What Is an Independent Medical Exam and Why Would Connecticut Insurers Order One?
Quick answer: An independent medical exam (IME) is an evaluation performed by a doctor other than your treating physician to assess your injury, medical condition, or disability. In Connecticut workers’ compensation cases, these exams are now commonly referred to as Employer/Respondent’s Examinations and may be requested by the employer or its workers’ compensation insurer. The examination can affect disputes over the nature of an injury, work capacity, treatment, and workers’ compensation benefits.
If you’re recovering from a workplace injury or pursuing a personal injury claim in Connecticut, you may be asked to undergo a medical examination by a doctor who is not treating you. Although these evaluations are commonly called independent medical exams, or IMEs, their purpose is different from an appointment with your own doctor.
The rules governing these examinations depend on the type of claim involved. Connecticut workers’ compensation law specifically provides for Employer/Respondent’s Examinations, while medical examinations in personal injury lawsuits are governed by separate rules. The personal injury and workers’ compensation attorneys at Jacobs & Dow, LLC, can help you understand why an examination has been requested, what rules apply, and how it may affect your claim.
What Is an Independent Medical Exam?
An independent medical exam is an evaluation performed for purposes related to a claim rather than to provide ongoing medical treatment. What happens during the examination depends on the nature of the injury and the medical issues being evaluated.
- Not Your Treating Physician: The examiner evaluates your condition for purposes related to the claim rather than taking over your ongoing medical care.
- Medical History and Examination: The physician may review relevant medical records, ask about your injury and symptoms, and perform a physical examination related to the condition at issue.
- The Report: After the examination, the physician prepares a report addressing relevant medical issues. Depending on the type of claim, the findings may affect disputes over the nature or extent of an injury, work capacity, treatment, benefits, or damages.
Why Are Medical Examinations Requested?
A medical examination can provide another medical opinion about an injury or condition when its nature, cause, severity, or effects are relevant to a claim.
- Evaluating the Injury: The examiner may assess the nature and extent of the claimed injury and whether the medical findings are consistent with the reported accident or workplace incident.
- Assessing Medical Issues: The examination may address questions involving treatment, recovery, physical restrictions, or the extent of an injury.
- Evaluating Work Capacity or Disability: In a workers’ compensation case, the physician may evaluate how the injury affects the employee’s ability to work or the extent of any resulting incapacity.
- Addressing Medical Disputes: An examination may provide another medical opinion when the parties disagree about the nature or extent of an injury, treatment, work capacity, or other medical issues relevant to the claim.
The examiner’s opinion does not automatically override the opinion of your treating physician. When medical opinions conflict, those differences may become part of the dispute between the parties.
What Are Your Rights Under Connecticut Workers’ Compensation Law?
For workplace injuries, Connecticut General Statutes § 31-294f governs medical examinations requested by an employer or directed by an administrative law judge.
An injured employee claiming or receiving workers’ compensation benefits must submit to an examination upon the reasonable request of the employer. The physician is selected by the employer from an approved list and the examination is paid for by the employer. The examination is performed to determine the nature of the injury and the incapacity resulting from it.
The employee is also allowed to have a reputable practicing physician or surgeon of their own choosing attend the examination, although the employee is responsible for that physician’s cost.
Refusing a reasonable examination can result in the suspension of workers’ compensation benefits during the period of refusal. If you have questions about whether a request is reasonable or what is expected of you, consider speaking with an attorney before the examination.
These rules apply specifically to workers’ compensation claims. Medical examinations requested during Connecticut personal injury litigation are governed by separate procedures.
Frequently Asked Questions
Do I have to attend an independent medical exam in Connecticut?
It depends on the type of case. In a workers’ compensation claim, Connecticut General Statutes § 31-294f requires an injured employee to submit to an examination upon the employer’s reasonable request, and refusing a reasonable examination can result in the suspension of workers’ compensation benefits during the period of refusal.
Can I bring someone with me to a workers’ compensation medical examination?
Connecticut General Statutes § 31-294f allows an injured employee to have a reputable practicing physician or surgeon of their own choosing attend an employer-requested or administrative-law-judge-directed examination. The employee is responsible for the cost of that physician.
Will I receive a copy of the workers’ compensation examination report?
Yes. Under Connecticut General Statutes § 31-294f, medical reports concerning a work-related injury must be furnished within 30 days after completion of the reports, at the same time and in the same manner, to the employer and the employee or the employee’s attorney.
What if I disagree with the IME findings?
An examiner’s opinion does not necessarily resolve a dispute over your condition. Medical evidence from your treating physician and other evidence concerning your injury may also be relevant. If medical opinions conflict, an attorney can help you understand how those differences may affect your claim.
Is an IME the same as a second opinion I request myself?
No. A second opinion you seek on your own is chosen by you and focused on your care. An IME is chosen and paid for by the insurer and focused on their claim decision.
Understand the Examination Before You Attend
A medical examination requested as part of an injury claim is different from an appointment with your treating physician. The examiner’s findings may become important evidence concerning your injury, ability to work, treatment, benefits, or damages.
The rules also depend on the type of case. Connecticut workers’ compensation claims have specific requirements for employer-requested medical examinations under state law, while personal injury lawsuits follow separate procedures for medical examinations.
If you have suffered a personal injury or workplace injury in Connecticut and have questions about an upcoming medical examination or ongoing claim, contact Jacobs & Dow, LLC for guidance about your situation.
