Jeffrey Lowenthal Explains IMEs and What they Mean for your Benefits
Hello. My name is Jeffrey Lowenthal. I am the managing partner here at the law firm of Lowenthal & Abrams. We practice Pennsylvania workers’ compensation law, as well as personal injury law. A frequent question we are asked involves independent medical examinations, aka IMEs, and how they can impact the workers’ compensation claim. An IME is supposed to be a physical exam by a doctor who is impartial and honestly trying to determine how seriously you’re injured and whether you still need benefits. The exam is requested and paid for by the employer’s workers’ compensation insurance company. By law the insurance company could order one as often as every six months.
However, these examinations are by no means independent. The doctor is selected and hired by the insurance company, which in most cases, sends that doctor a lot of patients to examine. As a result, the doctor wants to please the insurance company who’s paying for the exam. And nothing would please the company more than terminating your benefits so they can stop paying you. If the doctor says you can do your job, the company will be able to stop your checks. Plus, the law requires you, the claimant, to attend the IME or lose your benefits. Once at the exam, the claimant should cooperate and be honest. It is important not to magnify injuries nor make light of them.
For example, in everyday matters, if someone says “How are you?”, it’s normal for you to say “I’m fine!” But in a doctor’s office setting, if you say you’re fine, that could be written into the doctor’s notes, and then someone could say you don’t need workers’ compensation benefits. So if your knee has been throbbing all night long and keeping you awake, say so. Don’t fail to mention each of your pains from the accident.
Also, never argue with the doctor. Any issue that arises will be ironed out by your lawyer. In some instances you may want to call your lawyer from the doctor’s office. You don’t want to create a hostile relationship at the appointment. Don’t unnecessarily volunteer information. Just answer the question that is asked without supplying information that may not even pertain to your claim or could be turned against you.
Plus, be aware that you do not have to allow other people into the exam room, and that includes the nurse case manager. Nurse case managers are employees of insurance companies. They want you to think they’re only there to help you with your benefits. But one of their goals is to minimize or terminate your benefits, just like everybody else working with the insurance company.
The main thing to understand about an IME is that it just isn’t independent. And if you’re told by the insurance company that you’re going to have to have an IME, and you don’t have a lawyer, now is the time to get one.
At Lowenthal & Abrams, our workers’ compensation team is led by a certified expert in Pennsylvania workers’ compensation law. So please feel free to call us (888-566-5267) if you have a workers’ compensation claim, even if it’s just for some friendly advice. The consultation here is free, and there’s no fee unless, through our efforts, we get you benefits; or we enable your benefits to continue; or we negotiate a lump sum settlement on your behalf.
My name is Jeffrey Lowenthal for Lowenthal & Abrams. Thank you for taking the time to listen to this important information.