TOP TEN FACTS ABOUT INDEPENDENT MEDICAL EVALUATIONS IN A MARYLAND WORKERS COMPENSATION CLAIM

TOP TEN FACTS ABOUT INDEPENDENT MEDICAL EVALUATIONS IN A MARYLAND WORKERS COMPENSATION CLAIM

  • In a Maryland workers compensation case the workers Compensation insurance company will likely schedule an independent medical evaluation
  • In a worker’s compensation claim, insurance companies typically set up the plaintiff or claimant for an evaluation to be done by the insurance company doctor. Insurance companies call this an independent medical evaluation; however, this is actually an insurance company’s medical evaluation. The insurance companies carefully and deliberately pick what doctors they want to perform specific evaluations. Although most doctors are honest, the fact remains that they have been selected by the insurance company to perform this exam because they have given favorable results in the past.
  • Maryland workers compensation lawyers know most of these doctors are not in fact independent, have frequently done work for that insurance company and typically only work for insurance companies, rather than injured parties. These doctors solicit business from the insurance companies by offering to do medical evaluations for them knowing that the insurance company will not refer the doctor patients again unless the reports are favorable to the insurance company.
  • Be aware, that most of the workers compensation commissioners, actually practiced in the area of workers compensation before they became commissioners and therefore are aware of the tendencies of the different doctors whose names typically appear in a worker’s compensation independent medical evaluation. Commissioners typically know:
  •           If the same doctor is always used by the same insurance company, lawyer or law firm
  •           Doctor typically says the injuries are unrelated to accident or are pre-existing injuries
  •           Doctor only does independent medical evaluation and does not treat patients
  •           Doctor has been sanctioned by the medical boards
  •           Doctor has been sued for malpractice
  •           Doctor gives opinions in field that he has no expertise in.
  •           Doctor only testifies for defense
  •           Doctors rating are always lower than the injured parties doctor
  •           Doctor always says the claimant is faking or exxagerating.
  • Reasons why independent medical evaluation are requested. Maryland workers compensation Lawyers in Baltimore know Insurance companies usually schedule independent medical evaluations when
  •           they are skeptical of the claimant or plaintiff’s injuries,
  •           the injuries sustained are not consistent with the mechanism of injury,
  •           they feel that the extent of the injury is not consistent with the medical treatment that been provided to date,
  •           they want to get the injured party back to work,
  •           they would like any medical treatment provided so far to be terminated,
  •          questioning the reasonableness or necessity of any medical bills or treatment
  •          they are contesting the causal relationship between the accident and the medical treatment and/or injury.
  •          whether any permanent injury has been sustained from an accident.
  • Tips for success from Maryland workers compensation Lawyer when attending an independent medical evaluation
  •          Keep your appointment
  •                     Please make sure that when you have a medical evaluation scheduled with the insurance company, you keep the appointment.
  •                     Failure to keep the appointment can result in suspension of your workers’ compensation benefits, refusal of the insurance company to pay your medical bills and/or you being held responsible for the doctors’ fee for your failure to appear.
  •           Be honest—and considerate
  •                     Some doctors are very conservative in nature and are generally biased against people who are injured in a work- related injury.
  •                     Be sure that when you go to an independent medical evaluation you are honest, polite and cooperative with the doctor. If you try to lie or fake your injuries or exaggerate your injuries during the exam, the doctor will certainly recognize this and will undoubtedly mention it in his report.
  •            Do not be evasive in the medical examination and/or in your answers to the questions the doctor asks and always try to maintain eye contact when speaking with the doctor.
  •            Although it is unlikely that the doctor will help you in your case even if you are cooperative, it is even more unlikely that he/she will be helpful if he/she doesn’t like you or believes that you are not being truthful.
  •           Prepare for questions
  •                    Prior to attending an independent medical evaluation, please prepare yourself for questions regarding your medical history such as details about any prior injuries, other medical treatments, testing or test results.
  •                   Let the doctor know what parts of the body you have injured, your symptoms, times when your injuries cause you pain, any movements or activities that aggravate your injuries, any medication you take to mitigate pain, and what activities, if any, are limited or affected.
