In Part 5 of this series, I will discuss when to consider scheduling an Independent Medical Examination and what factors to keep in mind when choosing the examiner.
When it comes to workers’ compensation claims, the most common scenario is that an employee sustains an injury, get the treatment needed, and returns to work once medically cleared. Often, the treatment provided by either the emergency room or the panel provider proves sufficient and the worker is pleased with the results. However, all employers will inevitably have claims that do not go this smoothly and the restaurant industry is no exception.
Keeping open lines of communication with the employee, as discussed in part 4 of this series, remains the best way to determine whether a claimant will require more than just short panel treatment and a quick return to work. The failure to respond to phone calls requesting updates, the failure to return work once released (either full duty or light duty), and the procurement of counsel all serve as red flags that a claim may prove difficult. In these instances, obtaining an IME allows the employer to have an independent expert comment on the injured worker’s condition, diagnoses, prognosis, and ability to return to work. This can essentially give the employer a roadmap of how to return an injured worker to baseline and how long that will take.
While scheduling an IME often is the right decision, choosing the right examiner can prove difficult. There are literally hundreds of doctors who perform IMEs, covering dozens of specialties and sub-specialties. Which IME doctor to depends on the injury itself, the status of the claim, the treatment the worker has undergone thus far, and the employer’s long-term goals. In the restaurant industry, which usually offers a strong return to work program (more on this in future installments), the doctor should have a focus on the employee’s physical capabilities. After all, the common goal of both parties should remain rehabilitating the employee enough to return to the workforce.
Again, selecting the proper IME physician is highly fact specific so if you are having difficulty, your insurance company, TPA or attorney can recommend specialists they have used in the past. If you would like any additional insight, please feel free to contact me at 484-468-1231 or email@example.com.