Independent Medical Examinations (IMEs) and Workers’ Compensation Claims in North Carolina

Have you been injured on the job in North Carolina and filed a workers’ compensation claim? You may be asked to attend an independent medical examination, also called an IME. This can be a confusing and stressful part of the claims process, and you may have lots of questions. What exactly is an IME? How will it affect my case? Do I have any rights during the examination? The experienced workers’ compensation attorneys at Price, Petho & Associates can break IME down in a way that’s easy to understand.

What is an IME?

An independent medical examination is an evaluation performed by a doctor who’s not your treating physician. The purpose of an IME is to provide an unbiased medical opinion about your injury, treatment, and ability to return to work. The term “independent,” however, can be misleading. In most cases, the workers’ compensation insurance company chooses the IME doctor, and their goal is often to minimize the compensation they pay you. This is why it’s so important to understand the role of an IME and how it can affect your workers’ compensation case.

Why do I need to attend an IME?

North Carolina law allows the workers’ compensation insurance company to request an IME if there’s a dispute about your medical condition. Common reasons the company might schedule an IME include:

• The insurance company may question whether your injury is as serious as your doctor claims.
• They might want a second opinion on whether your current treatment is necessary.
• If your doctor has taken you out of work or assigned work restrictions, the insurance company might want another opinion.
• The IME doctor may decide you’ve recovered as much as possible (maximum medical improvement), which could affect your benefits.

If you’re asked to attend an IME, take it seriously. The doctor’s report can seriously influence your case.

How can an IME affect my workers’ comp claim?

Remember, the results of your IME can have a major effect on your workers’ compensation benefits. Depending on the doctor’s findings, the insurance company might take some of the following actions:

• If the IME doctor claims your injury isn’t work-related or isn’t as severe as your doctor says, the insurance company might try to end your benefits.
• If the IME doctor disagrees with your treatment plan, the insurance company may refuse to cover certain procedures or treatments.
• If the IME doctor says you can go back to work, even if you’re still in pain, the insurance company may try to stop your wage benefits.

The IME doctor is typically chosen by the insurance company, so their opinion may not always be in your best interests. That’s why it’s so important to be prepared and know your rights.

What should I know before attending an IME?

If you’ve been scheduled to take an independent medical exam, keep the following points in mind.

• The doctor is not your friend. Unlike your treating physician, the IME doctor isn’t there to provide care or help you heal. Their job is to evaluate your condition for the insurance company. So, be polite – but cautious.
• Be honest. Answer the doctor’s questions truthfully, but don’t offer any extra details that aren’t necessary. Stick to only what you know about your injuries and symptoms. Don’t downplay your pain, but you should also avoid exaggerating.
• If the doctor asks you something and you’re unsure, say, “I don’t know” – don’t guess. For example, if asked if you’ll recover, don’t try to predict anything. Leave that to your treating doctor.
• Sometimes, insurance companies hire private investigators to watch injured workers before or after an IME. If you claim you have trouble walking, for example, but they catch you jogging to your car, they may use it against you. Always be truthful about your injuries and condition.
• You have the right to obtain a copy of the IME report. If the findings aren’t in your favor, the Charlotte workers’ compensation attorneys at Price, Petho & Associates can help you challenge them.

What are my rights during an IME?

Injured workers have specific rights during an IME. These include the following:

• You have the right to have a witness. You may be able to bring a friend, family member, or nurse case manager to the exam.
• The IME doctor can’t force you to undergo painful or invasive tests.
• If you disagree with the IME doctor’s findings, you may have the right to request an independent evaluation from a doctor of your choosing.

If you feel your rights are being violated, our workers’ compensation lawyers can step in to help protect you.

What do I do if the IME report hurts my case?

If the IME doctor’s report negatively affects your claim, don’t panic. You do have options. Our skilled workers’ compensation attorneys can help.

• We can gather evidence from your treating doctor to dispute the IME doctor’s opinion.
• We can request a second opinion and push for an independent evaluation.
• If your case goes before the North Carolina Industrial Commission, we can argue as to why the IME report shouldn’t be trusted.

Do I need a workers’ compensation lawyer for an IME?

You’re not required to have a lawyer for an IME. However, having legal representation can make a big difference. Our experienced workers’ comp lawyers can:

• Ensure the insurance company follows the rules.
• Prepare you for what to expect during the IME.
• Fight back if the IME results are unfair.
• Protect your rights every step of the way.

Remember, the insurance company has lawyers on their side, and you should, too.

Have you been asked to attend an IME, or are you concerned about your workers’ compensation claim? Don’t hesitate to reach out to the skilled workers’ comp lawyers at Price, Petho & Associates. We’re here to help you get the benefits you deserve. Our team is ready to fight for you. Please call our office or submit our contact form to schedule a free consultation at one of our Charlotte, Rutherfordton, or Rockingham offices today.