Our Santa Barbara workers’ compensation attorneys at Ghitterman, Ghitterman & Feld represent first responders, including police officers, firefighters, and paramedics throughout California, because we understand how often they face unique risks and injuries that sideline them from doing the jobs they love.
When these crucial public service employees are hurt during their work, they are entitled to pursue and receive workers’ compensation benefits. Unfortunately, the insurance companies that supply these critical benefits will not simply approve their distribution without requiring the injured worker to undergo an Independent Medical Examination (IME).
IMEs play a significant role in first responders’ compensation cases, as in other workers’ compensation cases, and are conducted to assess the injured worker’s medical condition, the cause of the injury, the extent of the disability, and the need for ongoing medical treatment.
Here, we discuss the role of IMEs in workers’ compensation cases for first responders, so these brave workers understand their legal rights and options to comply with the request, undergo an evaluation, and challenge their findings when necessary.
Why Do Insurance Companies Require Independent Medical Examinations for First Responders?
IMEs are typically conducted by a medical professional chosen by the workers’ compensation insurance carrier. This independent examiner evaluates the injured first responder’s medical condition and may provide a second opinion on the diagnosis and treatment.
This includes:
- Determining Causation
One of the crucial aspects of an IME is determining whether the injury or medical condition is directly related to the individual’s job duties as a first responder. Establishing the connection between the injury and the job is essential for a successful workers’ compensation claim.
- Evaluating Disability
The IME examiner assesses the extent of the injured first responder’s disability. This evaluation can impact the level of compensation the injured worker receives. The examiner may provide a disability rating that will be used in determining benefits.
- Assessing Treatment Needs
The IME can also offer recommendations for ongoing medical treatment, including surgeries, therapy, or medications. These recommendations can influence the injured worker’s access to medical care and the extent of future benefits.
- Dispute Resolution
IMEs sometimes help resolve disputes between the injured worker and the workers’ compensation insurance carrier. If there is a difference of opinion between the treating physician and the IME examiner, the case may be resolved through mediation or other dispute-resolution processes.
- Return to Work Decisions
The IME can influence decisions regarding the injured first responder's ability to return to work. This assessment can be critical in determining if and when an injured first responder can resume their duties and under what conditions.
It is important to note that the outcome of an IME can significantly impact the first responder’s workers’ compensation benefits. In some cases, the findings of the IME can lead to a denial of benefits, a reduction in benefits, or a modification of the treatment plan.
Injured first responders have the right to challenge the findings of an IME and seek a second opinion or request a hearing to address any disputes, and we can help ensure their rights are protected throughout the process – including before, during, and after an IME takes place.
At Ghitterman, Ghitterman & Feld, our California workers’ compensation attorneys have six physical offices in Bakersfield, Fresno, Santa Barbara, Santa Maria, Ventura, and Visalia, and our top-tier technologies provide a virtual reach to serve clients throughout California. We offer free in-person, telephone, and virtual consultations to offer straightforward legal advice for your unique needs.
Contact us today to learn more about your legal rights and options to pursue the best outcome for your critical case.