Your Missouri Rights and What to Expect
The envelope arrives in your mailbox on an ordinary Tuesday afternoon. Inside, a formal letter from your employer’s insurance company requests your attendance at something called an “independent medical examination.” Your heart sinks as you read the unfamiliar doctor’s name and wonder what this means for your workers’ compensation case. Will this examination help or hurt your claim? Can you trust a doctor chosen by the insurance company to be truly independent?
These concerns are completely natural. Workers’ compensation medical examinations can feel overwhelming, especially when you’re already dealing with the stress of an injury and financial uncertainty. In Missouri, these examinations are a common part of the workers’ compensation process, but they don’t have to be intimidating when you know what to expect and how to protect your rights.
What Are Medical Examinations in Workers’ Comp Cases?
Medical examinations in workers’ compensation cases come in two main forms in Missouri. The first type involves the ongoing medical treatment you receive from doctors of your choice for your work-related injury. The second type, which often causes more concern for injured workers, is the Independent Medical Examination, called an IME.
An IME is a medical evaluation conducted by a doctor chosen by either your employer’s insurance company or, in some cases, ordered by the Missouri Department of Labor and Industrial Relations. The purpose of these examinations is to provide an objective medical opinion about your injury, treatment needs, and work capacity.
However, the term “independent” can be misleading. While these doctors are supposed to provide unbiased medical opinions, they are typically paid by the insurance company or employer, which can create an inherent conflict of interest. This is why having legal representation becomes so important when you’re required to attend an IME.
Your Right to Choose Your Doctor in Missouri
Missouri law provides injured workers with important rights regarding medical treatment that many people don’t fully appreciate. Under Missouri Revised Statutes Section 287.140, you have the right to receive medical treatment for your work-related injury, and Section 287.141 gives you significant control over who provides that treatment.
In Missouri, you have the right to choose your doctor for workers’ compensation treatment, with some limitations. Your employer cannot force you to see only their company doctor, though they may have a panel of approved physicians they prefer you to use. If your employer maintains a list of at least four physicians, they can require you to choose from that list initially, but you still have options within that framework.
You can find the specific requirements for physician selection in Missouri Revised Statutes Section 287.141. This statute outlines your rights to change physicians under certain circumstances and the procedures employers must follow when providing medical care options.
Once you’ve established care with a physician, that doctor has the authority to refer you to other medical professionals as needed for your treatment. Your treating physician’s opinions carry significant weight in your workers’ compensation case, which is why choosing the right doctor initially is so important.
When Can Your Employer Require an IME?
Your employer or their insurance company can request an IME under several circumstances, but they cannot do so arbitrarily. Missouri law, specifically found in Section 287.140, allows for independent medical examinations when there are legitimate questions about your medical condition or treatment needs.
Common reasons for requesting an IME include disputes about whether your injury is work-related, questions about the extent of your disability, disagreements about necessary medical treatment, concerns about when you can return to work, and disputes over permanent disability ratings.
The insurance company must have a legitimate reason for requesting the examination. They cannot simply order multiple IMEs to harass you or delay your case. If you believe an IME request is unreasonable, you can challenge it through the workers’ compensation system.
The timing of IME requests often coincides with important milestones in your case. You might receive an IME request when you reach maximum medical improvement, when you’re applying for permanent disability benefits, or when there’s a significant change in your medical condition.
What to Expect During an Independent Medical Examination
Preparing for an IME can help reduce anxiety and ensure you present your case accurately. The examination typically varies in length depending on the complexity of your injuries and the scope of the evaluation, ranging from brief consultations to more comprehensive assessments.
The IME doctor will review your medical records, ask about your injury and symptoms, and perform a physical examination. They may also review your work history and ask about your daily activities. It’s important to be honest and consistent in your responses, as discrepancies can be used to challenge your credibility.
During the examination, you should arrive on time and bring any requested documents, be honest about your pain levels and limitations, describe how your injury affects your daily life, mention all symptoms regardless of how minor they seem, and ask questions if you don’t understand something.
Remember that this doctor is not providing treatment. They’re evaluating the insurance company. You should not expect to receive medical advice or treatment recommendations during the examination.
The doctor will likely focus on objective findings they can observe or measure, such as range of motion, strength, and visible signs of injury. They may also perform specific tests related to your type of injury.
How IME Results Affect Your Case
The IME report can significantly impact your workers’ compensation case. The examining doctor will provide opinions on several key issues that directly affect your benefits.
