Independent medical exams (IME) can be problematic for injured workers receiving workers’ compensation benefits. Insurance carriers providing compensation and medical benefits have a right to an IME to assess a claimant’s condition from time to time under the statue and the rules. They often avail themselves of such right when a claimant’s treatment and recovery are not progressing at a suitable (to them) pace.
Claimants have only very limited rights to object to IME’s and only three days after receipt of an IME notice to file their objections with the Industrial Commission under the Rules. The Industrial Commission rarely issues a Protective Order against an IME especially if the objection is solely related to the identity of the particular examiner.
Due to the extremely short window of time for a claimant to file a written objection (Motion for Protective Order) to an IME, many claimants, especially those unrepresented by counsel, simply bypass the opportunity to object. Others, thinking that such exams are easily changed by a phone call to the examiner or the agency scheduling the IME, find out too late that they are not easily changed at all.
Irrespective of the fact that workers’ compensation carriers keep recycling the same tired group of friendly examiners to the great detriment of claimants who are awaiting approval for surgery or other procedures, just innocently missing one of these exams can result in the carrier unilaterally suspending both compensation and medical treatment and assessing costs of the IME which can run from a couple thousand dollars for an orthopedic or spinal surgeon to several thousand dollars if a psychiatric or psychological exam is missed. In many of these situations the examiners are paid guaranteed fees if the claimant doesn’t show up.
Fortunately for aggrieved claimants, the appellate courts in Arizona have put a humane interpretation on the statutory penalties for missing IME’s and the carriers must prove that the claimant intentionally rather than accidentally missed the IME to be able to impose any penalties at all. Enlightened members of the Industrial Commission judiciary usually limit cost assessments to exactly what the carrier paid the examiner for a no-show fee or what a typical first examination would cost with that type of specialist.
Even if a suspension is ultimately found to be unjustified however, it can take months in litigation to undo the effects of the suspension and get compensation and medical benefits reinstated imposing great financial hardship on the claimant’s family which might already be suffering mightily with the breadwinner being out of work. Consequently, claimants facing IME notification are best advised to seek legal advice immediately upon being notified of an IME.
If you or someone you know has been injured at work or suffers from a medical condition or injury that will keep them from working for 12 months or longer, contact Snow, Carpio & Weekley at 855-325-4781 for a free consultation statewide. You may also learn more about us by visiting our website at www.workinjuryaz.com.
