My employer just set me up for a “second opinion” or IME with another doctor. What is that?
An IME is an abbreviation for an independent medical examination. The purpose of an IME is seeking a second opinion from a non-treating doctor for your work injury in order to obtain an opinion on pretty much anything regarding your workers’ compensation injury: medical causation, diagnosis, treatment, restrictions, impairment, etc. The IME doctor, however, does not actually provide any treatment him/herself. The IME doctor merely dictates a report with his/her evaluation, opinions, and recommendations.
An IME can be requested by the plaintiff or defendant in a workers’ compensation claim. Although “independent” is in the name, oftentimes these exams are not independent at all. In fact, there are three different types of IMEs in Nebraska, and not all would be considered “independent.”
- An IME may be requested by plaintiff. In this scenario, the injured worker can choose his/her own doctor with the cost paid by that worker or that worker’s lawyer;
- An IME may be requested by both parties. If there is a medical dispute, the parties can agree to an IME doctor, or have the court appoint an IME doctor, the cost of which is borne by the employer or insurance company; and
- An IME may be requested by defendant. The employer or insurance company may choose its own doctor much like the worker can choose a doctor. The cost of this IME is borne by the employer.
Injured workers must be cautious of both #2 and #3 above. In #2, the IME opinion may be binding on both parties at trial if the doctor was agreed to by the parties. Without proper knowledge of the doctor involved, the injured worker may not know that a particular doctor is employer-friendly and is not likely to provide the worker with a favorable opinion.
Under #3, the injured worker must also be cautious. The worker cannot outright refuse to attend an IME, so the worker needs to be on his/her toes with the doctor, because the doctors hired by the insurance companies will go to great lengths to please the insurance companies that pay them big bucks for these IMEs (to the detriment of the worker). Sometimes that can mean denying further treatment for an injury or stating that a worker is “malingering” – or faking – an injury just because a worker didn’t look like he was hurt when he was getting out of his car in the parking lot. In other words, be warned that the doctor is always watching you during these IMEs.
Other advice that I give my clients before going to an IME is to be honest about all prior injuries, because the IME doctor will probably know more about your medical history than you. Be professional at the appointment and non-confrontational. Finally, bring a friend or family member with you to the IME. This can keep the IME doctor more honest hopefully, and can give the worker an additional “witness” about the examination when it comes time for trial.
Probably the best advice for anyone being sent to an IME is to contact a lawyer immediately. Chances are very good that your claim will be denied once you have been sent to an IME, and the sooner you contact a lawyer at that point, the better.