Vermont’s workers’ compensation laws allow injured workers to meet with a doctor of their choice for treatment. However, insurers are also allowed to send employees to be evaluated by a doctor of their choosing, called an Independent Medical Exam (IME).
An IME Explained
An IME is an evaluation for the purpose of providing an expert report. The purpose of an IME is not treatment; the doctor will tell you specifically that they are not treating you. The IME doctor is not paid to provide medical care. Rather, the purpose of an IME is for the doctor to provide a written report for use in the worker’s compensation process. The doctor is paid by the party who requested the IME to write a report and give a medical opinion on an issue in the case. Either your own attorney or the insurance company might send you to an IME.
Usually IME doctors are asked to opine about:
- Whether the injury or illness is related to work;
- Whether recommended treatment is reasonable;
- Whether you are at a “medical end point”
- Whether you have permanent impairment.
You Must Attend IME
When the insurer schedules an IME, you will get a letter telling you when and where to show up. According to 21 V.S.A. 655, you have to go. If you don’t attend a reasonably scheduled IME, the insurer can stop paying temporary disability benefits and possibly even your medical benefits.
You must be given a reasonable amount of notice (typically a few weeks), and if the scheduled appointment doesn’t work for you, you can reschedule by contacting the insurance company. If for some reason you miss the appointment, you should contact the insurance company as soon as possible to reschedule.
The insurance company is not allowed to schedule an IME more than two hours from your home. If the location is more than two hours away, you should contact the insurance company to let them know and they must find a closer location. You are eligible for mileage reimbursement for travel. If you need assistance with transportation you should tell the insurance company.
You can also be required by the insurance company to attend multiple IME&rsquo’s as long as they are reasonably spaced apart (generally a few months), and are not addressing an issue that has already been covered in an earlier IME. The insurance company also gets to choose the doctor. You cannot refuse to attend just because you don’t like the doctor or think they are unfair.
The good news? You can have someone go with you. You might feel more comfortable bringing a family member or friend along. You can also record the exam, if you let the insurer know ahead of time. Discuss this with your lawyer.
Prepare for the IME
It is critical to prepare ahead of time for the exam. In particular, you need to provide answers in a consistent way. Don’t tell the IME physician something different than what you told your own doctors. You might need to review your memories or paperwork about the accident. You always want to provide accurate, honest information.
Don’t try to convince the doctor of anything. Just answer the questions as accurately as possible.
Our Rutland Workers’ Compensation Attorneys Can Help
The IME is nothing to be afraid of. With the right legal team, you will be prepared for anything that happens. A negative report also isn’t the end of your claim. We can push back on the IME doctor’s conclusions and fight for the benefits you deserve. Call Larson & Gallivan Law today to learn more.