Workers' compensation insurance provides those who are hurt on the job with great benefits. Unfortunately, the time may come when problems arise with those great benefits. To understand why this happens, it might be helpful to understand that the insurance company is losing money when they have to pay for your medical expenses and the partial wage you are earning while out of work. That can mean you'll run into issues like:
- The workers' comp carrier says your injury is not related to your job.
- They insist that you are ready to return to work, but you are not ready.
- The carrier suspects your injury is permanent.
When any of the above occur or any other questions arise in your coverage, you will be asked to participate in an independent medical examination (IME). Being prepared for this exam could mean the difference between continuing to get benefits or not so read on to learn more.
Take these actions prior to your exam appointment
Review your medical history: You might want to review not only the records that pertain to your current injury, but for any past injuries. Your workers' comp doctor may ask you about past injuries, but you must make it clear that your current issues are not related to anything else but your most recent workplace injury. Reviewing your notes will make it easier to answer the doctor's questions, but you can always bring your records, notes, correspondence, and more into the appointment with you for reference.
Ask to see the referral letter: You have a right to review the correspondence between your doctor, the IME doctor, and the workers' comp carrier. Make your request in writing and do so as far in advance of the appointment as possible. This letter will provide you with clues to the reason why this IME is being performed. The letter might also have a summary of your case, a list of medical treatments so far, and any findings about your case that are in dispute. Check the letter carefully and contact the workers' comp agency, your state workers' compensation board, and your employer with your written corrections.
Make sure your answers are consistent: Your IME doctor will review your original claim form for more information about how the accident happened. Be prepared to answer questions about the incident and make sure your answers are perfectly consistent with your original information. Minor inconsistencies, details added or left out, and misstatements of the facts can cast a shadow on your entire claim and could make it appear you are malingering or faking the injury.
Sometimes your IME results in some unexpected changes in your benefits. Speak to a workers' compensation lawyer for help in appealing your claims and getting the help you need. For more information, contact local professionals or visit sites like http://www.walzlaw.com.