What Is an Independent Medical Examination (IME) in an Alabama Workers Compensation Case?

What Is an Independent Medical Examination (IME) in an Alabama Workers Compensation Case?

If you have been receiving medical treatment for a serious work injury, you may eventually receive a call, letter, or notice informing you that the workers’ compensation insurance carrier wants you to see another physician for an Independent Medical Examination, commonly called an IME.

This often raises several questions:

• What is an IME?
• Is this doctor going to take over my treatment?
• Do I have to attend the appointment?
• Can the insurance company force me to see its doctor?

Understanding the purpose of an IME can help reduce some of the uncertainty, although is the workers’ compensation adjuster informs you that they would like you to attend an independent medical examination-you should contact an experienced Alabama workers’ compensation lawyer if you do not already have one assisting you.

What Is an Independent Medical Examination?

An Independent Medical Examination is an evaluation performed by a physician who is not your Authorized Treating Physician.  Unlike your treating doctor, the IME physician is generally not providing medical treatment; instead, the purpose of the examination is to provide an opinion regarding issues such as:

• the nature of the injury
• whether the condition is related to the work accident
• the need for additional medical treatment
• whether requested medical care is reasonably necessary
• work restrictions
• impairment ratings
• whether Maximum Medical Improvement (MMI) has been reached

The physician performing the IME typically prepares a report that is provided to the party requesting the examination-typically the workers’ compensation insurance carrier, but sometimes the Court before whom the case lies.

Is the IME Doctor My New Treating Physician?

No. One of the most common misconceptions is that an IME physician becomes the injured worker’s new doctor. Generally speaking, the IME physician is evaluating you, not treating you. Your Authorized Treating Physician remains responsible for directing your medical care unless a court orders otherwise or other circumstances arise that affect treatment.

In situations where the authorized treating physician requests authorization to perform a form of treatment which has been denied due to the opinion of an independent medical evaluator (we use the term independent-but in the vast majority of the time they are paid directly by the workers comp carrier), legal action may be needed before you can receive the requested medical care.

Can the Workers’ Compensation Carrier Require Me to Attend an IME?

This is where Alabama law differs from some other states. Many injured workers are surprised to learn that an insurance carrier does not automatically have the right to compel an injured worker to attend an IME simply because it requests one. In Alabama, the employer is generally required to provide and pay for all reasonably necessary medical treatment recommended by the Authorized Treating Physician, but simply disagreeing with the treating physician’s recommendations does not automatically give the carrier the right to force an IME examination.

I have spoken to many injured workers who first called Powell and Denny when they were told they had to attend an appointment to see an IME doctor, and when we inform them the workers’ compensation adjuster cannot force them to go-this is the first time they have heard this.  In most cases, we do not allow our clients to be examined by and IME without court order.

When Can an IME Be Ordered?

Alabama law does provide a mechanism for an Independent Medical Examination in certain situations.

When a dispute arises concerning:

• the nature of the injury
• causation
• medical treatment
• permanent impairment
• disability

either party may ask the court to order an examination.  The court may also order an IME on its own initiative when it believes an independent evaluation would assist in resolving the dispute.

In practice, court-ordered IMEs are far less common than many injured workers believe, although we have requested several throughout the past 34 years in situations where the authorized treating physician was on the fence on an important issue.

Why Would the Insurance Carrier Want an IME?

There are several reasons an IME may be requested, and common issues include: disputes about future medical care, disputes as to causation, disputes as to the injured workers’ permanent physical restrictions, and to try and save money if we are being honest.

What Should I Expect During an IME?

Every physician conducts examinations differently, but most IMEs involve:

• a review of medical records
• a discussion of your medical history
• questions about the work accident
• a physical examination
• preparation of a written report

It is important to be truthful and accurate when discussing your symptoms and limitations should you decide to attend an appointment to have an independent evaluation.

If you have been asked to attend an Independent Medical Examination, have questions about your Authorized Treating Physician, or are involved in a dispute regarding medical treatment in an Alabama workers’ compensation claim, it may be helpful to speak with an attorney experienced in handling work injury cases.

At Powell and Denny, we have spent decades helping injured workers navigate complex medical and legal issues arising from workplace injuries.

If you have suffered a job injury and you have questions about your rights and benefits under Alabama’s workers compensation laws -don’t hesitate to contact and speak with one of the experienced Alabama Workers Compensation and Social Security Disability attorneys at Powell and Denny today for a free consultation. Appointments are available in person, or virtually via Zoom if more convenient.  Powell and Denny would appreciate the opportunity to help.  And remember, there is no fee unless you win.

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