Do I Have To Attend The IME Exam Scheduled By The Insurance Company In A New York Workers’ Compensation Case?
by Rosalind Asch-Hobeck
Photo by Matthew Henry from Burst
The Workers’ Compensation insurance company or your employer, if it is self-insured, is entitled to have you examined periodically. Most of the time the exams are on the issues of causal relationship, degree of disability, treatment or permanency.
In the early stages of your case, the insurance company or self-insured (hereinafter referred to as “the carrier”) will send you an IME-5 through a company hired to arrange an exam. The carrier cannot directly communicate with the IME physician selected to examine you. The initial IME would most likely be on issues of causal relationship and diagnoses that relate specifically to your accident or condition claimed. Often the degree of disability is also an issue, especially when your own doctor finds a total disability. The degree of disability will determine the $ rate of your weekly indemnity benefits.
YOU SHOULD NOT IGNORE THE IME-5 NOTICE TO ATTEND THE CARRIER’S MEDICAL EXAMINATION. If for some reason the date or time cannot be accommodated, you must call the number on the form and cancel. You have the right to videotape the IME exam.
If you have an attorney, it is always a good policy to communicate with them prior to your attendance at the IME exam so that you understand the reason for the exam and the questions you will likely be asked.
If you fail to keep two consecutive exams, the carrier can file a form with the Board seeking to SUSPEND your benefits. Unless your attorney advises you not to appear, you must comply with the carrier’s request.
The Workers’ Compensation Board website has a lot of information that you can access. Their website is www.wcb.ny.gov.
Navigating the worker’s compensation system as a claimant is difficult. The Board website is helpful, but to make sure you are on the right track and are getting the benefits you are entitled to under the law, you should consult a workers’ compensation attorney. Speaking to an attorney who specializes in this field is a good thing to do.
