Workers’ compensation and the independent medical examination

On Behalf of | Aug 26, 2022 | Workers' Compensation

Being injured at work can turn your life upside down. You’ll probably struggle to cope with the pain that you are experiencing, and your medical care might be quite extensive and costly. Given that your injuries might’ve forced you out of work, you may find it challenging to get by and to cover everything from rent to utilities and grocery bills.

Although that thought can be enormously stressful, you should take at least some comfort knowing that you may be able to offset some of these losses by seeking workers’ compensation benefits. However, recovering these benefits after a workplace accident isn’t automatic, which is why it’s helpful to understand the process as you begin to navigate it. That way, you can take the action needed to best position yourself for success.

Workers’ compensation and the independent medical examination

 One aspect of the workers’ compensation process that tends to give injured workers a headache is the independent medical examination. In many instances, the insurance company requires you to be examined by a medical professional of its choosing. The purpose is for the insurance company to obtain what it thinks is a more objective assessment of your medical condition and your prognosis. The examination tends to analyze how your injuries affect your ability to work.

Why the independent medical examination is important

 The outcome of this examination can be crucial to the outcome of your workers’ compensation case. In many instances, the opinion of the doctor who conducted the examination can tip the scales one way or another. This means that the impartiality and selection of the independent medical examination provider can be key to your case.

How the independent medical examination provider is selected

 You’ll want to do everything you can to ensure that the doctor who conducts your independent medical examination is appropriate and truly impartial. That may be difficult to do, but Florida law does give you some protection. This is because both you and the insurance company have the ability to request an examination and, therefore, select an independent medical examination expert. It just depends on who requests the examination.

However, keep in mind that if you request the examination, then you may be responsible for paying the fees associated with that examination unless you succeed with your claim, at which time the insurance company should reimburse you.

Can you change the examining doctor?

It depends on the circumstances. But if after selection of the medical professional you discover that the doctor’s qualifications don’t fit the injury that is in question in your case, or that doctor no longer practices in the specialty area that was initially applicable, you may be able to successfully seek a change of doctor. You and the insurance company can also agree to a change in provider, but you shouldn’t count on the insurance company agreeing to what you request.

Dealing with the medical examiner’s opinion

 It may seem like the opinion of the medical examiner is the be all and end all of your claim. But that isn’t necessarily true. You might be able to offset that provider’s opinion with your own doctor’s opinion, your own medical evidence, and even issues with how the independent medical examination played out. Your testimony and the testimony of other medical experts could be key to your case.

As you can see, there are a lot of moving parts to your workers’ compensation case. If you’d like to learn more about how to successfully address each of them, now may be the time for you to reach out to an experienced legal professional to begin the conversation.


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