IME

Your Doctor Says Your Ready to Go Back to Work but You Disagree

March 29, 2018 By James Hoffmann 1 Comment

If you don’t feel as if you are ready to return to work, you are entitled to seek the diagnosis of another specialist.

Workers’ compensation is insurance coverage that is taken out by an employer to ensure that they have the means to pay for an employee’s injuries if they are hurt while on the job, and it is required by Missouri law.

However, workers’ compensation isn’t like personal injury. If you collect workers compensation, then you are only entitled to specific things like economic damages in the form of medical bills and lost wages from work. You can collect benefits such as temporary disability and in extreme cases you can collect permanent disability. If you can no longer work in the same capacity you did before you were injured, there are instances where workers’ compensation will cover job retraining so that you can find employment in another field.

What You are Entitled To

While you are on temporary disability you only receive a portion of your salary, and you have to make sure to attend all physician appointments and follow through with any treatment plan like physical or occupational therapy. If you refuse to go to appointments, don’t show up for therapy, or don’t follow the doctor’s orders, your workers’ compensation benefits may be denied. When you are out on temporary disability, the intention is that you are working on healing and getting back to work.

What if You Don’t Feel You’re Ready to Return?

When your physician believes that you are well enough to return to your job, even if it requires modification, they will recommend that you go back to work and your temporary disability will end. But what if you don’t feel as if you are ready to return or feel as if you aren’t well enough to go back to your previous position? There may be instances when the medical professional who is in charge of providing the insurance company documentation believes that you are ready to go back, but you don’t agree.

If you are having a disagreement with your physician about whether or not you are ready to return, you do have the right to see another doctor and get a second opinion. Just like an insurance company can ask for an Independent Medical Examination, you are entitled to seek the diagnosis of another specialist. Be aware, however, that if you do, you will have to pay for the visit, and even if the other doctor sides with you, it might still be the case that workers’ compensation doesn’t agree with the new opinion.

St. Louis Workmens Comp Lawyer

In Missouri, if workers’ compensation does deny you coverage and demand that you return to work, then you either have to return to work and ask for modifications, or you have to try to appeal the decision. If you appeal, then you will want to have the help of an experienced St. Louis workers’ compensation attorney on your side to plead your case and to stop you from having to return to work too soon.

Contact the St. Louis Work Accident Lawyers

At the Law Office of James M. Hoffmann, our St. Louis Work Accident Lawyers have a strong history of helping injured workers get the medical attention and financial compensation that they need. Based in St. Louis, and handling workers compensation cases throughout the State of Missouri, we will ensure that your rights are protected. Please call (314) 361-4300 or fill out our Online Case Evaluation Form.

Do I Have to Comply With a Request For an Independent Medical Evaluation?

March 4, 2018 By James Hoffmann Leave a Comment

By denying the IME, you risk losing your workers compensation claim and ending up with nothing.

It is a law in the state of Missouri that all businesses or organizations with employees carry workers’ compensation insurance coverage. It’s not just used to cover an injured employee if they are hurt, it also ensures that one workplace accident with an employee doesn’t completely bankrupt a company or business. Workers’ compensation coverage will pay for anyone who is hurt while they are performing under the scope and authority of their employer.

Personal Injury vs. Workers Compensation

The major difference between personal injury and workers’ compensation is that when you make a workers’ compensation claim, although it isn’t based on any negligence on behalf of your employer, you are not entitled to receive any non-economic damages like pain and suffering. The trade-off is that a worker can be 100% at fault for their own injuries and still file a claim, as long as they can prove that they were doing work-related activities when the injury happened.

When you file a workers’ compensation claim, it is imperative that you have the proper documentation to show that you were not only injured, but also that you were injured while working under the authority of your employer. If you can prove those two things, then the only other issue might be the severity of the injuries that you are claiming. There might be times when an insurance company will question not just whether your work injuries were sustained while you were engaged in work-related activities, but also whether your injuries are as severe as you claim – or if they are even real at all.

Complying with the IME

If you have documentation from a physician, there are times when an insurance company will ask you to comply with an independent medical evaluation, or an IME. When asking for an independent medical examination, the insurance company will want you be evaluated by someone other than your own physician, to make sure that both physicians have the same diagnoses and conclusions regarding your injuries. The insurance company has the right to demand that you see someone that they choose. And although they have to pay for it, you do not have the right to deny the IME request – or you could risk losing your claim and ending up with nothing.

