Being injured in at work often leaves the victim employee in need of serious medical attention. While most workplace injuries will be rehabilitated to the best possible condition after medical treatment, others may not be so reparable.
Injured workers commonly must either be retrained on a less strenuous job or often cannot work at all in bad injury situations. Depending on the nature of the injury, much of the information needed to determine how serious it is comes form the victim and their description of pain and inability to work satisfactorily for the company.
A problem that many workers compensation claimants actually have is the medical professionals not accepting what is communicated by the patient, which means it is important to know what not to say to a workers comp doctor when being sent for evaluation in an independent medical exam.
What is an Independent Medical Examination
Even though the IME medical professional issuing a seemingly objective second opinion is termed as independent, this is not necessarily the case. The employer workers compensation insurance company chooses the doctor, and many times they are actually contracted directly by the provider.
Their only charge of objectivity is objecting to claims of severity or work relationship on the part of the injured party’s primary treating doctor and the victim themselves. The whole purpose of the IME is to give the insurance provider a potential argument with respect to paying associated medical bills.
Certain injuries can include being required to see multiple doctors in order to rehabilitate and treat the injury, which often is contested by the benefits provider and sometimes by the actual employer. And in addition to potentially attempting to reduce the severity of the injury, they will many times also claim the injury is not work-related based on certain medical details. This is actually what the insurance providers want in most cases so they can deny the entire claim.
Getting Prepared for the Exam
It is important to be very familiar with your injury and medical condition when going to an independent medical exam because the doctor will have more information about it than you realize. The workers compensation insurance provider will more than likely transfer all of their information to the doctor who can then ask questions looking for a counter-claim position regarding the injury.
They will assuredly be prepared for the exam, and injured workers should be ready as well. If the injury occurred during a workplace accident, it is important to recall the exact details of what happened and how the injury occurred. Information should be consistent with prior accounts when answering questions, of which there will easily be several looking for a contradiction in prior claims of severity.
Injuries that are based on repetitive motion job responsibilities can differ significantly from accident injuries, as these are also the most commonly denied workers comp injury cases. The workers compensation doctor will be looking for any angle they can find to help the insurance provider defend the claim, so be careful what you say to the examining physician. They will often be a specialist, and medical specialists are considered experts in the court system within their field of practice.
What NOT to Say to Workers Comp Doctor
The first thing to remember is that answering questions from the IME doctor is much like talking to the police. Anything you say or do will be used against you if it benefits the insurance provider’s cause. In many ways this is the reason for the perceived independent evaluation.
Answer questions succinctly, and do not embellish answers. In addition, the doctor may ask leading questions that will also be part of the ulterior motive for the exam. These questions can include hobbies and interests that require physical participation that could be a reason for the injury.
There is no detail too small for a contracted medical examiner to relay to the company. The ultimate goal is usually to deny the claim whenever possible using whatever reason is available. Never admit overexertion doing other things and keep answers work-related as much as possible. It is also a good idea to study your medical records in advance of the exam in getting prepared because the doctor could ask questions about health issues unrelated to the injury as well.
How a Workers Comp Attorney Can Help with the Process
Having a workers comp legal professional representing your case can provide more than just a representative to keep the employer and insurance provider honest. They can also investigate the case for negligence in the workplace, and especially when the injury is accident related.
Occupational Safety and Health Administration rules and regulations are essentially the law, and violating any required policies and provisions can constitute negligence on the part of the employer. This could land the injury case in court for a pain-and-suffering general damages claim.
Workers comp insurance is set up to exempt employers from general damage injury claims, but only when they comply with work rules and comp system rules without violating OSHA standards for employment environments and provisions from the employing company.
A general damages negligence claim is actually what makes an injured worker financially whole in the long run when they have been permanently injured and can no longer work in the same capacity as before.
Contact a Workers Comp Legal Professional
While it is not imperative to retain a workers comp attorney in all cases, and especially when employers are agreeable to the injury claim, it is still a good decision to speak with a legal professional from the beginning of the process. The claim could actually be much more valuable than the financial settlement associated with wage replacement during the time period of the injury rehabilitation.
Many injured employees do not pursue whole compensation because they fear retribution from the employer and potential future problems obtaining employment elsewhere. There is much to consider when being injured at work, and an employment legal professional can be a real advantage in injury cases with extenuating circumstances that could result in a standard personal injury lawsuit.