This issue arises more and more in our practice. Insurance companies and self-insured employers frequently schedule these “IME”s during the course of authorized treatment, often while the injured employee is still out of work and receiving temporary disability payments. Sometimes the reason for the exam is quite legitimate. If a worker has sustained a serious injury requiring surgery and is not making progress post-surgery, it is often desirable to have another expert physician in the same specialty as the current treating physician examine the worker to possibly suggest another approach to the injury which might improve the worker’s condition and return him or her to work. In this situation the worker’s attorney often will make a request for such an exam. Another situation is when a complicated surgery is recommended; the worker in this situation often will ask for a second opinion before proceeding to surgery. Exams in both of these situations are often needed.
Unfortunately, we are seeing an increasing use of the IME for a negative purpose; to “cut off” the worker from treatment which is still needed. To cite an extreme example, a worker injured in a specific incident was recovering from a very serious spinal surgery, was receiving post-surgical therapy, and was also recommended for surgery to another part of the body. The treating doctors were authorized and paid by the insurance company. The worker was also receiving temporary disability payments. The insurance carrier then sent the worker to a physician of its choosing for an IME. That IME physician examined the worker and wrote a report expressing the opinion that the surgery and treatment were not related to a work incident, that physical therapy should stop, and that the worker should be returned to work without restrictions. There was no real evidence justifying that opinion. Nonetheless, the insurance company then stopped all benefits. Fortunately, as soon as the appropriate Motion for Medical and Temporary Benefits was heard in Court the Judge of Compensation entered an Order restoring the worker’s benefits.
If you are injured in a work-related accident and require treatment it is important to obtain the services of Stark & Stark as soon as possible. By having an open file we are able to get into court more quickly should such an unfortunate situation arise with your treatment. We will be happy to help you with your Worker’s Compensation claim.