Can an Employee Say No to an IME?

If you file a workers’ compensation claim in Pennsylvania, the insurance company might ask you to attend an IME. Here’s what you need to know about the IME process, how an IME could affect your claim, and whether you can say no to an IME request.

What Is an IME?

An independent medical examination (IME) is an evaluation conducted by a doctor who does not have a prior relationship with you. In the context of workers’ compensation claims, insurance companies sometimes request IMEs to obtain a paid opinion about workers’ injuries. 

The doctor performing the IME does not treat you. Instead, they evaluate your injury to provide a paid opinion to the insurance company. They typically review your medical history, conduct a physical examination, and assess the severity and scope of your injury to evaluate whether it is related to the work incident in question. This examination is the basis for the insurance company’s decisions about your workers’ compensation benefits.

An IME is usually the start of the insurance company’s process to challenge your claim benefits or treatment.  You should speak with an attorney when you receive a notice to attend an IME.

Can I Refuse an IME Request?

Yes, you can refuse an IME request, but it’s usually not in your best interest. Pennsylvania workers’ compensation law allows insurance carriers to request that you undergo an IME as part of the claims process. If you decide to refuse, you must provide a valid reason. However, the insurance company will file a Petition with the Court to compel you to go.  You should speak with an attorney prior to refusing to go to an IME.

What Happens If I Fail to Attend an IME?

The consequences can be significant if you fail to attend the IME. The insurance company could take your refusal as a sign that you are not seriously hurt or that you are unwilling to follow the necessary procedures to validate your claim. As a result, they might stop your workers’ compensation payments or deny your claim altogether. To avoid losing your workers’ compensation benefits, it’s best to attend the scheduled IME unless you have an urgent and valid reason not to, which you should communicate to the insurer promptly. Ultimately, the insurance company will likely file a Petition with the Court to compel you to go to the IME. 

How Can an IME Impact My Workers’ Compensation Case?

An IME can have a significant impact on your workers’ compensation case. The doctor’s report can either support your claim or raise doubts about the severity of your injury and its connection to your job. If the IME doctor agrees with your own doctor’s findings, it can strengthen your case and help you secure benefits. However, if the IME report differs from your doctor’s opinion, the insurance company will use it to challenge your claim, potentially leading to a decrease in benefits, a denied claim, or having your benefits suspended.

Preparing for an IME

You can take steps to prepare for an IME and ensure the results accurately reflect your condition. First, arrive on time and bring all necessary medical records and documents related to your injury. During the examination, be honest and thorough when describing your symptoms and how the injury affects your daily life. It’s also a good idea to take notes about what the doctor asks and what tests they perform. After the exam, discuss the experience with your lawyer to prepare for any questions or issues that might arise from the IME report.

Contact Our Pennsylvania Workers’ Comp Attorneys for Help

Have questions about your Pennsylvania workers’ compensation claim or an upcoming IME? Reach out to Calhoon & Kaminsky P.C. today for a free initial consultation. Our workers’ compensation lawyers are here to protect your rights and secure the benefits you’re entitled to.