sent to :

Carol Britton, RN, BSN, MBA
IME Quality Assurance
Provider Credentialing & Compliance
PO Box 44322
Olympia, WA 98504-4322

This response is meant to be informational only and should not be considered legal advice. This information is neither meant to be nor should it be construed to be the establishment of an attorney client relationship. I work in the area of Workers' Compensation and Social Security Disability in Washington state.

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Roger Harvey van Hoy

Roger Harvey van Hoy

Posted

At the risk of sounding like a grouchy ol' guy, from my 27 years' experience with L&I it may very well be that the Department is happy with your IME results. Focus now on getting your own AP to disagree with the IME and send you to a consultant of your AP's choice. "Independent" is a cruel hoax; they're really Insurance Medical Exams, hired to not find much if anything wrong with you and, if they find something, to blame it on some other cause. It's become a matter of getting your AP to advocate for you. Don't hesitate to consult with a competent local workers' compensation attorney.

Asker

Posted

Sir, my doctor said that he will support my claim all the way, also when he will receive report from IME, he said that we together will go over and concur. Thank you for your advise.

Posted

Although you could document your disagreement with the DME's findings, the report itself is not appealable. Only if L&I acts on the report to your detriment would I advise you to protest or appeal. And your own Doctor may do that for you. In a DME vs treating Dr. smackdown, treating Dr. usually wins...

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