According to the International Labour Organization, there are approximately 340 million occupational accidents and 160 million victims of work-related illnesses yearly. In the United States, workers’ compensation is compulsory for almost all employers in most states. If you have been injured on the job and filed for workers’ compensation benefits, you may need to undergo an independent medical exam (IME). During the IME, a doctor appointed by the insurance company will examine you. This examination can have a major impact on your claim’s outcome, which is why it is important to know what and what not to say to your workers’ compensation doctor.
If you are concerned about how to navigate an IME, it may be helpful to speak to a lawyer for guidance. Robert Scimpiglia, Attorney at Law has decades of experience in workers’ compensation and may be able to provide you with the help you need. Reach out for a consultation at (203) 663-2803.
What to Expect at An Independent Medical Exam (IME)
After an employee files for workers’ compensation, the insurance company may require an Independent Medical Examination (IME) to evaluate the extent of the injury. Typically, the insurance company will request this if they disagree with the worker’s personal doctor’s opinion, if they feel that negotiations with the claims adjuster are taking too long or are too expensive, or if the treating physician determines disability.
Assuming that the employee already saw a doctor prior to the IME, the workers’ compensation doctor will have the medical records related to the injury. At the examination, the doctor will conduct a full medical exam, including physical exams, testing, and questions. The doctor will examine the employee’s physical appearance, movement, and will look for physical signs of pain and discomfort. When it comes to the questions, it is especially important to know what not to say to your workers’ compensation doctor. The doctor may ask the patient questions regarding:
⦁ Any pre-existing conditions or previous injuries.
⦁ The severity of any injuries and symptoms.
⦁ When symptoms began.
⦁ Any limitations that the injuries cause in work and daily life.
⦁ The diagnosis the employee may have received from their personal physician.
⦁ Any treatments the employee required or will require - including therapies, surgery, and medications.
⦁ The circumstances around the accident.
One of the most important reasons that you should know what not to say to your workers’ compensation doctor during an IME is that the doctor works for the insurance company and the insurance company will seek to limit the benefits payout. The workers’ compensation doctor is expected to evaluate your work status and determine when you can return to work. They will evaluate the extent of your injury and share this information with the insurance company. If you say the wrong thing, it can result in your claim being denied.
Knowing what not to say to your workers’ compensation doctor may seem overwhelming and confusing, which is why it may be helpful to consult an experienced attorney prior to the IME. Robert Scimpiglia, Attorney at Law may be able to provide legal advice on what to say to a medical provider while navigating the workers’ compensation process.
What Not To Say To The Doctor at An IME
According to the Insurance Information Institute, the top three industry occupations with the largest numbers of injuries and illnesses are laborers, truck drivers, and nursing assistants. Whether you are a part of one of these industries or not, after being injured on the job, you likely have questions about what and what not to say to your workers’ compensation doctor at the IME. Knowing what not to say can be broken into our main guidelines:
⦁ Avoid exaggeration.
⦁ Do not speak negatively about your employer.
⦁ Do not lie.
⦁ Avoid being vague.
While it is important to be honest about any symptoms and injuries, it is important to avoid any exaggerations. Medical tests and instruments can reveal these exaggerations and workers’ compensation doctors can also often identify exaggerated claims or fake displays of pain. You may assume that exaggerating pain or symptoms will result in a bigger workers’ compensation payout but it can backfire and result in your claim being denied.
Do Not Speak Negatively About Your Employer
A good rule of thumb is to assume everything that you say in an IME will be reported back to the insurance company and your employer. It is important to avoid speaking negatively about your employer - even if you feel they have mistreated you. You want to build a good relationship with the workers’ compensation doctor and have them write a good report on you. If it is mentioned in your official medical report that you said negative things about your employer, this could cast doubt on your case.
Do Not Lie
In addition to avoiding exaggeration, it is important not to lie and make up symptoms. For example, avoid saying you can not bend over or drive, if you can. Doctors will quickly determine if you are making up symptoms or injuries and this further diminishes the credibility of your case.
Avoid Being Vague
It can be difficult to recount the accident - you may feel embarrassed or be worried that the accident makes you look bad, so you end up leaving out details. Do not do this. Be as specific and clear as possible when explaining how the accident happened to the doctor. The doctor will look for inconsistencies in the story, which is why it is important to avoid vagueness and focus on being as clear and concise as possible.
How An Experienced Workers’ Compensation Lawyer Can Help
It can be frustrating and overwhelming to navigate the workers’ compensation process and facing an IME may be especially intimidating. If you have concerns about what not to say to your workers’ compensation doctor or you feel your claim was unjustly denied following an IME, an experienced workers’ compensation lawyer may be able to help. Consider reaching out to Robert Scimpiglia, Attorney at Law for the guidance that you deserve at (203) 663-2803.