The workers’ compensation system is designed to get workers benefits after an on-the-job injury. Before Iowa established workers’ compensation, any injured employee would need to sue their boss for damages. Workers’ compensation introduced no-fault benefits and therefore streamlined the process.
However, sometimes disagreements break out in a workers’ compensation case. In particular, your employer or their insurance company might think you are not seriously injured. Or they think you should have healed much faster than you do. In short, they want to stop paying you benefits because they don’t believe you deserve them.
This is where an independent medical exam (IME) comes in. It’s pretty much what it sounds like: a “medical exam” which is “independently” conducted. Either workers or insurers can request an IME, though usually for different reasons. Call our Des Moines workers’ compensation lawyer if you have received notice of an IME or have questions.
The Purpose of an IME
To receive workers’ comp benefits, a worker must be injured. Often, there are disagreements over whether you are really injured and to what extent. Put simply, you probably think you can’t go back to work because you have bodily limitations, including pain. The other side, your employer and their insurance provider, think you’ve healed enough that you can get back on the job. Or they don’t even think you were injured in the first place.
An IME is conducted by a physician who has no ties to either you or your employer/insurer. That’s what makes it independent. The goal of the IME is to get an outsider’s perspective on your disabilities.
During the exam, the physician might:
- Ask you questions about your injuries and pain,
- Evaluate your condition using tests,
- Recommend different or additional treatment,
- Set a possible date to return to work.
The doctor will probably issue a medical report, which the judge overseeing your case will use to determine benefits.
Does Every Worker Have an IME?
No. Thousands of injured workers never have an IME. But that’s usually because there are no disputes over whether they are injured. Put simply, there is no “requirement” that you have an IME. Either a worker requests one or the employer/insurance company does.
Is a Worker Required to Attend an IME?
Yes. The law states that if you don’t go, you forfeit your benefits. The good news is that the employer or their insurance carrier should cover all expenses, including the cost of transportation to the exam. (See Iowa Code § 85.39) So they should pay if you need to travel to a different city.
Reach out to us if you have concerns. We can discuss the exam and what to expect.
Requesting Your Own IME
Sometimes a worker wants to request their own IME. Under the law, you have the right to seek an IME for a work-related injury.
Typically, patients request an IME when they receive treatment from their company’s doctor and are unhappy for some reason. The company doctor might:
1. Clear you to return to work when you believe you are still disabled.
2. Give the green light to return to light duty when you believe your injuries are totally disabling.
3. Make a diagnosis you don’t agree with.
4. Recommend a course of treatment which you don’t agree is necessary.
5. Have prescribed treatment which you do not feel is making you well.
You typically need to pay for any IME you request, but you might receive reimbursement if certain conditions are met.
Nonetheless, it can make sense to pay for your own IME, if it could help with your claim. For example, the physician might agree you are still disabled and therefore cannot go back to work. That would be powerful evidence in your favor with the judge on your case.
Why the IME Matters
Inevitably, an IME is requested when there is a dispute about your disability. Typically, an employer does not think you are hurt and wants you back to work. That will reduce the benefits you receive. However, you might still feel substantial pain and feel like you can’t work.
A judge hearing your dispute can use the IME findings when determining your injury, as well as level of impairment. For example, an IME could make the difference between a judge finding you only partially disabled versus totally disabled.
An IME usually directly impacts whether you receive workers’ compensation benefits and the amount. In our experience, judges put great weight on the IME findings, so you should take an IME very seriously.
Can Ball, Kirk & Holm, P.C. Help?
The physician performing the IME does not work for your employer and should be independent. Nonetheless, this is a critical moment in your workers’ compensation case. If you don’t yet have a lawyer, you should reach out to one.
Our Des Moines workers’ compensation attorney can discuss the IME and provide an overview of what to expect. We are available to clients 24/7, so don’t hesitate. We can also offer tips for how to ensure it goes smoothly. The physician performing the IME might ask questions you feel are invasive. We have ideas on how to respond honestly and tactfully.
You don’t want to do or say anything in the IME that hurts your case. This is another reason to talk with an attorney to develop a strategy.
We will also review any medical report issued by the physician performing the IME. There might be gaps or missing information, which we can correct. Because it’s a critical piece of evidence, you’ll want an attorney.
Call Our Law Firm for a Free Consultation
At Ball, Kirk & Holm, P.C., we have seen workers’ compensation benefits transform lives. Injured workers who cannot work to support themselves used to fall into poverty after a workplace injury. Still, getting the benefits you deserve is a challenge. An IME could make the difference in your case. Call our firm to discuss whether to request an IME or how to respond to one. We can also help you appeal any denial of a workers’’ compensation claim.