When you’re hurt on the job in Arizona, it’s not uncommon for your employer’s insurance company to require you to be seen by a different doctor than your treating physician for an independent medical examination (IME).
Even though doctors are supposed to be impartial and patient-focused, there are instances where the medical examiner is biased and will skew their report in favor of the insurance company. For this reason, it’s important to take time to understand the purpose of the independent medical examination and tips that will help make the IME go smoothly.
Purpose of an Independent Medical Examination
It’s in the best interest of your employer’s insurance company for you to be seen by an independent doctor. The insurance company does this for several reasons, including the following:
- To verify that the treatment your doctor gives you is appropriate and necessary
- To verify that the facts you’ve provided relating to your accident are consistent with the injuries you are experiencing
- To provide a report assessing any permanent work restrictions, permanent disability or the need for the supportive medical care
Tips for Independent Medical Examination
Going to see a new and unknown doctor can be intimidating, especially when you know that their report could prevent or minimize the benefits you ultimately receive. However, if the insurance company requests an IME, you are required by Arizona law to attend.
The following tips will help you prepare and know what to expect at the examination:
- Attend the examination. You will be ordered to attend the examination, even if you don’t want to go. Make arrangements to attend and understand that it is NOT optional.
- Be on time. If you miss the examination or if you’re late, you could be sanctioned and charged a fee to pay for the doctor’s time. It could also result in your benefits being suspended. It costs approximately $700-1,500 for the examination and report from the doctor.
- Don’t cancel at the last minute. You will be provided approximately 15 days notice. If you have a conflict in your schedule, inform your attorney immediately.
- Complete all forms accurately. You will be required to fill out forms regarding your work accident and injuries. It’s important to be accurate and honest in completing the forms. Don’t exaggerate your pain because it’s likely that it will be used against you later. At the Law Offices of Robert Wisniewski, we will seek to get the forms prior to your IME to help you complete them.
- Be honest with the doctor. Describe your pain in as much detail as possible and as accurately as possible. If you experienced pain prior to your accident, don’t be reluctant to state that if the doctor asks. It could be that you experienced pain before but tried to work through it because you needed to support your family. If that’s the case, explain so to the doctor.
- Explain gaps in treatment. If you didn’t receive treatment or care for a temporary period of time, be sure to explain the reason why. For example, it could be because your claim was denied or you could not afford it. Those are good reasons for not receiving care and should be explained.
- Be respectful and courteous. Answer the doctor’s questions directly, briefly and honestly, but be respectful while doing so.
- Record any time spent with doctor. Keep track of the time you spend with the doctor. Often, the doctor will spend limited time with you and most of the examination will be conducted by a physician’s assistant. Keep track of the time that you spend with both the physician’s assistant and the time spent with the doctor.
- Don’t volunteer information. Answer questions directly when the doctor asks, but be as brief as possible. There’s no need to provide more information than requested, as this might be reported to the insurer and used to deny or reduce your benefits.
- Make an appointment with your doctor. If possible, make an appointment to be seen by your regular doctor the same day as your independent medical examination. This will help resolve any discrepancies that may arise as a result of the independent doctor’s report.
- Don’t discuss conversations between you and your attorney. The discussions with your attorney are confidential and shouldn’t be discussed with the doctor during your independent medical examination. The doctor should only speak with you regarding the medical condition that’s at issue in the workers’ compensation claim.
- Don’t ask for a diagnosis or recommendations. At the end of the independent medical examination, don’t ask the doctor for his diagnostic or recommendations. You will be provided a copy of the report within 1-2 weeks and see it at that time.
Any disputes arising during the IME must be resolved through the hearing process, and it’s beneficial to have an experienced and knowledgeable attorney to represent you during this complex process. The attorneys at the Law Offices of Robert E. Wisniewski have the necessary experience.