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Independent Medical Exams for L&I Claims

During the course of your workers’ comp claim, you may be required to undergo an independent medical examination (IME) that is conducted by a doctor hired by L&I. The purported reason for an IME is to have a physician other than your primary provider give expert opinion regarding your medical condition. However, independent medical examiners sometimes misdiagnose a patient, or mischaracterize a workplace injury as one that is preexisting, or that occurred outside of work.

What is an Independent Medical Exam?

An IME is a patient interview that allows a doctor hired by L&I to learn the history of your accident and medical condition. This is followed by the physical examination, which should not be conducted for any reason unconnected to the condition in question. An IME usually takes no more than 30 minutes, but it can be awhile before you hear back from L&I regarding the outcome from the IME.

Who Pays For An IME?

L&I covers the costs of the independent medical examination as long as you appear and cooperate with procedures. However, if you do not attend and fail to provide a good reason for your absence, L&I may reduce your time loss benefits; other benefits may be jeopardized as well.

What Do I Need To Know Before An Independent Medical Evaluation?

While it is unlikely that the independent medical examination report will be fair, with the right preparation, you can minimize damage to your case by following these tips:

  • Have someone accompany you to the examination—preferably your significant other or trusted friend, a professional appointed by your attorney, or a nurse. The accompanying person should take detailed notes or make an audio recording of the exam.
  • Be aware that you may 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 to an injury. 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.
  • Do not sign any paperwork other than the sign-in sheet.
  • 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).
  • Be honest about relevant previous injuries. Insurance companies are skillful at uncovering past injuries.
  • Provide a thorough history of the symptoms, injuries, and medical care related to your case.
  • If you experience pain at any point during the examination, let the doctor know. The IME exam is no time to be “tough” or conceal your pain.
  • Do not agree to invasive tests or submit to procedures that your regular doctor has already performed. In addition, you do not have to endure painful procedures.

Are Independent Medical Exams required?

Insurance companies and employers are legally entitled to schedule you for independent medical exams and require you to attend. If you have received notification that you are scheduled for an IME, it is in your best interest to consult an attorney prior to submitting to the process.

Should I Hire a Lawyer For My Independent Medical Exam?

A knowledgeable personal injury or workers’ compensation lawyer will take certain steps to make sure that your rights are not violated during the independent medical examination, as well as go over the details of what you should expect during your IME. The attorneys at Emery Reddy have successfully prepared hundreds of clients for their IMEs and have over 15 years experience handling L&I claims, employment law cases, and third party injury claims. Call us for a free case analysis and see how we can help you get the workers’ compensation benefits you deserve.

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