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Why Evaluation is Necessary After a Work-Related Injury

DrEval

If you are injured on the job, there is a good chance that you will be unable to return to work for a significant period of time, and even if you can return to work, you may find that you are no longer able to perform the duties of your position. Fortunately, workers’ compensation law is on your side. According to the Florida United Business Association, any non-construction employers who employ four workers or more is required, by law, to carry workers’ compensation insurance. Construction industry employers who employ at least one worker must carry workers’ compensation as well. Bearing that in mind, if you do become injured on the job, you can rest assured knowing that you likely have at least one resource at your disposal to help you move forward in life and comfortably recover from your injuries.

Workers’ compensation benefits only cover a portion of your annual salary and will not last for forever. However, they will help you cover the cost of medical and living expenses during your recovery period. That said, to recover these types of benefits, you must first submit to a medical evaluation, which is required by the insurance company for your employer’s sake.

Why is a Valuation Necessary?

A medical evaluation is not always necessary, which makes the insurance company’s request for one all the more troublesome. Sometimes, when the insurance company does not agree with a doctor’s diagnosis or treatment plan, or when it feels as if you have exaggerated your injuries, the insurer may submit a request for an independent medical evaluation, or IME. The goal of an IME is to obtain a second option and to ensure that the diagnosis and treatment recommended by your doctor is accurate, and that your doctor is not just trying to help you “play the system.”

Who Performs the IME?

When deciding from whom to obtain a second opinion, your employer’s insurer is not likely to recommend your own physician. Rather, it will pick its own doctor to perform the evaluation and provide an expert opinion.

It is important to note that just as an insurance company can request a second opinion from its chosen doctor, so too can you request a second opinion from your doctor or chosen healthcare professional. If you do not agree with a diagnosis or treatment recommendation, you can submit a request for an IME, which should, by law, be granted to you.

What Questions Should You Expect During an Evaluation?

The interviewing doctor is bound to ask you several probing questions, many of which you may feel are designed to get you to contradict your previous answers. For this reason, it is important to prepare for the interrogation and know how to appropriately respond to each inquiry sent your way. Some questions you should expect during the evaluation are as follows:

  • What were the symptoms you experienced immediately following the accident or incident?
  • When do you anticipate being able to return to work, if you expect to return at all?
  • Do you believe that your injury or illness was accurately diagnosed?
  • Does your condition require medical treatment or testing?
  • Did you sustain a permanent disability? If so, how severe is the disability?

If your employer informs you that you will need an IME, you are well within your rights to ask for a copy of the letter the insurance company sends to the independent medical expert. This is a right you should exercise. Briefly examine the letter to double check that all the facts of your case are listed correctly and that any questions being asked regarding your case are even relevant. You can also make corrections which, if accurate, the insurer will have to incorporate.

Talk With a Tampa Workers Compensation Attorney Today

If you sustained an injury at work, you are entitled to compensation. However, expect the path to benefits recovery to be riddled with obstacles, such as IMEs and other investigations. While you should play along with the insurer’s request, as often times they are just customary, you should also know the difference between standard procedures and tactics used to delay benefits. An experienced attorney can guide you through the claim process, ensure that the insurance company does not string you along, and advise you on what you can do to speed up the process. To speak with one of the Tampa workers compensation lawyers at Barbas, Nuñez, Sanders, Butler & Hovsepian, contact our office online today.

Resource:

fuba.org/wp-content/uploads/Exemptions-at-a-Glance-August-2016.pdf

https://www.barbaslaw.com/your-rights-as-a-worker-under-osha/

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