  •                  When answering the doctor’s questions, make sure to answer each question carefully and to ask the doctor to rephrase the question or provide clarification if any of those questions appear unclear or confusing.
  •                                 Keep it simple and to the point
  •                                 Do not give long or elaborate answers to any of the doctor’s questions; rather, give each question an appropriate answer.
  •                                  Maintain courtesy and honesty throughout the interview by responding to a “yes or no” question with a yes or no answer and by responding to a short, to-the-point question with a short and to the point answer.
  •                                 When telling the doctor what your complaints are, describe each area fully and discuss at what times you experience problems. It is your responsibility to let the doctor know what causes your pain to flare up even if you are not in pain at the time of your evaluation.
  •                                 Do not under any circumstances exaggerate your injuries; doctors have ways of testing to see whether you are making up your complaints.
  •                                 On the other hand, don’t underestimate your pain and don’t be the type of person who doesn’t like to complain. These doctor visits are set up exclusively for you to tell the doctor what complaints you have as a result of the accident, so it is important to be truthful and forthcoming.
  •                     Behave consistently during your entire exam from the minute you park your car in the parking lot to the minute you leave the parking lot for the final ride out. Doctors who do independent medical evaluations are trained to observe the patient in the parking lot, in the exam room and the waiting room.
  •                      The right to an IME is provided by the Workers Compensation regulations in a worker’s compensation case. Maryland Workers Compensation regulation14.09.03.08 Medical examinations
  •                             Medical Examination Requested by a Party.
  •                                       A party may schedule a medical examination of the claimant with a physician, psychologist, or psychiatrist chosen by the party, by providing to the claimant and claimant’s counsel reasonable notice of the examination in writing.
  •                                       The party scheduling a medical examination of the claimant shall be responsible for all reasonable expenses associated with the examination.
  •                                      The parties shall, in good faith, attempt to resolve any differences in scheduling and scope of examination.
  •                                         A claimant shall appear for a scheduled medical examination.
  •                                        If a claimant fails to appear, refuses to submit, or fails to cooperate with the medical examination, the party requesting the examination may file an Issues form for a hearing to compel a medical examination and for reimbursement of reasonable expenses and costs.
  •                                        If a claimant fails to appear at, refuses to submit to, or fails to cooperate with the medical examination, without good cause, the Commission may order the claimant to attend a medical examination and order reimbursement of reasonable expenses and costs at a rate not to exceed $125 per missed examination.
  •                        Appearance by Examining Physician. A party requesting the appearance of an examining physician, psychologist, or psychiatrist at a hearing shall pay the appearance fee imposed by the provider.
  •                         Your lawyer can not prevent you from seeing the doctor that the insurance company wants to use unless:
  •                                        The doctor is to far away and there are other closer alternatives
  •                                         The doctor is not qualified in the required area of expertise
  •                                         Insurance company already had you seen by another independent medical evaluation doctor on the same issue
  •                      The lawyer can not go with you to the independent medical evaluation doctor. In Dziwanoski v. Ocean Carriers Corp., 26.F.R.D. 595 (1960) 1961 A.M.C. 297, 4 Fed.R.Serv.2d 640 Trotta v. Shell Oil Co., et al., Daily Record, November 21, 1960. Judge Niles said: ‘* * * The presence of the lawyer for the party to be examined is not ordinarily either necessary or proper; it should be permitted only on application to the court showing good reason therefor. If the attorney desires to be present in order to control the examination, that would invade the province of the physician; if he desires his observations to be the basis of cross-examination or possible contradiction of the doctor, he is making himself in effect a witness, with the difficulties which are likely to arise when an attorney asks questions on cross-examination based upon his own observations, and the possibility that he may wish to take the stand and thereby disqualify himself from completing the trial as the attorney. See Canon 19 of the Canons of Professional Ethics, adopted by the American Bar Association in 1908 and by the Maryland State Bar Association in 1948.

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