Workers’ compensation insurance fraud in the United States is a $30 billion-a-year problem, according to the National Insurance Crime Bureau (NICB).
People engage in this type of fraud to get time off work, monetary compensation, and other benefits. However, these acts could have some potentially severe consequences on taxpayers and other workers. For this reason, compensation fraud is a crime with punishments such as fines and the possibility of a conviction.
One of the most popular ways of committing worker’s compensation fraud is to make claims of false medical conditions. Some workers also go the extra mile and liaise with medical providers who specialize in treating workplace injuries to ensure their claims are verified and benefits collected.
This is where the workers’ comp IME comes in.
What Is an IME?
IME stands for independent medical examination. A workers’ compensation IME is an examination carried out by an independent physician or medical professional. This medical practitioner thoroughly assesses the worker’s injuries and determines whether or not they are actually a result of work-related issues.
What Is the IME Process?
If you file a workers’ compensation claim, the insurance company will be responsible for coordinating the medical exam. Here are a few things to expect from a typical IME:
- There is no need to bring your medical documents with you, such as medical records or test results. If you’re going in for an IME, it is at the request of the carrier or insurance company.
- For that reason, it’s the insurance company’s responsibility to provide all relevant information and documents to the medical facility and to pay for the doctor to conduct the examination. All the patient (worker) has to do is go in for the appointment.
- Don’t expect a typical consultation. It’s important that the worker understands that an IME is different from a visit to their usual healthcare provider. This examiner is expected to send a copy of the report to the patient, their doctor, and their lawyer, as well as the insurance company and the Workers’ Compensation Board.
Frequently Asked Questions about IMEs
If you still have questions about your upcoming IME, you’re not alone. Here are a few frequently asked questions that our worker’s compensation lawyers have heard from our clients.
- How much notice do I get before going in for the exam?
You will have at least seven business days’ notice.
- Who will examine me?
Independent medical exams are conducted by licensed and board-certified physicians and other medical professionals who are authorized by the Workers’ Compensation Board to perform the exam. These often include doctors, chiropractors, psychologists, psychiatrists, and podiatrists.
- How far can a worker be expected to travel for the exam?
A worker is expected to travel only a reasonable distance, depending mostly on where they live and any factors such as disabilities that could affect their movement. The insurance company often covers the cost of transportation if necessary.
Before going in for your independent medical exam, you should have your legal representation on standby. Our workers’ compensation lawyers will brief you on what to expect at your IME. Having them on standby ensures the entire process is carried out properly and that you receive your due benefits.
If you don’t yet have a workers’ compensation attorney, our team can help. Contact us at Erwin McCane & Daly for all your legal needs regarding workers’ compensation IMEs.