Work Capacity: The doctor will assess whether you can return to your regular job, perform modified duties, or if you’re completely unable to work. This opinion influences your temporary disability benefits and future wage loss compensation.
Maximum Medical Improvement: The IME doctor may determine that you’ve reached maximum medical improvement, meaning further treatment is unlikely to improve your condition significantly. This finding can affect your eligibility for ongoing medical treatment and trigger evaluations for permanent disability.
Causation: The doctor will offer an opinion about whether your current symptoms and limitations are related to your work injury. This is particularly important if you have pre-existing conditions or if significant time has passed since your injury.
Treatment Necessity: The IME doctor may recommend continuing, modifying, or discontinuing certain treatments. Insurance companies often use these recommendations to approve or deny coverage for specific medical care.
Permanent Disability Rating: If you’ve reached maximum medical improvement, the doctor may assign a permanent disability rating using established medical guidelines. This rating directly affects your permanent disability compensation.
Common Issues and Red Flags
Unfortunately, not all IME doctors approach their evaluations with complete objectivity. Some common issues that can arise include rushed examinations where doctors spend insufficient time with patients for complex cases, minimizing symptoms by downplaying complaints or focusing primarily on objective findings while dismissing subjective symptoms like pain, and selective record review where important medical records may be overlooked.
- Bias Toward Insurance Companies: Some doctors perform frequent IMEs for the same insurance companies, which can create financial incentives to provide opinions favorable to those companies.
- Inadequate Physical Examination: The doctor should perform a thorough physical examination appropriate for your type of injury. A cursory examination may not reveal important findings.
If you notice any of these red flags during your IME, document them and discuss them with your attorney. You may have grounds to challenge the examination or request a second opinion.
Protecting Your Rights During Medical Exams
Taking proactive steps to protect your rights during medical examinations can strengthen your workers’ compensation case and ensure you receive fair treatment.
- Before the Examination: Review your medical records and be prepared to discuss your injury history, symptoms, and limitations. Make notes about your daily activities and how your injury affects them. Bring a list of all medications you’re taking and any medical devices you use.
- During the Examination: Stay calm and professional, even if the doctor seems skeptical of your complaints. Be honest about your symptoms and limitations, but don’t exaggerate or minimize them. If you don’t understand a question, ask for clarification.
- After the Examination: Keep notes about what happened during the examination, including how long it lasted, what tests were performed, and any concerning behavior by the doctor. Request a copy of the IME report when it becomes available.
- Legal Representation: Having an attorney represent you in your workers’ compensation case is invaluable when dealing with IMEs. Your attorney can help you prepare for the examination, review the report for accuracy, and challenge problematic findings.
In Missouri, you have the right to have someone accompany you to an IME, though the specific rules may vary. Check with your attorney about whether you can bring a witness or advocate to the examination.
- Documentation: Keep detailed records of all your medical treatment, symptoms, and how your injury affects your daily life. This documentation can be crucial if the IME report contradicts your treating doctor’s findings or your own experiences.
Understanding Your Medical Treatment Rights
Beyond the IME process, it’s important to understand your broader medical treatment rights under Missouri workers’ compensation law. You have the right to receive all reasonable and necessary medical treatment related to your work injury. This includes doctor visits, medications, physical therapy, diagnostic tests, and in some cases, vocational rehabilitation.
Your treating physician plays a central role in determining what medical care you need. They can refer you to other healthcare providers, order diagnostic tests, and prescribe medications as appropriate for your condition. The insurance company generally cannot deny treatment that your doctor deems medically necessary, though they may sometimes challenge expensive or unusual treatments.
If you’re dissatisfied with your initial physician choice, Missouri law provides options for changing doctors under certain circumstances. This might be necessary if you’re not improving with your current treatment or if you have concerns about the quality of care you’re receiving.
Dealing with Treatment Disputes
Sometimes insurance companies may deny or delay approval for medical treatment recommended by your doctor. When this happens, you have several options for resolving the dispute. Your attorney can help you file appeals with the insurance company or pursue a resolution through the workers’ compensation system.
It’s important to continue following your doctor’s treatment recommendations even if there are coverage disputes. Gaps in treatment can be used to argue that your condition has improved or that you’re not taking your recovery seriously.
Keep detailed records of any treatment delays or denials, including correspondence with the insurance company and documentation of how the delays affected your condition. This information can be valuable if you need to pursue additional compensation for harm caused by delayed treatment.
