INDEPENDENT MEDICAL EXAMINATIONS - IME
If your doctor and your employer's doctor disagree about
your medical condition or your need for medical treatment,
the Louisiana Office of Workers Compensation
Medical Services Division or a Louisiana Workers
Compensation Judge may select a third doctor to perform an Independent Medical
Though both you and your employer have the right to request
an Independent Medical Examination, the cost of the exam
will always be paid by the insurance company.
Unfortunately, Louisiana Workers Compensation insurance company
representatives often tell injured employees that they have
arranged an Independent Medical Examination, when in
reality, what they mean is that they have scheduled a
Second Medical Opinion. Written notice of a true Independent Medical Examination
will come to you directly from the Louisiana Office of
Workers Compensation Medical Services Division or from the
Louisiana Workers Compensation Court.
Your attorney and the Louisiana Workers Compensation
insurance company should provide the doctor who performs the
Independent Medical Examination with copies of all of your
medical records. But you are not supposed to contact the
doctor who performs the Independent Medical Examination
except to schedule the appointment and go to the exam. You
should discuss with your attorney whether you are allowed to
take along copies of your medical records or diagnostic
films for the doctor to review.
that performs the Independent Medical Examination will send
the report of the examination directly to the Louisiana
Office of Workers Compensation Medical Services Division or
to the Louisiana Workers Compensation Judge who
will decide your case.
If your doctor reports that you need surgery, the insurance
company's disagrees and doctor who performs the Independent
Medical Examination agrees with your treating physician, the
Louisiana Workers Compensation insurance company will almost certainly
approve the treatment.
Conversely, if your doctor reports that you need surgery,
the insurance company's disagrees and doctor who performs
the Independent Medical Examination agrees with the
insurance company doctor, then you have a problem. The
Louisiana Workers Compensation insurance company is very, very,
unlikely to approve your treatment if the Independent
Medical Examiner has decided against your request. It
occasionally happens, but only in highly unusual
You can appeal to the Louisiana Office of Workers
Compensation. The Louisiana Workers Compensation Judge is
not supposed to just go along with whatever the Independent
Medical Examiner says. The Judge is supposed to weigh the
medical evidence according to the appropriate legal standard
and issue an independent decision.
We tend to have very fair and unpredictable Judges in
the Louisiana Workers Compensation system and in the
overwhelming majority of cases, a claimant can feel
confident that the Judge has considered all of the evidence
and tried to make an impartial decision.
Nonetheless, if the Independent Medical Examination goes
against you, you should be talking with your attorney about
alternative ways to get your treatment covered while your
claim is working its way through the Louisiana Workers
Compensation legal system
Therefore, you do not want to prepare for an Independent
Medical Examination by simply crossing your fingers. There
are many things to consider:
- Should you be having an Independent Medical
Examination in the first place? Are there really
conflicting medical opinions? Should you file an
objection to being required to go to an IME? And what is
likely to happen to your case if the Louisiana Office of
Workers Compensation agrees with your objection and
cancels the examination?
- You want to be certain that all of your medical
records and copies of your
diagnostic films have been submitted to the doctor who
will perform the Independent Medical Examination.
- You would like to know what else has been submitted
to the doctor. You would like to know whether they have
been provided information other than your medical
records. Has the doctor been provided with any
"summaries" prepared by the Workers Compensation
insurance company or their lawyer? What questions has
the doctor been asked to answer?
- What are you going to tell the doctor about your
medical condition? Are you going to appear to be a
"reasonable candidate for a good outcome" for surgery
from a psychological perspective? Do you have other
medical conditions other than your work-related injury
that the IME doctor should know about?
- Would it be a good idea to ask your primary treating
physician for a
supplemental medical report explaining why the treatment
they recommended is exactly the type of treatment
you need? If you get a supplemental report, how do you
legally submit it to the IME doctor without violating
the Louisiana Workers' Compensation laws?
Independent Medical Examinations are an important part of
the Louisiana Workers Compensation legal system. And it's
important that you understand your rights and
responsibilities in requesting and attending the Independent
Obtaining Your Medical Records