When you apply for workers’ compensation benefits in New York your doctor will submit a report to your employer’s insurer describing your injuries and how they are being treated. This report is used by the insurer and the Workers’ Compensation Board to determine the extent of your injuries and whether you should be approved for benefits.
Sometimes the insurer wants further evidence of your injury after receiving your doctor’s report. If so, the insurer might ask you to submit to an Independent Medical Examination (IME).
What is an IME?
An IME is a medical examination performed by a physician who works for the insurer. However, the physician is supposed to remain independent when evaluating your condition.
The physician will examine you to determine the extent of your injuries, but they will not provide medical care. Following the exam, the physician will issue a report on your condition. This report will be used when determining how much you should receive in benefits.
You will receive a minimum of seven business days’ advanced notice of the IME. The exam will occur during normal business hours and will be at a location that is near your place of residence.
You and the physician evaluating you are permitted to record the exam, although the physician cannot do so in secret. You can have someone come to the exam with you if you want.
If you refuse to attend the IME, your claim for benefits might be denied. So, it is important to attend your IME even if you think doing so is unnecessary or might hurt your case.
Who do IMEs benefit?
IMEs might benefit you if they provide the insurer and Board with the information that they need to approve you for the benefits you need to cover your lost wages until you can return to work.
But do not forget that the physician performing the IME works for your employer’s insurer. They are supposed to remain independent, but some physicians are more apt to look out for the insurer’s bottom line.
If you believe the independent medical examiner overlooked certain aspects of your case, and this led to the denial of workers’ compensation benefits, you have options. You can seek a second opinion from another independent medical examiner. Also, you can appeal the denial of benefits with the Workers’ Compensation Board.