workman's comp

mjh007 · 08-11-2004, 07:34 AM

The insurance company has delayed my IME (independent medical exam) for the second time. I called the doctor they are sending me to and they said that the insurance company gave no reason for the cancellation/rescheduling.
I am told as long as they are paying me disablity they can do whatever they want. I am in extreme pain and can't tolerate these painkillers anymore. Any suggestions? Please help.

mjh007 · 08-11-2004, 12:34 PM

Quote:

Originally posted by MJH007:

The insurance company has delayed my IME (independent medical exam) for the second time. I called the doctor they are sending me to and they said that the insurance company gave no reason for the cancellation/rescheduling.
I am told as long as they are paying me disablity they can do whatever they want. I am in extreme pain and can't tolerate these painkillers anymore. Any suggestions? Please help.

Max · 08-13-2004, 02:46 PM

In my opinion you should repost your question in life forum since these forums rarely visited by majority members who might help....anyway I'll try to post link in life

Hold on, Buddy

Help is onthe way!

Wesley · 08-13-2004, 05:21 PM

MJH-
I assume you have a work related injury. So do I. In Pennsylvania, a person with a WRI seeks medical care where ever, whenever they want. The healthcare provider must provide care and bill the insurer. The purpose of the IME is to allow the insurer to have their own Dr. examine you. The insurer's doc will attempt to minimize your injury, allowing the insurer to argue for less aide hours, pt, etc. Worker's Comp is a legally complex, highly adversarial system. I have been in court with my insurer continuously since my injury 4 years ago. They would have eaten me alive without a lawyer.

The bottom line is should be treating your pain by going to the best doc you can find and let a good lawyer deal with the insurer. Don't sweat the IME, its only one doc's opinion, and a highly biased one at that. Your lawyer can find docs with opinions that are more favorable to you. Take care of yourself first and foremost! Insurers will try to make you believe that they make the decisions concerning your care. That's total bull!

"The first thing we do, let's kill all the lawyers" Henry VI Part II

SCI-Nurse · 08-13-2004, 05:46 PM

I would just reinforce that you need an attorney who is well versed in Worker's Comp in your state on your side. Don't sign anything without their advice, and let them be the ones to push for getting the needed paperwork from your comp company.

(KLD)

metronycguy · 08-13-2004, 09:07 PM

the IME is only the doctor that works for the company, he does not write you prescriptions for pain killers etc.
you should have your own doctors , you should be seeing your doctors every 4 to 6 weeks for follow ups. in NYS its illegal for a doctor to bill you for a workers comp case.
i see orthopedic, urulogist, psyitrist and pain managment doc regularily for my workers comp case.
yes you do need a workers comp lawyer. there is no money up front to a workers comp lawyer at least in NYS.

you are probably entitled to to things that you are not aware of.

do not fill out paperwork at IME office ubnless your lawyer has seen it first and ok's it. i only know some NY state stuff.
acupuncture is paid for by wc in nys,
its good that they have delayed the IME , at least you can see the laywer forst.
remeber the IME s on the companys side and paid for by the company. so usually is biased , i have actually had good outcomes from the IME's appt.
i also advise you to contact the IME 's office once you get the date and apptointment asking them to fax any infromation about your injuries /care/abilities to your lawyers office in enough time for your attorney to go over the requested information and advise you on how to fill them out.

Kaprikorn1 · 08-13-2004, 09:12 PM

MJ...don't be in such a rush for the IME. That is just an evaluation of your condition. Go to a doctor and get treatment (of whatever kind) and have them bill W/C...if you have a case number just use that in lieu of insurance if you don't have ins.

Typically, State Disability (SDI) pays more than W/C does (about twice as much) once they determine you to be "permanent and stable". At that time they will decide what percentage of disabled you are and make your award based on that.

GET AN ATTORNEY!!! I can't stress that enough. My employer had let his W/C policy lapse and I almost didn't get ANY coverage. I had to sue in W/C Court.

