request a consultation
Fill out our contact form and we’ll be in touch with you right away.
What NOT to Say to Your Workers’ Compensation Doctor
If you have suffered a work-related injury, you have likely filed for workers’ compensation benefits to help pay for your lost wages, medical expenses, etc. You may or may not know what comes next —an Independent Medical Exam with a workers’ compensation insurance-approved doctor.
Of course, it is important to be honest and open with the doctor. However, there may be certain things that you should not say when attending your workers’ compensation doctor’s appointment.
It’s essential to understand how your words can affect both the outcome of your case and the medical care you receive. In this article, our personal injury attorneys discuss what you should never say to your workers’ compensation doctor to ensure successful compensation for your injuries.
Independent Medical Exam: The Basics
When insurance companies request an Independent Medical Exam (IME), they are verifying the extent of your injuries after a workplace accident. Yes, these exams are required.
A visit to an insurance company-appointed provider is an essential part of the claims process during a workers’ compensation case.
There are over 4.5 million workplace injuries each year and workers’ compensation pays out billions in claims.
Independent medical exams are typically requested by an insurance company when:
- The insurance company disagrees with your doctor’s opinion
- The negotiations with the insurance claims agent are taking too long, or becoming too expensive.
- Your treating physician determines total or partial disability
The doctor’s evaluation will outline any physical work restrictions, recommendations for time off work, or your return to work on light duty.
Remember, insurance companies will do everything they can to minimize their liability which is why you must prove the extent of your injuries sustained in a workplace accident. The workers’ comp doctor is an extension of your insurance company, and they will manage your case to carefully limit their liability.
Important Note: While insurance companies “request” an IME, failure to submit to this exam will result in the denial of your claim.
What to Expect During an IME
During the independent medical exam, the doctor will evaluate the extent of your injuries and pass this information to the insurance company (their employer). They will first ask about your medical history, any pre-existing conditions, and any medical treatments you may have undergone in the past.
The doctor will examine your physical appearance and how you move:
- How easily can you sit and stand?
- Are you limping or in discomfort when you move?
- Are you struggling to do daily tasks?
The doctor will look closely for signs of pain and discomfort—or a lack thereof.
Be prepared to explain in detail how your work accident is affecting your daily life and never downplay any details.
Remember, the doctor is scrutinizing your injuries. They are looking for anything that suggests that they are not as bad as you say. For this reason, make sure to share accurate details that indicate how your quality of life has suffered since the accident.
The most important thing you can do during your exam is to be honest and consistent. Don’t give your insurance company reason to find inconsistencies that will destroy your workers’ comp claim.
What Not to Say to The Doctor During Your IME
The outcome of your IME has the potential to make or break your claim. Avoid raising any red flags during the claims process by following the following tips:
#1. Don’t Exaggerate Symptoms
Workers’ compensation doctors are well-trained to spot exaggerated claims and false displays of pain. You may think that exaggerating your symptoms will increase the chances of a sizable workers’ comp payout. Be warned: this couldn’t be further from the truth.
You need to be honest about your symptoms. If you choose to exaggerate them and the doctor believes you aren’t being truthful, that may be reason enough to deny your claim.
#2. Don’t Speak Negatively About Your Employer
During your exam, do not be rude or difficult, and never speak negatively about your employer.
As an injured employee, you might harbor some negative feelings about your employer, which is natural. You may feel some resentment especially if you were injured in the workplace due to negligence or unsafe working conditions. It is fine to feel this way, but don’t disparage your employer during your exam.
If you speak badly about your employer this can tarnish the doctor’s opinion of you. What’s more troubling is the negative things you say about your employer can be noted on your official medical report, casting more doubt on your entire case.
#3. Never Lie
The golden rule for a successful examination and claim is simple—don’t lie.
You’ve been injured at work and want to receive the compensation you deserve to cover the cost of your treatment plan and physical therapy if needed. While it can be tempting to lie about what happened to embellish your condition, stick to the facts and be honest.
- Never hide an old injury. You may need to explain how the pain for your new injury is different from your old injury.
- Don’t omit details about the accident and be consistent with the initial accident report.
Honesty is key. Disclose every detail and tell the true story of what happened, even if they are embarrassing or make you look bad.
Protect Your Workers’ Compensation Claim
The process of filing a workers’ compensation claim and fighting for the compensation you deserve can be difficult and time-consuming. Thankfully, you don’t need to navigate the claims process alone.
Let our skilled personal injury attorneys at Mickey Keenan P.A. support you throughout your claim. We will defend you against the insurance company to ensure your workers’ compensation claim is successful.
Your fight is our fight. If you need legal counsel for a workers’ compensation case, contact our attorneys for a case review today.