The Unavoidable Bias of an Independent Medical Exam
In defending a claim for workers' compensation benefits, the employer is entitled to compel the injured worker to undergo a physical examination under Section 314 of the Pennsylvania Workers' Compensation Act.
July 27, 2015 at 08:00 PM
5 minute read
In defending a claim for workers' compensation benefits, the employer is entitled to compel the injured worker to undergo a physical examination under Section 314 of the Pennsylvania Workers' Compensation Act. While these examinations are commonly known as independent medical examinations, or IMEs, the examiner, who ultimately testifies and serves as the medical expert in opposition of the injured worker, is hand-chosen by the employer and paid by the employer. Thus, these exams are anything but independent.
Compensation for performing these examinations, which requires a one-time office visit without ever treating the individual, can range from a few hundred dollars to well over $1,000. There is no limit to the number of IMEs examiners are allowed to perform in a week, and in some situations they conduct up to 10 exams or more on a weekly basis. Clearly, the monetary stakes are significant. Let's ask a common-sense question: If examiners were to find that all 10 injured workers examined in a given week were disabled as a result of a work injury, how long do you think they would get cases referred to them by the insurance company? With thousands of dollars at stake, it is easy to predict what opinions will ultimately be given. Keep in mind, we are not even considering the pecuniary interest that exists in the depositions, which in some cases can result in fees ranging from $3,000 to $5,000 per deposition.
In addition, the employer is not confined to choosing an examiner who is located closest to where the injured worker lives so long as transportation is provided and the travel time does not exceed the individual's restrictions. Given the nature of an IME, it comes as no surprise that the examining physician often finds the injured worker to be fully recovered from a work injury, ready and able to return to full-duty work, or that the injured employee never sustained a work injury in the first place.
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