The Role of Your Treating Physician
Your treating physician serves as your primary advocate in the medical aspects of your workers’ compensation case. They document your injuries, track your progress, and provide opinions about your work capacity and treatment needs. Their medical records and opinions often carry more weight than IME findings because they have an ongoing treatment relationship with you.
Maintain open communication with your treating physician about your symptoms, concerns, and how your injury affects your daily life and work activities. The more information they have, the better they can document your condition and advocate for appropriate treatment.
If your treating physician releases you to return to work with restrictions, make sure you understand exactly what those restrictions are and communicate them clearly to your employer. Working beyond your restrictions can worsen your injury and potentially jeopardize your workers’ compensation benefits.
Key Takeaways
- Medical examinations play a crucial role in Missouri workers’ compensation cases, but they don’t have to be intimidating if you know your rights and prepare properly. Remember that you have the right to choose your own treating physician in most circumstances, and that doctor’s opinions carry significant weight in your case.
- When facing an IME, preparation is your best defense. Be honest, thorough, and professional during the examination, but don’t hesitate to question findings that don’t accurately reflect your condition. The IME report can significantly impact your benefits, so it’s important to take the process seriously.
- Having legal representation throughout your workers’ compensation case provides valuable protection, particularly when dealing with IMEs. An attorney can help ensure your rights are protected and challenge problematic examination findings.
- Your ongoing medical treatment remains important regardless of IME results. Continue following your treating doctor’s recommendations and keep detailed records of your symptoms and limitations.
- Building a strong relationship with your treating physician and maintaining detailed documentation of your condition will strengthen your case and help ensure you receive the benefits you deserve.
Frequently Asked Questions
Can I refuse to attend an IME?
Generally, no. Refusing to attend a properly requested IME can result in the suspension of your workers’ compensation benefits. However, you can challenge unreasonable or excessive IME requests through the workers’ compensation system.
Can I bring someone with me to the IME?
In most cases, yes. You typically have the right to bring a witness or advocate to the examination, though they may not be allowed in the examination room during the physical examination portion.
What if the IME doctor says I can return to work, but my treating doctor disagrees?
This creates a medical dispute that may need to be resolved through the workers’ compensation system. Your treating doctor’s opinion often carries more weight since they have an ongoing treatment relationship with you.
How long does it take to get the IME report?
IME reports are typically completed within several weeks of the examination. You should receive a copy of the report, and your attorney can help you review it for accuracy.
Can I request my independent medical examination?
Yes, you can obtain your medical evaluation, though you would typically need to pay for it yourself unless the court orders otherwise. This can be valuable if you disagree with the insurance company’s IME findings.
What if I have a bad day during the IME?
If you’re having an unusually bad day with your symptoms during the IME, make sure to mention this to the doctor and explain how your symptoms typically fluctuate. The doctor should consider this in their evaluation.
Can the IME doctor prescribe medication or provide treatment?
No, IME doctors are conducting evaluations only. They should not provide treatment or prescribe medications. If you need medical care, continue seeing your treating physician.
What if I disagree with the IME findings?
You can challenge IME findings through the workers’ compensation system. Your attorney can help you present evidence contradicting the IME report, including opinions from your treating physicians.
How often can the insurance company request IMEs?
While there’s no specific limit, insurance companies must have legitimate reasons for requesting IMEs. Multiple examinations without proper justification can be challenged as harassment or delay tactics.
What should I do if the IME doctor seems biased?
Document any concerning behavior or comments during the examination. Discuss your concerns with your attorney, who can help determine if there are grounds to challenge the examination or request a different evaluator.
Contact Us
If you’re facing medical examinations in your Missouri workers’ compensation case, you don’t have to handle the process alone. The experienced attorneys at Adams Law Group have helped countless injured workers protect their rights and secure the benefits they deserve.
We understand the stress and uncertainty that come with workers’ compensation claims, particularly when dealing with independent medical examinations. Our team will help you through every step of the process, from preparing for your IME to challenging unfavorable findings when necessary.
Don’t let insurance companies take advantage of you during this difficult time. Your workers’ compensation benefits are designed to help you recover and support your family while you heal. We’re here to make sure you receive everything you’re entitled to under Missouri law.
Contact Adams Law Group today to schedule your free consultation about your workers’ compensation case. During this free consultation, we’ll review your situation, explain your rights, and help you develop a strategy to protect your benefits. There’s no obligation and no upfront cost – we only get paid when you do. Your recovery is our priority, and we’re committed to fighting for the compensation you deserve.
