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What is an Independent Medical Exam in the Workers’ Compensation Context?

WorkAccident

An Independent Medical Examination (IME) is, in theory, supposed to be exactly as it sounds—a medical review by a health professional that is independent or neutral. The Claimant and/or the employer/carrier can elect one IME per case under Fla. Stat. 440.139(5).

Exams May Have Bias

At least, in theory, that’s how it is supposed to work. In practice, however, many IME physicians are anything but neutral. Many do hundreds of IME examinations every year (and make tens of thousands of dollars in fees) for the same employer/carrier or its defense firm and for Claimants and their attorneys. As such, there is certainly the potential for bias. An employer/carrier would not continue to use an expert who opines that the Claimant has suffered causally related injuries requiring medical care, and vice versa for the Claimant.

The employer/carrier’s IMEs will often testify that you aren’t as injured as you say you are, that your prognosis for recovery is better than it is, that you are not in need of any more treatment, or that there is a pre-existing condition unrelated to the accident that is causing your symptoms, and, again, vice versa for the Claimant.

Why Would I get an IME? 

It is the Claimant’s burden to prove his/her case. Most benefits to which Claimants are entitled require medical evidence. Unfortunately, the Claimant in a workers’ compensation case does not get to choose his/her doctor; thus, there is occasion where a Claimant cannot prove his/her case with the opinions of an authorized doctor. In this instance, a Claimant would need to secure an IME to provide required opinion to prove his/her case.

Likewise, the Employer/Carrier may need to prove an affirmative defense with medical evidence. If the authorized doctor does not support the employer/carrier defense, then the employer/carrier would need to secure an IME.

Lastly, there are occasions when a Claimant’s case is totally denied from day one, and the Claimant has not treated with an authorized doctor. Yet, the Claimant is claiming an accident occurred at work and he/she was injured as a result. In this case, both the Claimant and employer/carrier would secure an IME to provide medical opinions.

Contact Us Today for Help

Do you have questions about getting workers’ compensation benefits after an injury on the job?  Contact us today at the Celeste Law Firm in West Palm Beach for a free consultation about getting the workers’ compensation that you deserve.

Resource:

flsenate.gov/Laws/Statutes/2011/440.13

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