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Workers’ Compensation IME: What Is It and How Do I Prepare?

Unknown male doctor and patient woman discussing current health examination

An IME is an “independent medical examination” that your lawyer schedules for you to attend after your treatment has ended and the case is nearing a resolution. Both sides are required to schedule this medical examination, and your attendance is crucial to the resolution of your case since your case cannot proceed without it.

IMEs are not done for the purpose of treatment, but rather serve as a tool for determining the extent and percentage of your permanent disability and properly measuring how your injuries have affected your functionality both at work and in your personal life. Essentially, the exam will help determine the value of your case. Judges will generally rely on the reports generated by the evaluating doctors to assess the extent of your permanent disability and value of your case.

How to Prepare For a Workers’ Comp IME?

During an IME, you want to make sure you are completely honest with the doctor. Be sure to communicate all your physical complaints that pertain to the work injury to the doctor examining you as clearly and specifically as possible.

A good way to prepare is to sit down with a friend or family member before the appointment and go over the changes that you have experienced since this injury, so you are well prepared to explain all your present complaints and residual limitations that transpired because of the accidental injury.

Although the doctors will have all your medical records, you should treat this appointment as if the doctor knows absolutely nothing about your case and explain your symptoms from these injuries to him in detail from the beginning.

it is also very important that you bring all MRI films or X-ray films you may have so the examining doctor can review those and better assess your injuries. Objective or impartial medical evidence is also very important and required in the assessing of the extent of your disability so make sure you bring any and all films you may have from your work injury. If you had a prior injury to the same body part, be sure to disclose that to your attorney beforehand so he or she can properly advise you on that as well.

When preparing to discuss your injuries, anticipating questions like the following is a good place to start:

  • Think about your worst pain days. How do you feel on the days that your injuries flare up?
  • How has this injury affected your life?
  • What activities do you have difficulty with?
  • What activities are you now unable to perform completely?
  • What activities did you enjoy before the accident that you are no longer able to do at all?
  • Do you have difficulty performing daily household chores? How so?

Again, it’s important to be as specific as possible when discussing your injury and its impact on your life. Even if there are details or issues that seem like nothing, chances are it may matter to your case. Even the most minimal changes can be important to note in an evaluation to determine permanency.

These doctors on both sides are trained to evaluate petitioners and determine if they are exaggerating their injuries or if they are being truthful with their doctor. So be sure to communicate everything to the examining doctor when you see him or her. Don’t just tell the doctor you have pain. Be clear about the kind of pain you have. Do you have a dull ache? Is it a sharp shooting pain? Does it radiate? Do you have numbness? Do you have tingling? Do you have burning sensation?

Even if the above doesn’t apply, you can still have residual limitations that you may not feel have affected your life. However, it is important to communicate these limitations, no matter how unimportant they may seem, to the doctor evaluating you. Do you have difficulty performing basic mundane tasks like washing the dishes? It’s ok to mention that as well. Again, this will not determine your medical treatment. But it will invaluably aid in a speedier resolution of your case if you attend.

What if the Defense Doctor Doesn’t Take Down All My Complaints?

Defense doctors are trained to minimize the extent of your injury and disability as best as possible. That said, you are your own best advocate.

Make sure you communicate all your concerns and complaints to the doctor examining you. Most, if not all, judges in the state of New Jersey division of Worker’s Compensation are aware of this fact and they take most of these reports with a grain of salt so, although it is important that you are clear and specific as to your complaints, it is not fatal to your case if the examination is less two minutes and the doctor doesn’t even speak to you or is seemingly unconcerned about these complaints.

Instead, use this to your advantage. Be your own best advocate. Call your attorney right after the appointment while the details are still fresh in your memory. If that isn’t possible, take notes, after you leave the doctor’s office about what the doctor did or failed to do. Let your attorney know the details of the visit from start to finish so that they can utilize it to your advantage with regards to your case. Request a copy of the report to review any inconsistencies from the examination with your attorney.

I Reopened My Case – Why Do I Have to Go See The Original Treating Doctor Who Treated Me Previously?

In New Jersey, the workers’ compensation carrier controls the treatment and dictates who you see. This means that the carrier is required to return you back to the authorized treating doctor so that he or she can evaluate if there has been a material worsening of your condition. Sometimes, that same doctor will provide an objective independent evaluation and recommend treatment. Often, however, they will not and instead they may dismiss the need for additional treatment by minimizing your injury and complaints.

Be sure to clearly communicate all your concerns and treatment needs to the doctor and focus on how your injuries worsened since the case last resolved. Again, remember that you are your own best advocate. Only you can tell the doctor exactly what you need so that he can order treatment. Explain how additional treatment, including therapy, revised diagnostics and imaging studies, medications, and the like will help you function better.

If the authorized treatment physician still doesn’t think you need treatment, be sure to contact your attorney immediately so that they can obtain an independent treatment evaluation with a Certified Fellowship Trained Specialist to properly address your injuries, how they have worsened and the treatment that you need so that the process of reopening your case can run more smoothly.

What Happens After the IME?

After your IME, the attorneys will exchange reports and send a “settlement demand” or a request for settlement of the case based on the estimate of disability in the report. If the insurance company doesn’t respond to the settlement demand request, the attorney will require a value conference where the judge will make a recommendation regarding values.

Keep in mind, values are assessed based on percentages of disability that can be found on a chart. These are fixed statutory amounts that change yearly depending on the year you were injured and are based either on a statutory rate or your own wage rate, whichever is lower.

Independent medical examinations and determinations of value are just a few of the many important parts of a workers’ compensation case. If you’ve suffered a workplace injury or illness and need guidance through the process, our award-winning team at Levinson Axelrod, P.A. can help. We proudly serve workers across New Jersey from 10 office locations and offer FREE and confidential consultations. Call (732) 440-3089 or contact us online to request yours.

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