Tips For Your Workers’ Compensation IME Doctor Visit
If you file an L&I claim for workers’ compensation benefits, the Washington State Department of Labor and Industries (L&I) or a self-insured employer might require you to undergo an Independent Medical Exam (IME).
An Independent Medical Examination, or IME, is a medical evaluation that reviews your medical history and accident details, to establish finding, opinions, and conclusions about your physical condition. IMEs are conducted by approved L&I providers and no patient-provider relationship is established.
Tips For Your Independent Medical Examination
The decision handed down by the IME doctor can make or break your L&I claim, so it’s crucial to ready yourself ahead of time. Undergoing an Independent Medical Examination can be stressful and overwhelming. However, it is an important process for your L&I claim. With ample preparation and knowledge, you will be able to complete your IME appointment and maximize your chances of receiving the workers’ compensation benefits to which you may be entitled.
Here are our tips on how to beat an IME exam and see past IME doctor tricks:
Prepare And Provide A Thorough Medical History
Before your evaluation, review and gather all your medical records and any imaging results related to your workplace injury or illness. Being familiar with your own medical history allows you to provide the IME provider with important and accurate information regarding your claim including your symptoms, injuries, and medical care. Be sure to bring these with you to your Independent Medical Exam.
Provide An Accurate Account Of The Incident Or Cause Of Injury
During your Independent Medical Exam, the examiner will likely ask you to provide an account of what happened and might also have you submit an IME questionnaire. Prepare beforehand by listing important details to ensure you can provide an accurate account of the incident.
Here are some sample IME questions your examiner may ask you during your Independent Medical Exam that you should be prepared to answer:
- How did the injury happen?
- What symptoms are you experiencing?
- How would you rate your pain?
- Have you had the condition or been treated for it before?
- What is your current treatment plan?
- What are your current physical limitations?
- How do you spend your day (before and after injury or illness)?
Bring An Observer To Your Independent Medical Examination And Have Them Take Notes
Have someone accompany you to the examination—preferably your significant other or trusted friend. The observer should take detailed notes of the exam, you can prevent scenarios in which the IME doctor omits facts relevant to your case. You may not bring an observer to a psychiatric IME appointment.
Record Your Examination
You may record the examination using audio, video, or both. You or your representative must provide notice to the IME provider that you intend to record the examination no less than seven days before the exam. You are responsible for any costs associated with recording. If you choose to record the examination, you may not hold the recording equipment while the IME is occurring. Additionally, you must take reasonable steps to ensure the recording equipment does not interfere with the IME exam. For additional details regarding your rights and obligations regarding recording of IME examinations, please visit the L&I website.
Obtain A Copy Of Your IME Report
L&I or the self-insured employer must provide a copy of your IME report to you, your attending physician, and your representative. The IME examiner will use your intake as a baseline and reference when evaluating your injury or illness. Obtaining a copy of your IME report will help avoid misunderstandings and inconsistencies between you and L&I as you navigate the L&I claim process.
It is important to be honest and open with your examiner. More specifically, be honest about relevant previous injuries. Insurance companies are skilled at uncovering past injuries. Provide a thorough history of the symptoms, injuries, and medical care related to your case.
Withholding or exaggerating any information can damage your credibility, and doing so may have legal consequences—so be accurate and truthful. Your objective is to help the provider get a clear understanding of your injury.
If you experience pain at any point during the examination, let the doctor know. Describe how the pain feels and where it hurts, using words like searing, stabbing, or throbbing.
Be Polite And Cooperative
On the day of your Independent Medical Exam, make sure to dress appropriately and arrive at least 30 minutes early.
During your Independent Medical Exam, make sure to stay composed at all times. Be polite and cooperative with the IME doctor, but do not answer questions that pertain to fault or that are irrelevant to your case (such as questions about unrelated medical problems) as this is a typical IME doctor trick. It is also crucial not to interrupt your examiner or react to the length of the exam.
Remember that the doctor conducting your Independent Medical Evaluation is hired to get the necessary information on your claim. Do not consider them a threat or a hurdle. Rather, your examiner is there to help you get the support and evidence necessary to win your case, so always remain on your best behavior during the exam.
