Independent Medical Exams (IMEs) in NJ Workers’ Compensation Claims

Were you injured on the job in New Jersey? Then, you are about to file or have already filed a workers’ compensation claim. Filing an injury report with your employer begins but does not end the process. You must participate in the workers’ compensation proceedings by filing documents, answering discovery requests, and scheduling an Independent Medical Examination (IME). The IME is a third-party medical assessment to evaluate the injury, treatment, and recovery. The workers’ compensation insurer requires one to place a dollar value on your claim. In fact, the law requires it.

IME as a Third-Party Medical Assessment for Work-Related Injuries

Though New Jersey has a no-fault workers’ compensation system, which means any employee with a workplace injury can file a claim for workers’ compensation benefits, a claimant must follow the procedures for establishing the injury’s cause, extent, treatment, and recovery timeline. So, as an injured employee, you have the right to file a claim regardless of fault, but the insurer request an IME to appropriately assess the value of the claim.

The IME’s significance is in its supposed neutrality. The physician who examines you for the IME is not your doctor but someone who examines you for the first time. Their observations and findings are uninfluenced by your patient relationships with them or your financial investment in their practice. As such, a judge may consider a neutral doctor’s findings more unbiased and reliable. At least, that is the hope of the insurer.

Why IME Findings are Pivotal in a New Jersey Workers’ Compensation Claim

The IME report is essential to the worker’s compensation case since it is the basis for a settlement demand. The report’s estimate of the disability percentage is a critical factor in deriving a claim value. New Jersey law dictates the claim value based on whichever is lower, your wage rate or the legal rate. As such, the IME disability estimate plays an influential role in the claim outcome, at least in the settlement demand phase.

Ultimately, a workers’ compensation insurer will determine whether the injury is eligible for workers’ compensation benefits, and if so, how much money will be paid and for how long. However, that decision is subject to dispute at a formal workers’ compensation hearing before a judge. For example, the IME physician may report conflicting findings from your treating physician’s diagnosis and prognosis, affecting the amount of your benefits. A judge will weigh the findings of the IME against those of your treating physician to determine an award when there is a dispute.

How to Get Ready for Your Independent Medical Examination (IME)

An IME physician does not provide medical treatment. They review a worker’s medical records and conduct a physical exam and other tests, if necessary.  Knowing that, you should prepare for an IME by reviewing your medical records and documenting the history of your injury diagnosis and treatment.

When you are familiar with your injury history, you will feel more confident and less likely to make mistakes answering an IME doctor’s questions. You might prepare your answers for common questions physicians ask when examining patients for injuries.

Additionally, intimate knowledge of your symptoms, limitations, and pain is crucial to a successful IME. Keeping a diary of your injury’s impact on your daily life helps you detail the effects of the injury and treatment on your recovery. The more specific you are, the more the IME doctor knows about your condition. Accuracy and truthfulness help your case; trying to influence the doctor about the severity of your injury is not advisable.  Instead, you want to keep your facts descriptive and neutral.

What to Expect During Your Workers’ Comp IME

Anticipating questions about your pain level can help you prepare responses. In detail, you can explain when you feel the most pain and what brings it on. You might think of the pain level on a scale of one to ten, ten being the worst. Also, you might characterize the pain as sharp, dull, intermittent, or persistent. You aim to help the doctor understand how your life changed after the injury, specifying what tasks you cannot complete or activities you cannot do. Comparing what you could do before the injury to what you can do now is beneficial.

In addition, becoming familiar with the IME procedure will improve your experience. Before you see the doctor, you probably have documents to fill out and sign. During the exam, they might ask you questions before, during, and after tests, which is an opportunity for you to report your struggles, discomfort, or pain with the tests. The examining physician may or may not discuss with you what they found during the assessment. They may order further tests and send you back to your treating doctor.  

Your Rights when Facing a Workers’ Comp IME

You can request a copy of the IME report for review for errors. You can also notify the physician that you wish to record the examination. Recent case law supports allowing the recording, giving the burden of preventing it through a protective order to the physician and insurer.

Possible Consequences of Missing Your NJ Workers’ Comp IME

Missing or skipping the IME is not an option. Your employer can get an order from a Workers’ Compensation judge to ensure you attend your IME if you refuse to go. You must appear when ordered to maintain your employment compensation benefits. On the other hand, you may have a legitimate reason for missing an IME and requesting to reschedule the appointment.

Navigate the Process of Your Workers’ Comp IME with Help from Cohen & Riechelson

Worker’s compensation benefits and awards help you when you need them after a workplace injury. However, the procedures for getting compensation are specialized and need to be clarified. Our workers’ compensation lawyers at Cohen & Rielchelson routinely handle worker injury cases, so we have intimate knowledge of the system, judges, insurers, and the role of IMEs in these cases. If you wish and argue for higher compensation when the IME report shows a low disability percentage and your injury warrants a higher rate, our attorneys are prepared to challenge the findings and fight for the workers’ compensation benefits you deserve.

Keep in mind, you can report what happened during the exam after taking good notes or recording your IME. Your details may provide your attorney with strategies for attacking the IME report. Thus, when the IME physician took 10 minutes to ask questions without physically examining you, our attorneys may discredit the IME report and its findings as a valid basis for a claim evaluation.

Call (609) 528-2596  today to speak with one of our talented workers’ compensation lawyers about your claim in Trenton, Titusville, East Brunswick, Carteret, Woodbridge, Ewing, Hopewell, Mercer County, Middlesex County, Burlington County or elsewhere in New Jersey. The consultation is absolutely free and if you so choose, our team is dedicated to successfully handling your claim for work-related injuries.