After sustaining a workplace injury and filing a workers’ compensation claim, your employer’s insurance company might disagree with your diagnosis and treatment. Under these circumstances, the insurance company might ask you to submit to an independent medical examination (IME) by a designated doctor who is not currently treating you. If you receive this request, you must see a designated doctor to settle the dispute.
In Texas, an IME has several purposes. First, it identifies the cause, severity, and treatment necessary for a workplace injury. Second, it helps assess if the patient already achieved maximum medical improvement (MMI). Lastly, an IME determines if any permanent damage exists after the patient receives treatment. For example, if your employer’s insurance company suspects you achieved MMI and believe your workers’ compensation benefits should end, the company might order an IME.
A designated doctor is a medical professional who does not have a connection to your employer, your attorney, the workers’ compensation insurance company, or you (the injured employee). To settle the dispute regarding your injuries and benefits, the Division of Workers’ Compensation will select the designated doctor for your IME. The IME’s results have a substantial impact on the outcome of a workers’ compensation case. Unfortunately, although the designated doctor’s opinion is often viewed as the most objective, it often lacks the background and information the injured worker’s treating physician has. A designated doctor forms his or her opinion after a brief visit with the injured worker and, in many cases, the doctor might not perform a full physical examination. Moreover, anything you say during your IME with the designated doctor can affect your workers’ compensation claim, so it is crucial to be wary of what you say during this examination. Generally, when an insurance company requests an IME, it is because they already doubt the veracity of your claim. You must do what you can to avoid providing a statement that might support their doubts, so keep your responses to the designated doctor brief, succinct, and avoid volunteering any unnecessary information. Otherwise, the insurance company might cut off your workers’ compensation benefits.
If you sustained a work injury in San Antonio and your employer’s insurer requested an IME, contact the San Antonio workers’ compensation lawyers at The Aguirre Law Firm, PLLC to protect your rights as an injured worker and ensure you receive the benefits you are entitled to. Our legal team has more than two decades of legal experience, so you can trust in our ability to effectively represent you. We understand the difficulties you are facing and are here to provide you with the compassionate support and guidance you need to get through it. Get started on your workers’ compensation case today and reach out to our law office at (210) 922-0808 to set up a free initial case review with one of our attorneys.
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