What is an Independent Medical Examination in California?

As part of your workers’ compensation claim process, you might be required to undergo an independent medical exam (IME) from a doctor who has not yet seen or treated you. The purpose of an IME is to double-check the primary care physician’s diagnosis, prognosis, and proposed course of treatment, as well as your injuries. The underlying purpose in most cases, though, is to give the insurance company another opportunity to challenge or deny your claim.

If you have an IME scheduled soon, then don’t waste any to connect with our attorneys at Wax & Wax, A Law Corporation in Santa Clarita, California. We can help you prepare for an IME and the steps that follow. When the IME seems unreasonable, such as if you already underwent an IME and the insurance company wants another for no clear reason, then we can also help challenge the IME outright.

What You Can Expect from an Independent Medical Exam

The insurance company might order an IME if it believes you are receiving unnecessary or optional medical treatments. You can also request an independent medical exam if you think you aren’t getting the necessary medical care because some part of your health condition was overlooked. To get to the bottom of the matter, another physician will conduct the IME and give an expert opinion about your injuries and how they think those injuries will affect your work.

The IME physician can reach several conclusions, like:

• You are fit to return to your original job position.
• You are fit to return to work but at a reduced or different capacity.
• You are not fit to return to work yet.
• You have a permanent disability that will impact your work for the foreseeable future.

For most IMEs, the third-party physician is selected by the insurance company, which can raise some suspicions about whether the doctor is actually assessing the injured worker from a truly neutral vantage point. It is advised that you plan on recording the IME with your smartphone. The doctor cannot prohibit the use of a recording device, but you should let them know you will record it before the examination begins. Depending on the nature of your injuries, you might want to bring a trusted family member with you to record the session instead.

How to Prepare for an Independent Medical Exam

A good way to prepare for an independent medical exam is to review any inquiries the insurance company has already sent you. The questions they ask in those inquiries that led to the IME will most likely be repeated in the IME itself. Bring this letter and any similar communications to our law office, so we can analyze what they are going to say. There might be leading questions designed to trap you into inadvertently losing workers’ compensation coverage. We can help you prepare your statements ahead of time to avoid such pitfalls.

Three things to never do in an independent medical exam are:

• Exaggerate: Be completely honest about your injuries and how they are affecting you. Don’t exaggerate symptoms, but also don’t feel ashamed if you have to admit that a simple task hurts too much to complete now. Lying will only complicate matters and risk your claims’ validity.
• Exclude: Details about your health and the workplace accident that caused your injuries are important. The IME needs to know everything that could be affecting you, so don’t exclude things just because you think they might not be relevant. Preexisting injuries, in particular, should be brought up if they are impacted by your new injuries.
• Gossip: Although the IME physician should reach an objective conclusion, everyone is affected by their opinions in one way or another. Do not gossip or “trash talk” your employer or the insurance company during the IME. The doctor could find such behavior as a sign that you are exaggerating your injuries or that you are just being difficult, so it could hurt your chances of getting the benefits you need.

The IME physician will probably ask you to complete some basic motions, too. Sitting, standing, lifting both arms, etc. are commonly asked of patients to gauge their injuries and debilitations. Prepare the day before by gently testing your range of motion, but not in a way that could worsen your injuries.

An independent medical exam can take about an hour to complete. You should plan on arriving early to the appointment. While in the waiting room, review your symptoms and your doctor’s proposed treatments if you did not re-review them that morning. Lastly, dress in a way that shows your injury is real, i.e., don’t wear a tight-fitting jacket if you are complaining about a shoulder injury because the IME doctor will assume you would not want a jacket at all if your shoulder injury was actually painful.

Legal Guidance for IMEs in Santa Clarita

Allow the Santa Clarita IME attorneys of Wax & Wax, A Law Corporation to help you prepare for your independent medical examination and take the stress of the situation off your shoulders. After your IME is complete, we can also assist you with follow-ups and the next steps in your workers’ compensation case. For more information about our legal services, please contact us now by dialing (818) 247-1001. We look forward to helping you.