California workers who sustain injuries while performing their jobs may file for workers’ compensation benefits. However, disputes are common in the process.
Injured workers may be unsatisfied with the medical care they receive, while insurance companies may challenge the severity of injuries to reduce liability. For an objective resolution, both injured workers and insurance companies may seek a review involving an independent medical evaluation (IME).
An IME involves a doctor who has not dealt with the patient before and aims to verify the primary physician’s findings. This medical exam is a critical part of the claims process as it can make or break a case. So, injured parties must be aware of what not to do during their IME.
Dishonesty can ruin a claim
An IME doctor’s job is to establish the cause and extent of a person’s medical condition and determine their capacity to return to work. Knowing whether they require further treatment or they can go back to work on light duty can affect the benefit payout from an insurance company.
Before speaking with the IME physician, injured workers must prepare to disclose necessary medical information and communicate the truth by avoiding the following:
- Inflating symptoms, or the degree of their pain and discomfort
- Leaving out crucial details, such as how the accident occurred and relevant medical history
- Speaking ill of an employer and sharing inaccurate remarks
Engaging in false statements in hopes of increasing the amount of compensation can only risk a worker’s credibility and jeopardize their claim. After all, medical professionals have the experience, technological tools and intuition to uncover the truth.
Vigilance can work in a person’s favor
An IME doctor has a significant role in providing a neutral evaluation of the injured worker’s condition. However, there are cases when their biases and the potential profit from insurance companies may entice them to manipulate their medical reports. Injured workers can fight back with their legal team to reveal inconsistencies and pursue the financial relief they deserve.
