If the insurance company believes that the claim might be false, they might request that you be subjected to an independent medical examination.
To be eligible for workers’ compensation benefits, you have to prove that you were engaging in work-related activities when you were hurt. It isn’t enough just to be injured while you are at your workplace; you must show that you were working under your employer’s authority and the scope of your duties.
To collect workers’ compensation, you also have to show that you were injured and prove the extent of your injuries by having official documentation from a physician. So if you are hurt while on the job, it is imperative that you seek medical attention and make your employer or supervisor aware that you have been injured. If you fail to do so, it might be possible for the insurance company to question how your injury happened and question whether or not you can collect workers’ compensation.
An independent medical examination (IME) can be requested by the insurance company or by the victim’s attorney, and it’s meant to provide a neutral, objective point of view to the case.
This is why, in most cases, you can’t pick your IME doctor yourself unless it’s on a list approved by the insurance company or workers’ compensation commission. With this in mind, be aware of the IME doctor’s role in giving the insurance company an advantage.
How To Prepare for an Independent Medical Examination After a Work Injury
What can you do to you prepare for your IME? Remember, the point of the exam, and what will work in your favor, is to be truthful and consistent during the whole discovery phase of your claim. Here are some tips:
- Review the facts with your lawyer
- Don’t exaggerate or belittle your pain, your loss of function, etc.
- Dress appropriately
- Review the IME findings by going to your own doctor on the same day
- Be concise and stick to the facts, as insurers can poke holes in long stories more easily
If you are not sure what you will be asked or how you should respond, speak with an experienced Missouri work injury lawyer before going to the IME. They will be able to prepare you, as they have been through it before, and give you the best chance to get the settlement you are entitled to, without obstacles brought by unfortunate wording or a zealous IME doctor.
How the Insurance Company Might Try to Deny Your Claim
There are times when an insurance company might seek to claim that you aren’t entitled to collect. Circumstances where they might deny coverage, include if the insurance company can prove that you weren’t performing work-related activities. They might also challenge whether your injuries were as extensive as you claim they are – or in some instances, if you were even injured at all.
If the insurance company believes that the claim might be false, they might request that you be subjected to an independent medical examination. An IME is when you have to be seen for a second opinion by a physician selected by the insurance company. Although they get to choose the physician and you don’t have to pay for it, you are required to comply. If you refuse, it might be possible for the insurance company to deny your claim or stop paying benefits.
If your physical and the IME show different results or come to differing conclusions about your injuries, it is important to discuss your case with an experienced workers comp attorney. If the insurance company is reducing your payments, denying your coverage, or demanding that you return to work, and you feel it is the wrong decision, you are entitled to a hearing for an appeal. To ensure that you have more than even footing with the insurance company, it is important that you have a qualified attorney on your side.
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