If you have been involved in a Minnesota work comp case lasting more than a few months, you may have had the experience of being ordered to attend an Independent Medical Examination (usually referred to as an IME). Not everyone with a work comp claim will be subjected to an IME. If your claim involves a relatively minor injury or you make a quick recovery, the insurance company may not spend the time or expense to have you examined by their own doctor.
However, in my experience, the longer your claim remains open, the more likely it becomes that the insurance company will send you for an independent medical examination. If you are reading this article, you probably have some questions. Let me try to help.
What Is an Independent Medical Examination (IME)? First of all, at Bradt Law Offices, we refer to these exams as A ME’s, not IME’s. In my world as an employee’s attorney, AME stands for anadverse medical examination. After representing injured workers for over 28 years, I have come to the conclusion that these examinations are anything but “independent". They are simply an opportunity for the insurance company to hire a doctor to give an opinion which favors the insurance company.
But I digress. An independent medical examination is an evaluation performed by a physician chosen by the work comp insurance company. Because the majority of work injuries involve the back, neck, bones and joints, the physician will often be an orthopedic surgeon. If your injury is something more unusual, the insurance company may have you seen by some other type of specialist.
Do I have to attend an IME? As a general rule, yes. The law in Minnesota states that “The injured employee must submit to examination by the employer’s physician, if requested by the employer, and at reasonable times thereafter upon the employer’s request." (Read the actual statute here). If you fail to attend a scheduled IME, unless you have a good reason (such as illness or an emergency) you could jeopardize your claim. The insurance company will argue that you have failed to cooperate with them and will probably attempt to discontinue your wage loss, medical benefits or both.
How far do I have to travel for an IME? The general rule requires that the examination must be scheduled within 150 miles of your residence. However, you may be ordered to attend an IME beyond the 150 mile range if:
Does the insurance company have to pay my mileage and expenses for traveling to the IME? Yes
Why does the insurance company need an IME? An insurance company is always trying to pay as little as possible on any injury claim. Even though your treating physician or surgeon may be in the best position to give opinions about your case, the insurance company might not agree with your doctor’s opinions. For that reason, they need a contrary medical opinion which will allow them to cut off your benefits, limit your medical care, deny a surgery, establish more lenient work restrictions or give a lower permanent partial disability (PPD) rating. For that contrary opinion, they hire an “independent" (adverse) doctor to examine you and write a report.
How do I fight against an independent medical examination report? An experienced work comp attorney will usually be able to get reports from your treating doctors to support your claim. Your treating physicians will generally have more credibility than the insurance company's “hired gun" at a workers' compensation hearing. In some cases, your own attorney may even send you to a medical specialist for an independent medical examination and report, if necessary, to combat the insurance company doctor’s opinions.
If a deposition is taken of the insurance company doctor, your attorney will get a chance to cross examine him and point out how frequently he does examinations for insurance companies and how he almost never writes a report which supports the injured employee.
If you have a work comp claim and receive a notice from your insurance company that you are being scheduled to attend an IME, that might be a good time to touch base with a lawyer. A workers’ compensation claim can be a confusing, frightening and frustrating ordeal. Please don’t be afraid to contact us, anytime, if we can answer some questions for you. It won’t cost you anything and we will give you our honest assessment about whether you need a lawyer to represent you.
You are dealing with an insurance company which handles hundreds or thousands of claims every day. They have experienced claims adjusters and attorneys managing their files. Even if you don’t need a lawyer at the moment, a little information about the work comp system can make a big difference for you in your dealings with the insurance company.