It’s not uncommon for the insurance company to ask for an IME, and generally speaking, they are not necessarily a cause for alarm.
When you suffer a work injury or have contracted an illness because of your job, and open the worker’s comp process, you will generally receive treatment by a doctor of your employer’s choosing, as is stated in Missouri’s legislation.
In most cases, this decision is left to the insurance company, since they are the ones who will need to interact with the doctor throughout your claim, but you may also be asked to take part in an independent medical examination(IME).
So why, if the company chooses your doctor, would they ask for another examination from a third party? And what will this examination look like?
Why an Independent Medical Examination May Be Required
Usually, the insurance company will ask for an IME for two reasons:
- To clarify certain aspects of your injury or illness, before you even begin your treatment
- When they do not agree with the course of treatment
Say you went to your doctor with a cough. Upon investigating, your doctor tells you that you have some lung scarring you most likely got as a result of your job, where you are breathing in airborne dust. You file a worker’s compensation claim, as is your right, but the insurance company may not agree with the diagnosis, or that your condition is work-related. So, they ask for an IME to shed some light on the matter.
Or, say you’re already receiving treatment, from the doctor of the insurance company’s choosing. At one point, the doctor may recommend a certain expensive procedure, and the insurance company doesn’t want to pay for it. They will need an IME so establish if that procedure is really necessary, or if there is an alternative.
It’s not uncommon for the insurance company to ask for an IME, and generally speaking, they are not a cause for alarm.
What to Expect from an IME
Here’s what usually happens during an IME:
- The doctor reviews your medical records, and other records relevant to your injuries (sometimes, doctors may review them after the examination)
- You will meet with the doctor in-person for a discussion and an examination
- The doctor will ask you questions about your injuries, the accident, life after the accident, and make note of your answers
- Some physical exams and tests may also be performed
After that, the doctor writes a report and sends it to the insurance company. Note that this report holds a lot of weight, and if the IME report finds any inconsistencies in your case, or sides with the insurance company, your entire case may take a turn.
Ensure Your Rights Are Protected
If you haven’t yet done so, get in touch with an experienced St. Louis worker’s compensation lawyer as soon as possible. They can ensure you receive a copy of the IME report and help fight back against any claims that may jeopardize your claim.
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