What is an independent medical exam? Everything you need to know about your upcoming appointment.

What is an independent medical exam?

As part of the workers’ compensation claim process, WorkCover may require that you attend an independent medical examination (IME).

When you have a worker’s compensation claim, your treating doctor will determine your medical treatment, whether you can return to work and whether you have a permanent disability. Where there is a dispute with your employer’s insurance company about any of these determinations, WorkCover will require that you see an IME doctor.

It is important that you understand IMEs and the role of the IME doctor since in many cases, IME reports can significantly affect your claim.

Is an IME doctor different to my regular doctor?

An IME is conducted by a physician who will give an expert opinion about any disputes in your claim. The IME doctor is engaged by WorkCover and their role is very different from your regular doctor. Whilst your general practitioner’s role is to treat your condition, an IME doctor’s role is to provide information about your condition to WorkCover in relation to your claim.

Importantly, while you enjoy the benefits of a privileged doctor-patient relationship with your regular general practitioner, nothing you say to the IME doctor will be confidential. The purpose of an IME is for the doctor to gather information about you that WorkCover can use to determine your case. 

What should I expect from the IME?

The IME doctor will likely begin by asking you general questions about your injury, the work-related incident that led to the injury, and your medical history. The doctor may also conduct some exams and tests to assess your injury.

Everything you say to the IME doctor in response to these questions can be relayed to WorkCover. This is the same for any observations that the doctor makes about you. For example, if you come into the examination wearing a neck brace and grimacing from neck pain, and later the IME doctor observes you in the carpark taking off your neck brace and freely moving your neck, the doctor will make note of this and this inconsistency can be used against you in the claim.

What should I do to prepare for an IME?

Before your IME you should plan for the following:

• Be familiar with your medical history – the IME doctor has access to your medical records and will likely ask you about your past medical history. It is important that you take the time to review your records.
• Review how the work accident happened – the IME doctor will ask you in significant detail about how the injury occurred. By being familiar with how your injury came about, it is less likely that you will tell an inconsistent account of the incident.
• Know your medical treatment – the IME doctor will ask you about the treatment you received for the injury. Whilst it won’t be expected that you remember every detail of every treatment, it is beneficial to know generally the treatment you have received and when.
• Review your past and current symptoms – the IME doctor will ask you about your symptoms so make sure you include everything, regardless of how minor the symptom may be.
• Plan to arrive early – there are consequences for being late or missing an IME. It is important to be on time to avoid suffering the penalties.
• Plan to bring someone with you – it is recommended that you bring a trusted friend or relative with you to the exam. Whilst the person cannot speak during the exam, they can and should take notes since they can act as a witness to the exam.

After the IME, you should do the following:

• Write down what happened – take the time to write down what happened in the IME. This may be important later if your claim is rejected.
• Review the IME report carefully – IME reports are given significant weight in the determination of compensation claims. It is therefore vital that you review the report carefully and make note of any clarifications that need to be made.

How will an IME affect my WorkCover claim?

IME reports carry a substantial amount of weight as they are often used as evidence at workers’ compensation hearings to establish an employee’s degree of permanent disability or how much he or she should receive in benefits.

The results of an IME can have a big impact on your claim. IME doctors are often perceived as being unbiased experts and as a result, their opinion is given significant weight. This can mean that if the IME report contradicts your treating doctor’s opinion, your employer can refuse to pay additional benefits or can reject additional treatment.

Victoria’s workers’ compensation laws are complex, so being injured at work is not only painful but can also leave employees who have suffered a workplace accident unsure of their next steps. Having the advice of a dedicated and experienced lawyer can make all the difference in the outcome of a case, especially for employees who are severely injured. If an IME has been scheduled for you by the WorkCover insurance company it may be a good time to get some independent legal advice about your claim. Contact Gordon Legal today on 9603 3000 to get advice on your compensation claim today.