Guide to Independent Medical Exams (IME) in Massachusetts
Work is a major part of most people’s lives in Massachusetts, so it is no surprise that workplace injuries are common. When workers are injured, they can receive Workers’ Compensation benefits but only after undergoing an independent medical exam (IME).
IMEs are medical evaluations conducted by a third-party doctor that your employer chooses. Your employer’s Workers’ Compensation insurance provider needs an “impartial” assessment of your injuries to determine how long you will miss work and what benefits to pay. This makes IMEs incredibly important, so you will want to prepare for yours with our experienced attorneys. We can fight back if the IME concludes you can work when you cannot. We can also arrange for your own physician to be present during any IME requested.
Call the Law Office of John J. Sheehan at (617) 925-6407 for a free case review with our Massachusetts Workers’ Compensation lawyers.
Understanding Independent Medical Exams (IME) in Massachusetts
When someone gets injured on the job, they can choose their own treating physician in Massachusetts for care. However, an injured worker’s employer has the right to request an IME to confirm you are as injured as your doctor says you are under the state’s Workers’ Compensation rules. After that, an employer can request further IMEs to determine if a worker is still injured but cannot make the request more than once every six months. The exam is “independent” because your employer’s Workers’ Compensation insurance provider chooses the physician conducting it, as per Mass. Gen. Laws Ch. 152, § 45.
However, the term independent is a bit misleading, as the physician examining you is doing so at the insurance company’s request. Thus, you should not assume that they will have your best interests in mind. Make no mistake; your employer’s insurance provider does not want to pay more than it has to, so they have an incentive to get you back to work. Our Massachusetts Workers’ Compensation attorneys can help protect your rights while navigating the claims process. While IMEs are mandatory if you want to receive benefits, you have options if you disagree with the doctor’s diagnosis. The following will tell you everything you need to know about IMEs in Massachusetts:
Attending Your IME
You must attend your IME after suffering a workplace injury and will likely need to attend more the longer you are out of work. Otherwise, your Workers’ Compensation claim will have zero chance of being approved since your right to even file one will be suspended. If you are already receiving benefits and refuse an IME request, they will be forfeited.
When you report the accident to your employer, they will tell you which doctor to visit for your IME. However, they cannot just spring the IME on you. You should receive a notice for your IME detailing the date, time, and location, as well as the physician who will examine you. Fortunately, your employer or their insurer is responsible for covering the IME’s costs.
You have the right to prepare for your IME, hence the notice requirement. While the insurer’s physician will conduct the IME, the law allows you to have your own doctor present during it. However, it is your responsibility to provide and pay to have your doctor at the IME. If, for some reason, your physician cannot attend, you will still need to undergo the IME so that your compensation is not held up.
If your injuries are relatively minor and expected to heal in a few months, you might only have to go to one IME since your employer cannot make another request for six months. If you are projected to be out of work for some time, the insurance provider can request an IME once every six months for as long as you remain injured. Refusing any subsequent request will result in a suspension of benefits.
Obtaining Copies of Your IME Records
Like private medical records, you also have a right to be furnished with copies of IME records within 14 days of the exam, according to § 30A and § 20A. If the doctor or insurer does not release your IME records in that time, they can be fined between $25 and $1,000 for each violation of the reporting requirement.
The IME records must also be complete. Reports should include all the various examinations you underwent, any previous medical history obtained, the treatment you received, your diagnoses, and prognosis.
Reimbursing Your Expenses
Because the insurer is requesting the IME, it makes sense that they should pay for the expenses you incurred to obtain it. Fortunately, the law requires that you be reimbursed for expenses, like reasonable transportation costs. For instance, you should be compensated if you took the bus to and from the IME or needed to fill up your gas tank.
You will also be compensated for any lost wages you sustained to attend the appointment. Since most doctors have regular business hours, you will likely need to take off work for your IME, but our team will ensure you do not lose out on your rightful pay.
What to Do After Your IME
The best way to ensure your IME goes well is to be prepared before and after it. First, you should consult our legal team as soon as you get your notice to attend. We can review your previous medical records and prepare questions you will want to ask the doctor, like how they will assess your time out of work. However, take their medical advice with a grain of salt since they technically work for the insurance company. We can gather the IME records for your personal doctor to review and provide advice. If the IME doctor concludes you can go back to work, but your physician has a different opinion, we can prepare the case for a Workers’ Compensation judge to decide.
We will also guide you on how to describe your injuries. You should never exaggerate your condition since it can jeopardize your claim, but you also do not want to undersell your injuries. If you minimize the damages or “act tough,” you might be sent back to work before you are fully healed.
Contact Our Workers’ Compensation Attorneys in Massachusetts Today for Help Preparing for Your Independent Medical Exam
For a free case evaluation with our Medford Workers’ Compensation attorneys, call the Law Office of John J. Sheehan today at (617) 925-6407.