What is a Workers’ Compensation Independent Medical Exam?

When you’re injured at work or become ill due to exposure to a toxic substance in the workplace, you’re entitled to workers’ compensation benefits. Workers’ comp is an insurance program employers are required to enroll in that is designed to cover the medical expenses and other damages suffered by employees while on the job.

However, these insurance payouts are expensive for companies, so representatives do everything they can to make sure the claims are legitimate, and then enable workers stop collecting benefits and return to their jobs as soon as they are able. To ensure this, your employer may require you to undergo an Independent Medical Exam (IME). We explain what that means and why you may need an attorney.

How Does Workers’ Compensation Work?

There are many ways to be injured at work—it’s not just construction workers and warehouse employees who get hurt on the job. People in healthcare, food service, retail stores, and even offices can suffer slip and fall or repetitive use injuries, or experience toxic exposure illnesses.

Whether or not the accident that left you injured was your fault, if it happened at work or while you were offsite but on the clock, you should receive workers’ comp benefits to cover your medical bills and pay you while you are unable to work. Your employer wants proof the accident occurred at work and that you’re actually injured or ill.

To fulfill the first requirement, you should report the incident to your supervisor as soon as possible. You may also need witness statements or surveillance video footage to support your claim. To prove you’re actually injured or ill, you’ll need medical tests and a doctor’s report. However, you employer or his insurance company may not trust your personal physician’s diagnosis and may require you to see one of their own doctors for an IME.

How Does an Independent Medical Exam Work?

If you want to receive workers’ comp benefits, you have to follow your employer’s instructions to have an IME. You’ll be sent to a doctor of the workers’ comp insurance company’s choosing. Most states maintain a list of doctors approved to conduct IMEs and your employer tells you where to go.

The insurance company is legally obligated to ensure its requirement is “reasonable.” This means you shouldn’t have to travel a great distance or submit to an excessive number of examinations. If you’re required to travel to see the approved doctor, worker’s comp benefits should reimburse you for your travel expenses.

Some employers require you to have an IME before approving your benefits. Others accept your incident report and emergency medical treatment report as sufficient to grant your initial benefits. In either case, if your recovery is lengthy, you’ll likely be asked to attend follow-up IMEs as deemed necessary by the insurance company. Again, the insurer is required to be “reasonable” in its request, but may require you to submit to multiple medical evaluations.

In an IME, the doctor is determining the following:

  • Were you injured?
  • Is your injury as serious as you claim?
  • Is your injury consistent with your description of the workplace accident?
  • Have you fully recovered?

If the doctor concludes as a result of the IME that you’ve recovered and are capable of returning to work, your benefits may be revoked, and you’ll be required to return to work, despite how you feel or what your personal physician might say.

When You Need A Workers’ Compensation Attorney

As a no-fault system, workers’ comp programs are designed to be fairly straightforward. However, if your employer denies your claim following an IME, or an IME determines that you’re ready to return to work and you and your doctor disagree, you should consider hiring an experienced workers’ comp attorney.

Have You Been Injured On The Job?

If you’ve been hurt at work on the job in Kansas City you need to speak with an experienced workers’ compensation attorney as soon as possible. Please contact us online or call our Kansas City office directly at 816.471.5111 to schedule your free consultation.