The Insurer’s

Massachusetts Workplace Disability Lawyers

The Massachusetts workers’ compensation attorneys at Kantrovitz & Associates work closely with medical experts when proving job-related harm. For over 20 years, we have helped injured workers obtain fair appraisals of disputed medical conditions and fight for the compensation they need. Based in Boston, we are committed to protecting disabled workers across Massachusetts, Rhode Island, and New Hampshire.

Insurer’s “Independent” Medical Exam (IME)

IMEs are used by workers’ compensation insurers when the claimant’s medical condition is at issue. Because the award of workers’ compensation requires a job-related injury, insurers may request examination by their own “independent” physician rather than the worker’s chosen doctor. IMEs may involve:

• Paid exam and report
• Compensation for mileage
• Submission of medical history
• Explanation of evaluation’s scope
• Notice of appointment by examiner
• Other physicians’ lab reports and consults
• Signed permission to obtain other documents
• Examiner’s sworn testimony in deposition or trial
• Waiver of privilege regarding notes about claimed condition

In an IME, the medical doctor is supposed to perform a physical examination in order to provide the insurer with “credible” written evidence and “clarify” medical restrictions or limitations. Insurers may later use the evaluation as evidence to support termination of benefits or deny a claim. Many IMEs report that the claimant is not really disabled and can actually work.

“Independent” Means Risk Management

Workers should not think that insurance companies request IMEs to award benefits. Despite impressive credentials lending an appearance of fairness, examiners are still employed by insurers. Insurers, in turn, do not profit from awarding benefits. IME doctors are armed with previous medical records, in-house medical reports done by the insurance company, and even the amount of the worker’s monthly benefits. Because these inform the opinion rendered by the physician, IMEs are rarely impartial, but merely “independent” from the previous diagnosis.

Preparing for the IME Process

The help of experienced workers’ compensation attorneys is essential to preparing for IMEs and discussions with claims adjusters. Never engage in a phone consultation with a claims adjuster without obtaining legal counsel. Recorded statements can be later used to prove alleged inconsistencies and deny relief. Key things to remember in preparing for the IME process include:

• Meet with your own physician on same day as IME if possible
• Review medical history and illness with an attorney
• Practice describing history, disability, and treatment
• Attend IME with someone who can take detailed notes
• Keep documentation provided by both IME and doctor
• Discuss in detail previous physicians, work restrictions
• Avoid exaggeration, distraction, unnatural overreactions
• Be kind, courteous and polite with the physician

Patients do not undergo IMEs to receive treatment or advice. Be prepared to answer questions, not ask them as you would a normal doctor. Although human instinct searches for approval by giving “correct” answers, refrain from “bending” the truth during an IME. Most importantly, prepare before an IME with your own physician and workers’ compensation attorney.

Passing the IME

If you were asked to obtain and independent medical examination by an insurer, contact the Massachusetts workers’ compensation lawyers at Kantrovitz & Associates today. For over 20 years, we have helped injured workers understand this often-biased and adversarial process in seeking the relief they deserve. We have recovered substantial awards for disabled workers injured in Boston, Essex, Middlesex, Norfolk, Suffolk, Plymouth, and Merrimack counties, among others. Call 800-367-0871 for a free consultation or contact us online.