If you’re receiving benefits after a job-related injury in South Carolina, your employer’s insurance company may ask you to attend an independent medical exam for workers’ compensation. This exam can influence decisions about your diagnosis, medical treatment, work restrictions, and benefits, so it’s important to understand how IMEs work and how to prepare for them.
What Is an Independent Medical Exam for Workers’ Comp?
A workers’ comp independent medical examination (IME) is an evaluation performed by a doctor other than the provider who is overseeing your ongoing treatment. This physician will review your condition and give an opinion about issues related to your workers’ compensation claim, such as the nature of your injury, your ability to work, or whether you need additional treatment.
According to the state Workers’ Compensation Act, the doctor conducting the IME may be designated and paid by your employer or the S.C. Workers’ Compensation Commission. On the surface, an IME may seem like a routine exam or second opinion. However, the examiner’s assessment can play a critical role in determining whether you will continue to receive benefits.
Why Is an IME Requested in a Workers’ Compensation Case?
Insurers often have questions about injured workers’ condition or recovery. Requesting an IME enables them to get another healthcare provider’s opinion. The exam may address factors like whether the injury is work-related, whether you need your current treatment, when you can return to work, or whether you face permanent limitations. The insurer may consider the doctor’s findings when making decisions about whether to continue, modify, or challenge the benefits you are receiving through their South Carolina workers’ comp system.
It’s crucial to attend an IME. Under S.C. Code Ann. § 42-15-80(A), an employee who refuses to submit to or otherwise obstructs the examination process may have their right to workers’ compensation suspended until the Commission determines whether the claimant’s actions were justifiable.
What Happens During an Independent Medical Examination?
During your workers’ compensation IME, you can expect the examining doctor to review your medical history, relevant medical records, ask about your injury and symptoms, and perform a physical examination. Depending on your medical condition, the doctor may also:
- Test your range of motion, strength, reflexes, or mobility
- Ask how the injury affects your daily activities and ability to work
- Review imaging studies, test results, and prior treatment records
- Evaluate whether your reported symptoms are consistent with the medical findings
After the exam, the IME doctor will prepare a report with their opinions about your condition and treatment needs and send it to the insurance carrier for review.
How Can an IME Affect Your Workers’ Compensation Benefits?
A workers’ comp IME can have a significant effect on your claim because the insurer will draw on the examining doctor’s conclusions when making decisions about your benefits. For example, if the IME physician finds that you can return to work, no longer need certain treatment, or have reached maximum medical improvement (MMI), their opinions could contribute to an insurer’s decision to reduce or terminate your workers’ compensation benefits.
However, an IME doctor’s report won’t solely determine what happens next with your case. Your treating physician’s records and other medical evidence may support a different conclusion and become important if the insurer disputes your continued benefits.
Talk to a South Carolina Workers’ Compensation Lawyer About Your IME
If you’ve had an independent medical examination or have been asked to attend one, an experienced South Carolina workers’ comp lawyer can help protect your rights during this crucial stage of the claims process. At Land Parker Welch LLC, our legal team has over 120 years of combined experience and is committed to fighting for our clients’ rights at every stage of their case. Contact us today to schedule a free consultation.
