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Submitting the documentation for a workers' compensation claim is only the beginning of receiving what is due. Many insurance companies for employer-provided workers' compensation policies also require the injured employee to get an Independent Medical Examination (IME). It helps them discover any discrepancies they can use to dispute the origin, severity, and limitations of an employee's workplace-related injuries. It will be also helpful to fully understand what you cannot do while on workers comp.
What Is an IME?
An IME is a medical evaluation conducted by a third-party workers' compensation doctor to assess injuries and their impact on an employee's ability to work.
The insurance provider for an employer's workers' compensation coverage typically requests an IME. It uses it to evaluate the validity of a workers' compensation claim.
If necessary, the insurer uses it to refute the amount and impact of the injuries on their ability to earn a living.
Questions Often Asked in a Workers’ Comp IME
An IME doctor first requests medical records or other related paperwork, after which they perform a physical examination. During an IME, they ask several questions relevant to the claim. These include the following:
What are the victim's symptoms before, during, and after the workplace accident?
Did they have a medical problem before the workplace accident?
Did the victim experience any signs of this pre-existing condition at the time of the accident?
Did the collision cause any injuries or make pre-existing condition symptoms worse?
Are the injuries preventing the victim from working in any way? Was there any persistent handicap as a result of the accident?
Has the accident or wound affected the victim's day-to-day activities?
Does the injured employee require more medical attention for their injuries, such as physical therapy, surgery, or specialist care?
What was the diagnosis made by the victim's doctor?
Another important question often asked and may interest you is, whether or not a job can fire you while on workers comp.
What Not to Say at an IME
Do Not Ask the Physician for a Diagnosis
Employees should remember that it is not the independent medical examination doctor's responsibility to diagnose the injuries sustained. That is the job of the medical professional to supervise their healing process.
The IME doctor's responsibility is to evaluate the injuries and to compile a report for the employer's insurance provider.
Victims should refrain from asking the doctor for a diagnosis since the examination only determines if the damage is as severe as alleged.
It also helps them decide whether the victim qualifies for workers' compensation payments.
Do Not Exaggerate the Symptoms of the Injury
Many believe exaggerating their symptoms to the IME doctor will aid their quest for workers' compensation payments. However, this will only work against their claim.
The doctor has experience in identifying such attempts, and detecting it hurts the victim's credibility.
During the independent medical evaluation, the injured employee must be as straightforward and honest as possible.
Avoid Oversharing
The victim should be direct when answering questions regarding the injuries or disease and its accompanying symptoms. They should also try not to talk too much after giving the answers.
Employees should remember that the insurer hires the doctor to find issues with their claims.
Regardless of how chatty and sympathetic they seem; they are not on the victim's side. Oversharing could unintentionally harm the case and hinder their ability to get maximum workers' compensation benefits.
A seemingly harmless remark could become evidence to dispute parts of the claim.
Never forget that the doctor's commitment is to the insurance company that serves the employer. Their interests and that of the injured employee are different regardless of how nice and understanding they are.
Contact an Experienced Workers' Comp Attorney for Guidance
Workers' compensation claims and the subsequent process are challenging, and defense counsel and insurance providers are frequently not on the side of the accident victim, this is why it is best to contact Columbus work injury attorneys for support.
It is easy for many people to think they can attempt to file a compensation claim on their own to save money. However, this action costs them more than the attorney fees they try to avoid.
The claim fails, or they get an amount way below a fair settlement.
Larrimer & Larrimer has years of experience helping workplace accident victims get fair compensation from employers. We offer a free consultation for anyone who wants to file a claim and guide them through the processes. This includes what to say and what not to say during an IME.
Call us at (614) 820-1855 to speak to our reliable attorneys or visit any of our offices in Ohio.
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