Remember You Are Being Observed At All Times
Be aware that you will be under observation at all times, from the moment you get out of your car in the parking lot until you leave the premises. The IME physician will be looking for any signs that cause suspicion or that contradict your claim of injury. If you spring out of your car or a waiting room chair, the doctor may testify that you are not experiencing pain. In addition, some independent medical examiners set up scenarios that catch patients off-guard; for instance, a doctor may drop something or make a sudden movement that triggers the patient to quickly turn his or her head.
Mistakes To Avoid During Your Independent Medical Exam
Undergoing an IME often makes people feel uncomfortable, or that they are being investigated or doubted. It is important to remember that being defensive or aggressive during your IME appointment will not help to support your claim. An IME is conducted to establish finding, opinions, and conclusions about your physical condition, and you should consider it as a step rather than a hurdle. Be aware of your attitude and mindset to make sure that you have done your part to ensure that the examination rating is an accurate determination of your injury or illness.
Some of the most important things to avoid during your Independent Medical Exam include:
Avoid Providing Lengthy Answers
Your examiner only has a limited time to conduct the IME so it is important to keep your answers brief but thorough and elaborate only when your examiner asks you to. Preparing a detailed but concise account of your injury or occupational illness before your appointment will help you avoid this common IME mistake.
Do Not Sign Anything Other Than The Sign-In Sheet
Be cautious of signing anything other than a sign-in sheet or evaluation consent form. By doing so without fully understanding the document, you might accidentally waive legal rights, subject yourself to unfair terms, or agree to provide information that could be used against you.
Do Not Discuss Your Lawsuit
The purpose of the IME is to assess your medical condition, not your lawsuit. Focus on your injury and the evaluation. If the examiner asks you why you filed a lawsuit, keep your answer brief. You do not need to go into detail about your case.
Do Not Agree To Invasive Testing
Do not agree to invasive tests or submit to procedures that your regular doctor has already performed. There is no reason to endure painful or repetitive procedures.
Avoid Discussing Pain Medications
You do not want to give your examiner the impression that you are abusing over-the-counter or prescription drugs—or that your condition is not bad enough to require a higher or more frequent dosage. If you are asked about pain medication, answer it with a simple yes or no.
Independent Medical Examination Doctor Tricks To Watch Out For
In addition to knowing which mistakes to avoid during your IME appointment, you also need to be aware of IME doctor tricks that could be used against you in an attempt to devalue your L&I claim. IME doctor tricks might include:
Asking About Your L&I Claim Or Case Value
Your IME is conducted purely for the purpose of establishing medical finding and opinions. There is no reason for them to ask you any further or in-depth questions about your claim or case value. Anything discussed during your IME is recorded in your file and passed along to your employer and the insurance company, so it’s best to avoid talking about your claim at all to prevent saying something that could harm the case.
Asking Irrelevant Questions
Another popular IME doctor trick is to ask questions that have nothing to do with your injury. It may seem as though they are just being friendly and making conversation, but this is rarely the case. As an example, maybe you’ve injured your shoulder on the job, but during your exam, the IME doctor asks if you play tennis. This could be a tactic to blame a different scenario on your injury instead of the work-related accident.
Surveilling You Or Trying To Catch You Lying Or Exaggerating
This IME doctor trick can be particularly problematic for injured workers. An IME doctor or one of their associates may surveil you—follow you without your knowledge—to try and catch you doing things you shouldn’t be able to do if you are, in fact, injured.
This trick could also extend to your Independent Medical Examination, where the doctor may ask you different questions that counteract things you’ve previously said. They do this to see if you’ll change your story or suddenly exaggerate what happened or how you’re feeling. This is because, while IME doctors are meant to be independent contractors, they are often biased as they are paid by the insurance company and could make more money if they deny your claim.
Tying Your Injury Or Illness To Prior Injuries Or Symptoms
If you have a previous injury or illness that could have similar symptoms to your work-related injury, a common IME doctor trick is to connect your new injury to your old one. Doing this could discredit you or weaken your claim, as it could cause the insurance company to question your L&I claim and ultimately deny it.
Speculating About Alternate Causes
Without a previous injury or illness, your IME doctor may start suggesting other causes of your injury. They may imply that the medication you’re taking, your lifestyle, your family history, or even a hobby could be to blame. This ties into our previous point of them asking you irrelevant questions, as they can use your answers to speculate that anything other than work could have led to your injury.
