Independent Medical Exam For Workers Compensation

Many of our clients want to know why they have to go to an Independent Medical Exam, otherwise known as an IME.   The short answer is because the Virginia Workers’ Compensation Act requires you to do so.  If you do not attend the IME, the Workers’ Compensation Carrier can refuse to pay for any additional lost wage benefits AND any additional medical treatment.  Then, in order to get these benefit reinstated, you will have to wait on a hearing, even if you later agree to go to the IME. This process often takes three to six months.  Really, it is best to attend the IME.  If the IME is scheduled at a time you cannot attend, it can be rescheduled if your plans cannot. However, you have to let the doctor’s office and the Workers Compensation Carrier know in advance.

What Is an IME?

An Independent Medical Exam is an examination scheduled by the workers’ compensation insurance carrier with the doctor of their choice.  You nor your attorney get any say in what doctor is chosen.  An IME is not to be confused with a second opinion, which is a completely different examination.

IME Rules

Only One IME Per Year, Per Specialty

here are rules to getting IME’s.  The workers’ compensation carrier can only schedule one IME per year, per specialty, without the Commission’s permission. This means that if you have an IME with an orthopedist in January, the workers’ compensation insurance carrier cannot schedule you for another IME with an orthopedist until the following January without specifically getting the Commission’s permission to do so.

However, the carrier can schedule an IME with an orthopedic specialist in January, and then a neurosurgeon in June, even if they are both back specialists, because they have different medical specialties. This specific example happens quite a bit with back injuries because there can be both orthopedic specialists and neurosurgical specialists who treat backs.

Don’t Do Their Job

While the Virginia Workers’ Compensation Act requires you to attend the IME and answer questions for the doctor, it does not require you to do the Carrier’s job for them.  This examination is being done at their request, not yours, so all you need to bring is identification and a smile.  You are not required to bring any other records, x-rays or MRIs, no matter what the adjuster, nurse case manager or doctor’s office tells you (even if the letter notifying you of the appointment says to bring something).  If the doctor performing the examination needs records or diagnostic testing results, they can get what is needed from the Carrier.

All you need to do is answer the doctor’s questions truthfully, and be polite.  No matter how the doctor treats you, it will not help you if you are rude to the doctor.  You do not have to be their best friend, just be polite.

The Doctor Isn’t Required to Give You Their Opinion on Your Condition

The doctor performing the IME is not your treating doctor, so they are not required to tell you anything about their opinions.  In fact, the doctor is not even required to prepare a report.  Often, if the doctor is not going to say what the Workers’ Compensation Carrier wants the doctor to say, the Carrier will not ask for a report.   Your attorney knows this and will use to this your advantage.

How an Attorney Can Help You

If you are scheduled for an IME, please let your attorney know as soon as possible.  While the workers’ compensation carrier is supposed to let your attorney know, the Carrier does not always do so. If you ensure your attorney is aware of the appointment, your attorney can prepare for what actions, if any, need to take place next.  Typically, this will involve sending a copy of the IME report to your treating physician to determine whether your treating doctor agrees with any of the IME doctor’s opinions.   In most cases, the treating physician’s opinion will mean more than the IME doctor’s opinion.  

While there are some doctors who perform IME’s who seem to be on the workers’ compensation carrier’s payroll, not all of them are. Some of the doctors who perform IME’s are good physicians and will give honest opinions.  If you have any questions about your IME, please contact your attorney.