What is an Independent Medical Examination in Workers’ Compensation?

independent medical examination

If you have a workers’ compensation claim for an on-the-job injury, you may be asked to undergo an independent medical examination. The outcome of an IME can affect your benefits, so it’s extremely important to understand what an IME is and what to do if you’re asked to have one. Getting assistance from an experienced workers’ compensation lawyer is strongly recommended if you do not already have an attorney helping with your claim.

What Is an IME?

An independent medical examination is a procedure authorized by the Virginia Workers’ Compensation Act, in Virginia Code § 65.2-607. Refusing to cooperate with an IME can jeopardize your workers’ comp benefits.

The employer and their insurance company are entitled to ask you to undergo an IME at any point during your case. The physician who conducts the IME is not your treating doctor and likely is not a doctor you have ever seen previously. The insurance company chooses the physician who conducts the IME. You and your lawyer have no input into choosing the IME physician.

The doctor–patient privilege does not apply to communications that occur during the IME. You cannot have your attorney attend with you, but the statute does allow you to have your own doctor attend the examination (at your cost). Your lawyer discusses those issues with you before you go to the IME.

The insurance company is limited to scheduling an IME for you only once a year per medical specialty without permission from the Workers’ Compensation Commission. But it is possible to have more than one IME scheduled in a year. For example, back injuries may require input from both an orthopedic doctor and a neurosurgical specialist, which could mean two different IMEs in a single year.

The doctor who conducts the IME provides a written report to your employer and the insurance company. You and your lawyer receive a copy. The IME report may support your claim for benefits, or it may be in disagreement with your own treating doctor’s assessment.

When Is an IME Ordered?

An IME can be requested at any time in any case. Often, an IME is used in cases involving catastrophic injuries, other significant injuries that take more than three months to heal, injuries requiring substantial surgery, or injuries that require ongoing chronic pain management. The insurer also may request an IME if your treating physician determines that you have reached maximum medical improvement, and the company disagrees with that conclusion or with the permanent restrictions in your functional capacity evaluation or permanent impairment rating.

If an IME is scheduled, and you do not attend, the insurance company can refuse to pay any additional wage loss benefits and refuse further medical treatment. If you receive a notice of an IME for your workers’ compensation case, it’s imperative that you attend or notify the doctor’s office and insurance company if you have valid reasons for being unable to attend the scheduled session, and request rescheduling. Your lawyer will handle all the details for you.

Attending an Independent Medical Examination

At the IME, the physician will review your medical condition with you. They will ask questions about your medical history, overall health, and about the accident that caused the injury. You are not required to volunteer information or provide records to the IME physician. But you should cooperate, be polite, and answer the doctor’s questions truthfully.

Your lawyer will help you prepare for the examination session before you go but does not attend the IME with you. You may be required to complete written questionnaires at the session. You should have already received these forms and reviewed them with your attorney, so you can provide correct and appropriate responses. The doctor also likely will examine you as part of the session.

After the examination, the doctor sends a written report to the insurance company and to you or your attorney. That report may play an important role in your case going forward.

If the IME report is unfavorable, your attorney will have strategies available to contradict and challenge the IME report. If you go through the IME process without assistance from a workers’ compensation attorney, it will be difficult for you to overcome an adverse report from a physician who conducts an IME. You should always contact a workers’ comp lawyer immediately if you receive a notice of an independent medical examination, and you have not already retained a workers’ comp lawyer for your case.

Schedule a Free Consultation with our Virginia Workers’ Compensation Attorneys

If you receive an injury at work, it’s important to ensure that you receive the maximum benefits you are entitled to under Virginia workers’ compensation law. To accomplish that goal, you can count on our experienced workers’ compensation attorneys to make certain your claim complies with all applicable legal requirements, including those relating to an Independent Medical Examination. Our Richmond injury lawyers at Renfro & Renfro are here to help with your claim and work with you closely throughout the entire process. We welcome you to contact us for a free consultation.