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Workers Comp Independent Medical Examination

The independent medical examination (IME) is something every worker who makes a claim for workers compensation must submit to. There may be more than one IME depending on the facts. The insurance company or employer must make the IME request in writing and adhere to strict protocols of notice in the letter. The IME notice letter must include the date, time, and place of the exam; the procedure for changing the date, time, and place; and the independent medical examiner's area of specialty. The notice must also explain the employee's rights to have a personal physician present at the exam (employees never utilize this option because of the expense), to request and receive copies of all reports generated from the exam, and to have a translator present if the employee has difficulty communicating in English. Wis. Stat. § 102.13(1). The injured worker cannot be required to travel more than 100 miles, as the crow flies, to participate in the examination unless (1) the ALJ determines that circumstances warrant the claimant's traveling a greater distance, or (2) the place where the claimant has been treated is more than 100 miles from where the claimant lives. Wis. Stat. § 102.13(4). Mileage expenses or transportation must be tendered in advance. Wis. Stat. § 102.13(1)(b). By departmental policy, expenses include wages lost as a result of the examination.

Injured workers do not need request copies of IME report but are entitled to receive such reports immediately upon receipt of the reports by the employer or the worker's compensation insurance carrier. Many times the insurance adjuster does not send the worker the report and if this happens the worker should request it or contact an attorney.

If the worker refuses the IME, his or her right to workers compensation may be suspended for as long as the claimant refuses to be examined. But a claimant's refusal to be examined based on the advice of the claimant's treating physician has been held reasonable. Penokee Veneer Co. v. Indus. Comm'n, 252 Wis. 396 , 31 N.W.2d 622 (1948) . A respondent may be entitled to defer an examination under Wis. Stat. § 102.13(1) until the claimant has established a prima facie case.

The department have discretion in deciding whether a second independent examination is justified. Dane Cty. Hosp. & Home v. LIRC, 125 Wis. 2d 308 , 371 N.W.2d 815 (Ct. App. 1985). Usually one year is reasonable, maybe six months. Also they are entitled to a separate IME for each claimed injured body part.

McCormick Law Office in Milwaukee advises handles workers compensation disability benefit claims often after an independent medical examination doctor has denied a claim. Get a second opinion.

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