What will happen during an independent medical examiner visit for workers' compensation injuries?

Your employer may require verification of your workers' compensation injury by way of an independent medical examiner (IME). Prior to the appointment, this physician will request your medical records and relevant documentation to review, including any statements you've given in incident reports and injury testimonies.

It’s up to your employer's insurance company to send any specific questions or concerns it may have to the examiner concerning previous diagnoses or treatment plans. The insurance representative may also include his or her interpretation of your injury and a summary of the treatment you’ve received to date.

Once you make your appointment—your employer cannot schedule the appointment for you, no matter what he or she may say—you must make an honest attempt to keep it, and follow any instructions the physician may have regarding preparation.

IME Appointment Expectations

The day of your examination, you should prepare yourself for the following:

• Company. Your employer has a right to have a representative present at your appointment, but not during the exam, to get a firsthand account of the physician’s findings, ask the examiner questions on the employer’s behalf, and to verify what you're told. If you’re uncomfortable with this arrangement or any of the following potentialities, contact Johnson & Gilbert, P.A. for your own representation and peace of mind.

• Questions. Before examining your injury, the doctor may ask questions about how the injury occurred, the kinds of treatment you’ve tried, any triggers that make the pain worse, and your rating of pain. He’ll then compare your answers to the documentation he has on the injury already, including your employer’s interpretations.

• Clarifications. The examiner will most likely go over the previous documentation and ask you to explain certain discrepancies. If for some reason the doctor fails to volunteer the information sent to him by the employer or insurance company, make sure you bring it up—you have the right to correct or challenge your employer’s opinion. Otherwise, incorrect information may influence the IME's report.

• Difference. Unlike a traditional physician, independent examiners are taxed with verifying the connection between your injury and the workplace accident. As a result, they may try to play devil’s advocate to pry information from you. It’s important to note that independent examiners aren’t restricted by standard doctor-patient confidentiality. This means anything you tell them can be used as evidence for or against you. The same goes for any observations that he may make—for example, if he walks into the room and you’re aimlessly kicking your feet but then immediately stop and wince with pain when you see him, he’ll make a note of it, which might be used to discredit your claim.

• Feedback. An appointment with an IME is not only for the benefit of your employer; it’s also a time for you to get your questions answered. You should ask him direct questions on how he’ll diagnose the injury, how he’ll determine the severity, and what treatments and limitations he would suggest. You also have the right to request a copy of his report for your own records as well as to immediately point out any miscommunication errors, such as you told him you had a hard time standing, but he reported that you had a hard time walking.   

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