Workers’ compensation is supposed to be a no-fault system that gets injured workers the medical care they need without the need for a lawsuit.
But, insurance companies exist to make a profit – not to provide unlimited benefits to the insured. If your injuries are serious or even simply taking longer than the insurance company thinks is normal to heal, don’t be surprised if you’re sent for an Independent Medical Examination (IME).
You’re required to attend this appointment to receive benefits
Unfortunately, even if the insurance company’s demand seems unreasonable, you have to attend this exam in order to keep your benefits. If you refuse, they will likely terminate immediately.
Typically, the insurance company wants an IME to investigate things like:
- Whether or not your injuries could have been caused as you describe (or whether they’re more consistent with some other, non-work cause)
- Whether or not your condition is a serious as you claim (which means they may believe you are exaggerating your symptoms)
- Whether you actually need the treatment recommended by your physician (or a more-conservative, less-expensive treatment will do)
Sometimes an insurance company will demand an IME right away, particularly is they’re suspicious about something, but they may also request one at any point during your recovery to see if further treatment is actually going to improve your condition or you’ve reached the point of maximum medical improvement.
Workers’ comp pays for the IME, along with any x-rays, lab work or other testing that the physician may order, so that isn’t something that you have to worry about. Your main concern is staying focused, providing accurate information about your condition and your medical history, and clearly connecting your condition to your workplace or job duties.
When you’ve suffered a workplace injury, you rely on your workers’ compensation benefits to help you during your recovery. Don’t let an IME deprive you of what you are due. Experienced legal guidance can help you successfully navigate a potentially tricky situation.