July 25, 2024


Law For A Better Future

How Long After Ime Report Settlement

How Long After Ime Report Settlement

How Long After Ime Report Settlement Independent Medical Examinations (IMEs) in L&I Claims: An Overview Severe workplace injuries can be devastating, often leaving individuals in chronic pain with permanent disabilities. In such cases, the Department of Labor and Industries (L&I) may employ an Independent Medical Examination (IME) as a final step to potentially terminate the injured worker’s claim. It is crucial for the injured party to defend their rights and resist this seemingly unfair tactic.

At Sharpe Law Firm, we stand beside injured workers, supporting them in facing the challenges posed by L&I and their “independent” medical examiners. We exclusively represent individuals, never employers or insurance companies. If you’ve experienced a serious workplace injury and feel that you’re battling for the compensation you rightfully deserve, schedule a free case evaluation with us today to explore how we can assist you in confronting these injustices.

Demystifying Independent Medical Examinations (IMEs)

How Long After Ime Report Settlement
How Long After Ime Report Settlement

While the stated purpose of an Independent Medical Examination (IME) is to assess a worker’s medical condition, the actual aim is often to curtail or terminate their L&I claim. L&I utilizes IMEs to advance its predetermined agenda, with questions posed to the examining doctor meticulously crafted by claims managers seeking specific answers to aid in closing your claim, denying treatment, and minimizing compensation. These questions typically revolve around matters such as the necessity of further medical treatment, the achievement of maximum medical improvement, work restrictions, and the presence of permanent impairment.

In reality, IMEs are frequently viewed as a disingenuous tool used by claims managers to obstruct medical treatment and resolve claims unfairly. They are neither impartial nor genuine medical examinations; instead, they serve as one-sided reviews designed to undermine your L&I claim.

Who Are the Independent Medical Exam Doctors?

How Long After Ime Report Settlement
How Long After Ime Report Settlement

The doctors conducting Independent Medical Examinations are compensated by L&I and self-insured entities, and many have aligned themselves with these organizations. Few are active medical practitioners, with some earning substantial incomes by challenging the claims of injured workers. Their opinions are often prejudiced, and some may hold preconceived notions that the worker is not genuinely injured before even commencing the examination. Their primary objective is to produce a favorable report enabling L&I to terminate your claim without offering fair compensation.

Why Are Independent Medical Examinations Scheduled?

How Long After Ime Report Settlement
How Long After Ime Report Settlement

L&I and self-insured claims managers arrange IMEs to steer claims toward the outcomes they desire. IME appointments are made with doctors who are amenable to furthering their goals. In essence, these exams are attempts to garner “professional” opinions that align with L&I’s interests, enabling them to manipulate your L&I claim to their advantage. The rules governing IME scheduling and conduct can be found in RCW 51.36.070. Claims managers request IMEs to:

  1. Collect information.
  2. Determine maximum medical improvement.
  3. Isolate specific medical conditions.
  4. Reject certain medical conditions.
  5. Discontinue medical care.
  6. Assess your disability rating.
  7. Conclude and close your claim.

Who Can Request Independent Medical Examinations?

How Long After Ime Report Settlement
How Long After Ime Report Settlement

Various entities involved in your claim can request an Independent Medical Examination, presenting potential challenges for injured workers and their workers’ compensation claims. The following parties may initiate an IME:

  1. Labor & Industries (L&I) – (a common source)
  2. Self-insured employers – (also a common source)
  3. Your doctor – (an occasionally problematic source)
  4. The Board of Industrial Insurance Appeals

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When Can Independent Medical Exams be Requested?

Independent Medical Evaluations can be requested for specific reasons, as detailed in RCW 51.36.070 (1). These reasons encompass:

  1. Making a determination about claim allowance or reopening.
  2. Addressing new medical issues arising after filing an appeal or assessing case progress.
  3. Evaluating a worker’s permanent disability, work limitations, or employability.

Specialized rules and regulations regarding IMEs are outlined in Washington State statutes, and injured workers or their workers’ compensation attorneys should be familiar with them. Pertinent statutes include:

  • RCW 51.32.110: Outlines requirements related to attending an examination, reimbursing travel expenses, and compensating for time lost from work during the IME.
  • RCW 51.36.070 (1)(a): Specifies where an IME can be scheduled and introduces telemedicine as an option when physical locations are not reasonably convenient. Refer also to RCW 51.36.072 and RCW 51.36.070 (1)(b).
  • RCW 51.08.121: Defines “new medical issue,” with additional information available in WAC 296-23-302 and WAC 296-23-308.
  • WAC 296-23-309: Governs the total number of examinations per claim.

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Is Recording an IME Permissible?

Recording an Independent Medical Examination is allowed, either in audio, video, or both formats. Several key considerations regarding recording include:

  • Providing at least seven calendar days’ notice to the IME provider that recording will take place.
  • The worker may not physically hold the recording equipment while the examination is conducted. (For example, mobile phones must be set to record and then placed down.)
  • The observer may also record the IME but must ensure that the recording equipment does not disrupt the examination.
  • Prohibiting the posting of the recording on social media platforms.