In workers' compensation terms, an IME is an "Independent Medical Examination." IMEs are common throughout the country, but what many clients don't realize, and many insurance adjusters don't know is that in Nebraska there are two types of medical exams as part of a workers' compensation claim – and the IME has specific rules and regulations set forth in the state workers' compensation statute. Here is information on both types of Nebraska workers' comp medical exams and how they affect your claim.
As set forth to the Nebraska's Workers' Compensation Act, an independent medical examiner can be appointed either by agreement of the parties or by the Court to issue a report to the court concerning a medical dispute that has arisen in the course of the workers' compensation case. IMEs in Nebraska have specific rules as to how they are handled and what situations they are used. If an insurance company, on its own, decides that you should submit to an examination and has chooses the physician whom you should see, this is not an IME under Nebraska workers' compensation law. IME's are examinations physicians appointed by the Court and not ones chosen by the employee or by the insurance company. However, many adjusters are unfamiliar with the terminology in Nebraska, so you should always check with your attorney when you receive an "IME" notice to determine which type of exam you are facing.
The second and more common type of medical exam is the type that is set forth in section 48.134 of the Nebraska workers' compensation code. This exam, which we often refer to as a "DMA" or "Defense Medical Exam" to differentiate it from an IME, is not optional. The law requires that the injured employee has to submit to an examination requested by the insurance company. This exam is often with a physician of the insurance company's choosing. If you refuse to attend an examination, the insurance company can deny your claim, and if you delay going to an examination, they can halt your benefits until you submit to the exam.
If you have received a notice of a medical exam, this is one of the most important times to speak to an attorney. This often indicates that the insurance company is looking to deny your claim or curtail your benefits. If the insurance company is trying to dispute an element of your claim or believes that your benefits have run their course, you need to speak with an attorney as soon as possible.
Whether you received notice of an IME or a Defense Medical Exam, both are crucial fact-finding elements of your claim and can have a major impact on your case and the benefits available to you. Call our office today to have an attorney go over the medical exam process with you to ensure that you are prepared.