Someone who recently clicked on my chat button (which I assume you’ve seen already) and asked a really good question. She wanted to know how long it would take to get her IME report. An IME report is an “independent medical exam” finding. Basically, the insurance company gets to pick a doctor to examine you and offer their opinions on: your medical condition, the care needed and whether or not your problems are work-related.
We didn’t chat long, so I don’t have all of the case facts, but for purposes of this post, let’s assume that the IME was a month ago. The insurance company is paying a decent amount of money for the IME, and most doctors want to keep that gravy train rolling, so they usually provide a quick turn around to add some customer service to the experience. Some doctor’s offices do so many of these, that they essentially use a template so every report looks similar, and a nurse plugs in the doctor’s notes to customize the report.
So why doesn’t this injured worker or her lawyer have the report yet? There are three likely reasons, all of which are good for her in the long run.
1. After the IME the doctor called the insurance adjuster or defense attorney who ordered the exam and said that he agrees that the problems are work related and a surgery is needed. Since it didn’t help their case, they told the doctor not to write a report at all.
2. The report was written and provided, but they don’t want to turn it over because it’s bad for them. At that point your option is to nag or to subpoena the IME doctor.
3. The worker’s attorney is being lazy and hasn’t asked for it. The insurance company knows the report is bad for them, but also know that it’s not their job to advocate for the injured worker. If her lawyer gets pushy they will send the report, but until then their strategy would be to try and settle the case as if the report will be in their favor.
These are the three likeliest scenarios. Most IME reports go against you so it’s kind of a good news, bad news situation. You are delayed, but it will likely work out in your favor. At a time like this though, especially if benefits are being delayed or denied, you really need an aggressive attorney. When the IME goes against them and you get punished, it’s just cruel, and you need someone who will push back.