When to Hire a Workmens Comp Lawyer

If it is found that the IME disagrees with your physician’s recommendations or diagnoses, then there is a way to argue your case so that you don’t end up not getting your medical bills paid or having to return to work before you are healthy enough to do so. The best way to handle any discrepancy is to hire a St. Louis workers’ compensation lawyer to argue your side and to ensure that you receive the settlement that you deserve – not just for the here and now, but for any medical problems that could arise in the future. A St. Louis workers’ compensation attorney can help walk you through the complexity of the demand for an IME and any related issues.

If you have been injured at work and are having your claim denied, contact the Law Office of James M. Hoffmann today. We have more than 20 years of experience with helping injured workers receive the benefits they need and deserve. Call us at (314) 361-4300 or fill out our online case evaluation form to request a free consultation.

What if You Have an IME and it Differs from Your Physician’s Diagnosis?

February 7, 2018 By James Hoffmann Leave a Comment

If the IME does not reach the same conclusion as your doctor, then you do have a right to appeal the IME’s decision.

Workers’ compensation insurance is mandatory coverage that an employer is legally required to have in the state of Missouri. Designed to protect both employer and employee, it gives the employee a safety net to know that if they are injured while on the job, those injuries will be paid for. In the same respect, it protects employers from potential lawsuits that could bankrupt them.

The difference between personal injury lawsuits and workers’ compensation benefits is twofold. The first is that you do not have to prove that your employer was negligent to make a workers’ compensation claim. You can be solely responsible for your injuries, but if they happened while you were working under the scope of your employment, then you are likely eligible to collect. However, the second difference – and the downside – is that unlike personal injury lawsuits, if you make a claim for workers’ compensation, you are not typically entitled to emotional distress or pain and suffering.

What is an IME?

In most instances, if you are hurt on the job, you can seek the medical attention of your own physician unless the workers’ compensation insurance carrier has their own professionals that you have to see. But if you do seek medical attention with a physician of your own choosing, then it is possible that the insurance carrier might question the validity of the diagnosis and findings by your doctor or practitioner. They can order an IME (an independent medical examination), which simply means that you have to have another doctor evaluate your injuries.

The reason that some insurance companies will order an IME is if they believe that the severity of your injuries is in question or if they want to challenge the fact that they are work-related. If your injuries are determined not to be work-related, then they might have the potential to deny you coverage and ultimately negate their responsibility to pay.

What if the IME and Your Physician Disagree?

Your insurance carrier is only allowed to subject you to one IME, and they are responsible for both choosing who performs the IME and for covering the cost. If you are asked to seek an IME, failure to comply can mean losing your eligibility for coverage. If the IME does not reach the same conclusion as your practitioner, then you do have a right to appeal the IME’s decision and have a review board go over your case.

Although you are required to have an IME when ordered for your workers’ compensation claim, if your physician and the IME disagree about the severity of your injury or how it happened, then it is important that you hire a St. Louis workers’ compensation attorney to help you to file an appeal. They can help you prove that the IME is wrong and that the original diagnosis was right. A St. Louis workers’ compensation lawyer can help to plead your case and ensure that you don’t lose your eligibility to collect.

St. Louis Work Accident Lawyer

At the Law Office of James M. Hoffmann, our attorneys will work with you, regardless of where you are in the process. Attorney James M. Hoffmann has spent a majority of his more than 20 year legal career dedicated to protecting the rights of injured workers.

Based in St. Louis, and handling workers compensation cases throughout the State of Missouri, our law firm will ensure that your rights are protected. Please call (314) 361-4300 or fill out our online contact form. All communications are returned promptly.

Injured at Work? Your Responsibilities Regarding Your Claim

January 30, 2018 By James Hoffmann Leave a Comment

You have an obligation to mitigate your injuries and return to work when you are able.

When you are a business owner in Missouri, it is mandatory that you carry workers’ compensation insurance. Workers’ compensation covers both the employer and the employee should someone be injured while on the job. As a way of protecting everyone, it is used to ensure that a company has the means to cover an employee’s injury without going bankrupt and that an employee isn’t left without recourse if they are injured on the job.

Any employee is entitled to workers’ compensation if they are injured while performing under the scope of their employment duties, regardless of negligence. Unlike personal injury suits, to make a claim for workers’ compensation, you can be negligent (at fault) for your injuries and still collect. That does not mean, however, that if you collect workers’ compensation you don’t have some responsibilities of your own. If you don’t do what is required, you risk losing your eligibility.

