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Independent Medical Examinations are Far From Independent

By: Kevin Kampschror, Esq.

If you have been injured at work, you may receive a letter from the insurance company requiring you to attend an independent medical examination (“IME”) with a doctor. It is not unreasonable to assume that the doctor you see will be “independent,” as the title suggests, but unfortunately, this is not the case. There is nothing independent about an insurance adjuster dictating which doctor they want you to see.

At our firm, we often see insurance companies using the same doctors over and over because they know they can rely on the IME doctor to make a diagnosis they agree with. Often what will happen is that the adjuster will send a letter to the doctor behind the back of the injured worker and his or her attorney prior to the examination, encouraging the doctor to give the “right” diagnosis. For example, if an injured worker goes to their doctor and is diagnosed with a herniated disc, and the insurance company is unhappy with this diagnosis, they can require the injured worker to attend an IME with a doctor they know will diagnose a less serious condition.

To compound the problem, it is only the insurer that has the ability under the law to send the injured worker to an IME. The injured worker does not have the ability to attend an IME on their own, unless they want to pay thousands of dollars out of their own pocket. Furthermore, failing to attend the appointment could result in a loss of benefits.

While not all insurance adjusters engage in this unethical practice, there are enough that do to make it a big problem. That is why injured workers are strongly advised to involve a qualified workers’ compensation lawyer who can help counter a loaded IME. An attorney may be able to immediately file an appeal upon receipt of the letter ordering the worker to visit a known defense doctor. In the litigation stage, an Appeals Officer may order another IME, but with a doctor the attorneys can agree upon. If the attorneys cannot agree on a doctor, the Appeals Officer usually asks the attorneys to provide three names, and the Appeals Officer chooses the doctor.

The Officer will also order that the only person allowed to speak with the IME doctor is the patient, and that the doctor only answer questions set forth in the interim order.

If you have been injured at work in Nevada, we encourage you to get in touch with a Las Vegas workers’ compensation attorney at Shook & Stone. We can help ensure that your case is handled properly, that you receive a fair medical evaluation, and that you receive the benefits you are entitled to. Call us today to discuss your claim.

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