When claims are not moving fast enough for the adjuster, or the adjuster disagrees with your treating doctor’s opinions, the adjuster may send you to what is referred to in work comp as an “independent medical examination” or “IME.” The adjuster can make it sound helpful, “this doctor is a specialist” or “this doctor understands work comp and what is needed.”
In most cases, these doctors are not helpful. The doctors who conduct these examinations are usually part of a highly paid network of doctors. Some companies have a list of doctors who travel all over the western United States doing as many exams as possible and charge a high price to do so. Some doctors, tired of handling their patients, start a side business doing exams. They travel to Montana from neighboring states and rent office space from a physical therapy clinic and do as many exams during the day as possible. They attend work comp conferences and market their services directly to adjusters. The happier the adjuster is, the more referrals the IME doctor gets. For their efforts, they usually charge about $2,000-$2,500 at a minimum and sometimes as high as $5,000-$6,000. It’s big business.
Honestly, independent medical examinations are the worst. Rarely do these examinations end up helping the claimant. Unfortunately, Montana’s work comp law gives the insurer the right to make you go in most cases.
And remember, the IME doctor is not your doctor! There is no physician / patient relationship. Whatever you say to the doctor may be shared with the insurer.
Do You Have to go to your IME?
In most cases, yes. But there are some limitations under the law. Under §39-71-605(1)(b), MCA, the adjuster must consider your convenience, physical condition, and ability to attend at the time and place that is as close to the employee’s residence as is practical. Many adjusters will race past this requirement and schedule appointments with IME doctors based on the adjuster’s experience with the doctor rather than where the examination is taking place.
You should insist that the examination take place as close to your residence as possible. IME doctors travel on a regular schedule, so there is no need for you to trek across the state of Montana just for the convenience of the adjuster or IME doctor. If you do have to travel, the adjuster should also provide you with mileage and meal money. Mileage and meal money should be paid in advance if you ask for it.
The IME doctor will usually take a medical history from you (Spoiler: The IME doctor has your records and probably knows the answer to the question he is asking.)
Be honest, but short with your answers. The IME doctor is not your doctor, and absolutely anything you share will make its way back to the adjuster.
What happens after the IME report comes back to the adjuster?
The adjuster should share the report with your treating physician and ask for their opinion on the conclusions. Under the law, the opinion of your treating physician counts for more than the one-time examination from an IME doctor. That doesn’t mean the Court won’t agree with the IME doctor. If the treating physician disagrees, though, it is harder for the adjuster to go with the IME doctor’s opinion.
If you want to watch our video on independent medical examinations, click HERE.
You can also learn about the independent medical examination process in our book, Hurt at Work: An Insider’s Guide to Your Montana Work Comp Claim. It’s available on the main page of our website, www.mtworkcomplawyer.com. The next several blog posts will provide more information about independent medical examinations and offer you tips about what you should do and what types of testing the doctor should do for your specific type of injury.