You Have to Mitigate Your Injuries

When you are collecting workers’ compensation, you have the responsibility of mitigating your injuries. That means that you are required to do everything possible to make your injury better and follow the advice of your physician. If you don’t take the initiative to follow through with your doctor’s appointments, don’t participate in physical rehabilitation, or miss specialist’s appointments, it is possible for the insurance company to deny you workers’ compensation benefits. It is important that you keep all of your appointments and that you follow through with the recommendations that specialists and physicians make for rehabilitation.

You Have to Return to Work When You are Able

Your physician will determine when you are capable of returning to work. That might not always mean that you can return to your position in full capacity, or even in the same capacity. But if the doctor says you can go back to work, even with limitations, then you have the responsibility to return. Your employer must make the necessary accommodations for your limitations, but you do have to return or have a physician explain why you can’t.

Follow Through with an IME

An IME is an independent medical examination. There are times when your injuries or their severity might be questioned by workers’ compensation insurers. They have the right to order an IME, which means that another medical professional besides your doctor is allowed to examine you to verify that your injuries are real, work-related, and that the extent of them is as severe as reported. Workers’ compensation has to pay for the IME, but you are required to attend or you will likely forfeit your eligibility.

Although workers’ compensation is not based on fault or negligence, that does not mean that you don’t bear some responsibility for your injuries. The objective of workers’ compensation is to provide you a safety net to heal and return to work as quickly as possible. You have an obligation to do so by mitigating your injuries and returning to work when you are able. If workers’ compensation is questioning your eligibility, it is always a good idea to hire a St. Louis workers’ compensation lawyer to be in your corner.

Call the Law Office of James M. Hoffmann to discuss your case at (314) 361-4300 or fill out our online contact form.

What Is an Independent Medical Examination?

December 15, 2017 By James Hoffmann Leave a Comment

They may request an IME to prove that you were not injured at all.

Workers’ compensation is a type of insurance that employers are mandated to carry in Missouri. It’s an insurance policy that ensures that if an employee is injured while working, the employer has the assets to pay for their injuries. The trade-off is that if you are injured while working, you cannot collect for non-economic damages or sue your employer in a personal injury suit.

There are times when a workers’ compensation insurance company will allow you to go to your doctor, and others when they will send you to their preferred physician for medical attention.

In some cases, an insurance company will question the type of treatment that you are receiving. Most often, they will ask whether it is necessary and appropriate. If they feel the duration or extensive nature of your treatment is more than necessary, they might request that you seek an independent medical examination (IME) to prove what your injuries are and whether the care is appropriate. They may even request it to prove that you were injured at all. Sometimes an IME is required before an insurance company will pay for any medical treatment.

What is an Independent Medical Examination

An independent medical examination allows the insurance company to request that you be seen by their preferred physician. They do have the legal right to request that you be examined and that you go to the physician that they choose. If you do not go to the IME, then you might risk losing your workers’ compensation eligibility.

If an insurance company is asking you to seek an IME, then it is an excellent idea to contact The Law Office of James M. Office. We understand how the insurance companies work and can advise you about what your rights and obligations are. The insurance company has the right to require that you seek a second opinion to verify that you were injured, that you were injured to the extent that was diagnosed and to help verify that your injuries were actually work-related and not caused by something else.

Who pays for the IME?

The good news is that although it is a hassle, the insurance company is required to pay for the IME. There are even times when they will have you seek more than one IME if there are conflicting findings, any costs of which would also be the responsibility of the insurance company.

If you are injured while on the job and have been asked to have an independent medical examination, then it is imperative to have a St. Louis workers’ compensation lawyer review your case. There is a great likelihood that the insurance company is trying to find a way to deny coverage. Having someone to protect you is crucial to ensure that you receive fair compensation for your injuries and the treatment that is necessary to make a full recovery.

Work Injury Lawyer St. Louis

Missouri Workers’ Comp enables an injured worker to receive medical benefits as well as income benefits. You should be receiving treatment for ALL of your injuries, not just the ones the insurance company wants to accept. Do not let the carrier deny you benefits.

If you have any questions about your work injury or your work comp claim, contact The Law Office of James M. Hoffmann by calling (314) 361-4300 or by filling out our online contact form.