Kap

"It's not easy being green"

08-11-2004, 07:34 AM	#1
mjh007 Junior Member Join Date: Aug 2004 Posts: 4	workman's comp The insurance company has delayed my IME (independent medical exam) for the second time. I called the doctor they are sending me to and they said that the insurance company gave no reason for the cancellation/rescheduling. I am told as long as they are paying me disablity they can do whatever they want. I am in extreme pain and can't tolerate these painkillers anymore. Any suggestions? Please help.

08-13-2004, 02:46 PM	#3
Max Senior Member Join Date: Jul 2001 Location: Montreal,Province of Quebec, CANADA Posts: 15,036	Hi In my opinion you should repost your question in life forum since these forums rarely visited by majority members who might help....anyway I'll try to post link in life Hold on, Buddy Help is onthe way!

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08-13-2004, 05:21 PM	#4
Wesley Senior Member Join Date: Jul 2003 Location: Pennsylvania Posts: 1,751	MJH- I assume you have a work related injury. So do I. In Pennsylvania, a person with a WRI seeks medical care where ever, whenever they want. The healthcare provider must provide care and bill the insurer. The purpose of the IME is to allow the insurer to have their own Dr. examine you. The insurer's doc will attempt to minimize your injury, allowing the insurer to argue for less aide hours, pt, etc. Worker's Comp is a legally complex, highly adversarial system. I have been in court with my insurer continuously since my injury 4 years ago. They would have eaten me alive without a lawyer. The bottom line is should be treating your pain by going to the best doc you can find and let a good lawyer deal with the insurer. Don't sweat the IME, its only one doc's opinion, and a highly biased one at that. Your lawyer can find docs with opinions that are more favorable to you. Take care of yourself first and foremost! Insurers will try to make you believe that they make the decisions concerning your care. That's total bull! "The first thing we do, let's kill all the lawyers" Henry VI Part II

08-13-2004, 05:46 PM	#5
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,516	I would just reinforce that you need an attorney who is well versed in Worker's Comp in your state on your side. Don't sign anything without their advice, and let them be the ones to push for getting the needed paperwork from your comp company. (KLD)

08-13-2004, 09:07 PM	#6
metronycguy Senior Member Join Date: Dec 2002 Location: ny Posts: 5,677	the IME is only the doctor that works for the company, he does not write you prescriptions for pain killers etc. you should have your own doctors , you should be seeing your doctors every 4 to 6 weeks for follow ups. in NYS its illegal for a doctor to bill you for a workers comp case. i see orthopedic, urulogist, psyitrist and pain managment doc regularily for my workers comp case. yes you do need a workers comp lawyer. there is no money up front to a workers comp lawyer at least in NYS. you are probably entitled to to things that you are not aware of. do not fill out paperwork at IME office ubnless your lawyer has seen it first and ok's it. i only know some NY state stuff. acupuncture is paid for by wc in nys, its good that they have delayed the IME , at least you can see the laywer forst. remeber the IME s on the companys side and paid for by the company. so usually is biased , i have actually had good outcomes from the IME's appt. i also advise you to contact the IME 's office once you get the date and apptointment asking them to fax any infromation about your injuries /care/abilities to your lawyers office in enough time for your attorney to go over the requested information and advise you on how to fill them out.

08-13-2004, 09:12 PM	#7
Kaprikorn1 Senior Member Join Date: Sep 2002 Location: S.F. Bay Area, Calif. Posts: 1,369	MJ...don't be in such a rush for the IME. That is just an evaluation of your condition. Go to a doctor and get treatment (of whatever kind) and have them bill W/C...if you have a case number just use that in lieu of insurance if you don't have ins. Typically, State Disability (SDI) pays more than W/C does (about twice as much) once they determine you to be "permanent and stable". At that time they will decide what percentage of disabled you are and make your award based on that. GET AN ATTORNEY!!! I can't stress that enough. My employer had let his W/C policy lapse and I almost didn't get ANY coverage. I had to sue in W/C Court. Kap "It's not easy being green"