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The Independent Medical Exam

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Dealing with medical records and bills can be one of the most difficult parts of sustaining an injury at work. It can be made worse sometimes by the fact that your insurer will require you to undergo a medical exam from a doctor other than the one you would prefer. This is referred to as an independent medical exam (IME), and many employers will require you to complete one before they will approve benefit expenditures. It is nonetheless important to be aware of the potential pitfalls that can await you.

Not Always Required, Not Always “Independent”

An IME is not always mandated in workers’ compensation cases; most often one will be ordered by your employer’s insurer, if there is any kind of discrepancy suspected regarding your injuries. On rare occasions, one will be ordered by Florida’s Division of Workers’ Compensation or a judge of compensation claims, but this is extremely unusual. In Florida, the scope of an IME is fairly broad, unlike in other states where its parameters are more clearly delineated, and as such, the medical provider has a significant amount of leeway to ask questions and investigate your condition. The relevant statute does not limit the medical provider solely to questions about the work-related injury.

While most IME providers operate perfectly legitimately and in accordance with the ethical rules of the profession, it is important to be aware that a small subset of these doctors can and do collude with insurance companies to produce unfair results. Some medical providers in the past have received financial incentives to either downplay the extent of an injury, or to clear a person to return to work far too soon, which saves the employer from both paying that person’s benefits and their insurance premium going up. While this is far more rare than it used to be, it is nonetheless a good idea to be aware of potential malfeasance on the part of either the doctor or the insurance company.

Dos & Don’ts

If your employer requires you to submit to an IME, it is recommended, above all else, to be honest. Exaggerating symptoms or fudging dates only contributes toward an atmosphere of suspicion, and if you have been asked to undergo an IME, it means suspicion is rife already. It is also a good idea to review any relevant accident records and ensure that your story is the same as it was when it was told to your employer. Being familiar with what you are asking for is also critical – for example, compensation for pain and suffering is not compensable in Florida, as it is simply too subjective to assess in a medical exam.

It is generally a good idea, if possible, to take notes during your IME, or to take a friend or your attorney with you to help remember. Even with an honest medical provider, getting into a situation where it is essentially your word against theirs is a less than optimal position to be in. Doctors are not immune from making honest mistakes, and having a written record of the discussions between you may be beneficial in defending your case from being closed. The ultimate goal is to receive compensation for your injury, and while it should not be difficult, sometimes it will be.

Contact A Winter Park Workers’ Compensation Attorney

Obtaining workers’ compensation after an on-the-job injury can be a drawn-out process, even if your employer is fair and your medical providers are legitimate. An attorney can be of great help to move the process along. The Winter Park workers’ compensation lawyers at the Hornsby Law Group are well versed in these types of cases, and we are happy to put our experience to work for you. Call the office today to set up an initial appointment.

Resource:

leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0440/Sections/0440.13.html

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