Maryland workers’ compensation law allows injured employees to choose their doctor for treatment after a job injury. The employer’s insurance company must honor the worker’s choice and pay the cost of covered medical expenses stemming from the accidental injury.
But getting paid is not always that simple.
While the insurer must accept the worker’s choice of provider, it can also ask its own doctor to examine the employee and advise on whether the recommended treatment plan is reasonable and necessary. The results of these independent medical examinations (IMEs) could lead to challenges if the workers’ comp doctor disagrees with the employee’s provider.
You should always be honest with your treating physicians. However, you can also protect your claim by learning what not to say to the workers’ comp doctor. An experienced lawyer from Trollinger Law LLC can provide guidance before you submit to an IME in Maryland.
What Is an IME for Workers’ Comp?
An independent medical examination (IME) is a formal exam that may be performed at some point during a workers’ comp claim or while the injured worker is receiving workers’ comp benefits. The exam involves getting a third-party physician’s opinion on the extent of a claimed work injury, illness, or resulting disability.
Typically, an employer or its workers’ compensation insurer will request an employee undergo an IME. This usually happens when the insurer disagrees with the treating provider’s medical opinion or if the doctor deems the employee permanently disabled. Although an employer or insurer “requests” an IME, an employee’s refusal to submit to the exam can result in the denial of workers’ comp benefits.
What to Expect During an IME
In an IME, you will be examined by a medical doctor with expertise in work injuries and occupational illnesses. During the exam, the physician will take your medical history and may perform various physical and/or lab tests to evaluate your medical condition. After the exam, they will provide a medical opinion to your employer’s workers’ comp insurer.
Keep in mind that the physician will also be looking for signs or indications that you are intentionally exaggerating your symptoms. Workers’ compensation fraud happens, and you don’t want to be accused of it.
Workers’ Comp Doctors Work for the Insurance Company
Remember that while your provider is there to help you, the workers’ comp doctor works for the insurance company. For that reason, the doctor will be looking for ways to limit the insurer’s responsibility to pay you full and fair workers’ compensation benefits. Watching what you say can protect your claim. If you’re worried about the IME, a workers’ comp lawyer can coach you on what you should and shouldn’t say.
Mistakes to Avoid with Your Workers’ Comp Doctor
You can avoid the common pitfalls that complicate many workers’ compensation claims. Do not:
- Delay seeking medical treatment for a work injury or occupational illness
- Exaggerate your symptoms, pain, or limitations
- Minimize your symptoms
- Falsely state or omit facts about the circumstances that led to your injury or illness
- Lie to cover up prior accidents, injuries, or preexisting conditions
- Stop treatment before your treating physician declares you reached maximum medical improvement (MMI)
Dishonesty could have several consequences. First, it could lead to a denial of workers’ comp benefits. The doctor might decide you’re ready for work when you still need time to recover. And if you are caught submitting a fraudulent claim, you could be fined and forced to repay past benefits.
Talk to a Workers’ Compensation Attorney First
If you have been asked to undergo an independent medical examination as part of your workers’ comp claim, talk to a Maryland workers’ compensation attorney from Trollinger Law LLC right away. We’ve got the answers you need when times are tough.
Call or contact us today for a free consultation.
Visit our Workers’ Compensation Attorney offices near Waldorf, MD.