Performing Fake Tests
IME doctor tricks often include performing unnecessary or fake tests to “find” pain that couldn’t possibly be related to your injury. For example, maybe you’ve hurt your wrist in a fall at work, but they want to test your inner ear to see if a balance issue could have been the real culprit behind the injury.
Don’t be afraid to politely question any recommended tests to see exactly what the IME doctor is trying to test for before moving forward.
Writing An Incomplete Summary Of Your Medical Records
Another IME doctor trick to be aware of is a provider’s purposeful decision to omit relevant details of your examination in their summary report. Instead, the IME doctor could highlight irrelevant details that discredit your claim and lead to a denial. This is why we recommended bringing an observer to take notes on everything discussed, so you can then compare their notes to what is listed in your assessment.
If you suspect the IME doctor is withholding important details or relevant information for your claim, your Seattle L&I attorney can help identify and expose the inaccuracies of the IME report.
Your L&I Claim Is Worth More If You Also Have An Employment Law Claim
A significant number of L&I workers’ compensation claims often involve additional legal claims such as employment law or third-party claims. Many people file their claims without seeking representation from an L&I attorney and thus never discover that in addition to their L&I claim, they may be missing out on the ability to file an employment law claim or a third-party claim. Pursuing additional legal action has the potential to significantly increase a claim’s overall compensation.
What Is An Employment Law Claim?
Many injured workers find that their employer has taken, or plans to take, adverse action against them because they filed an L&I claim or they are out of work. You can file a lawsuit against your employer for several reasons, including retaliation, wrongful termination, disability discrimination, or unpaid wages. An L&I attorney who is experienced in both L&I workers’ compensation law and employment law can help you with your L&I claim while simultaneously filing a federal or state law claim for the violation of workers’ rights by your employer.
What Is A Third-Party Claim?
A third-party claim is one in which someone other than your employer or co-worker is responsible for your injury. If you have been injured on the job due to someone else’s actions or negligence, you may be entitled to additional compensation through a third-party claim, which combines your L&I claim with a personal injury claim using the same facts.
Unlike workers’ compensation payments, there is no limit to the amount of compensation an injured worker may seek in third-party damages.
Who Is At Fault For A Workplace Injury?
L&I is a no-fault system, ensuring compensation for any workplace injury. However, if a third party is involved in causing the injury, you may be able to pursue legal action against them for additional compensation under third-party claims.
How Do I Know If I Have A Case?
The bottom line is that anyone who isn’t familiar with L&I claims should seek the input of experienced L&I attorneys who do.
After years of helping injured workers, Emery | Reddy has recovered hundreds of millions for our clients. Our team of L&I attorneys is experienced in litigating L&I claims, injury law claims, and employment violations. We understand how to leverage each claim in state (or federal) court and before the Board of Industrial Insurance Appeals to maximize the value of all of your claims.
Emery | Reddy Can Help You With Your L&I Claim
Emery | Reddy, PLLC is the only law firm in Washington State that is equipped to provide comprehensive representation on your case from every angle. Our Seattle L&I attorneys thoroughly assess every case to determine if our clients have additional claims, and at times this can extend far beyond the underlying workers’ compensation claim.
If you have been injured in the workplace call Emery | Reddy today to speak with our legal team for a free case review. Please remember to have your L&I claim number readily available.
Want More Information?
To determine the value of your L&I claim you first need to understand the different types of L&I awards offered in Washington state.
The L&I workers’ compensation process is anything but straightforward. Find out the answers to your L&I workers’ comp questions today.
Self-insured employers account for one-third of workers’ compensation in Washington State, and they provide benefits directly to injured workers.
Meet The Team
The L&I attorneys at Emery | Reddy are passionate about helping workers with L&I claims and employment law issues. We Help Workers®: it’s our motto and it’s what drives us every day.
We know how L&I and big companies think, and we understand the tactics they use. Our labor and industries attorneys use that knowledge coupled with over two decades of experience to help our clients get access to the L&I benefits to which they are legally entitled and hold employers accountable when they break the law.
If you’re struggling with an L&I claim, injury, or legal issue at work, please call us and see how Emery | Reddy can help you today.