Even the safest of work situations sometimes turn dangerous. The latest statistics reveal slips, falls and trips increasing in the workplace.
Overexertion injuries represent about 33% of on-the-job injuries. Have you sustained an injury at work? If so, your employer may ask for an independent medical exam (IME) before paying a claim.
If you’re wondering what that is, keep reading for the details.
What Is Workmans’ Comp?
Workers’ Compensation is an insurance program mandated by the state. There are different programs depending on what state you live in since each state has its own laws.
The insurance program addresses on-the-job injuries. Federal employees have a workers’ comp program from the federal government.
There are some limits to the program. But most on-the-job injuries are typically covered, even if you’re at fault.
Were you intoxicated or using illegal substances when you got injured? That’s a problem. It’s legal to deny a claim in this instance.
Violating company policy is another reason for the denial of a workers’ comp claim. After you file your case, your employer may ask for an independent medical exam.
What Is an Independent Medical Exam?
An IME is an exam by a doctor who works for your employer’s insurance company. You can refuse the exam. But that most likely ends with a denial of the claim.
Keep in mind that the insurance company selects the “independent” doctor. Most doctors working for the insurance company are supplementing a private practice. Some retired doctors also work for insurance companies for extra money.
Workers’ comp doctors are financially motivated to keep insurance company costs low. For this reason, you need to know how to choose the right Workers’ Compensation doctor.
What to Expect
During an IME, the doctor asks lots of questions. The doctor then tells the insurance company whether you’re ready to get back to work.
Give honest answers to all questions and never fake symptoms. Everything you do during the exam gets reported to the insurance company.
From the moment you pull up in your car, someone will track your behavior. Are you complaining of severe back pain? They’ll look for the ease with which you exit your vehicle.
Do reveal any pre-existing medical conditions. The doctor will ask how your current injury affects those conditions.
If you no longer have any pain from a previous injury, be clear about that. Insurance companies often try to deny claims on the basis of previous injuries.
Most exams are about 15 minutes. If possible, have a friend come and take notes during the exam.
Ask for a copy of the doctor’s report. If you see a mistake in the report, challenge the report.
Your Workers’ Compensation Claim
After filing a workers’ comp claim, most employers require an independent medical exam. Always be truthful but remember the doctor works for the insurance company and is not your advocate.
Be clear about any and all limitations caused by your on-the-job injury even if the doctor doesn’t ask. Be as calm and polite as you can when talking with the doctor.
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