If you are receiving workers’ compensation benefits in Louisiana, your employer or its insurance company may ask you to attend a medical examination with a doctor you did not choose. This is commonly called an independent medical examination, or IME.
In many situations, an injured worker must attend a properly requested examination. Louisiana law allows an employer to require an injured employee to be examined by a qualified medical practitioner paid for by the employer when the examination is reasonably necessary. The law also places limits on how these examinations can be requested and conducted.
An IME can affect disputes over medical treatment, work restrictions, disability benefits, and whether an injury is related to the job. We help injured workers throughout Louisiana understand what an IME request means and how to protect their workers’ compensation rights before and after the appointment.
An independent medical examination is an evaluation performed by a doctor other than the worker’s regular treating physician.
The employer or workers’ compensation insurer may request the examination because it wants another medical opinion about the employee’s condition. Under Louisiana law, the employer generally pays for the examination.
The examining doctor may be asked to evaluate issues such as:
An IME is generally an evaluation rather than an appointment intended to establish an ongoing treatment relationship.
That distinction is important. The doctor may examine you and issue an opinion that becomes evidence in the Louisiana workers’ compensation claim, but the IME doctor does not ordinarily replace your authorized treating physician simply because the insurer requested the examination.
Often, yes.
Louisiana law states that an injured employee must submit to an examination by a qualified medical practitioner provided and paid for by the employer when requested after the accident and as often thereafter as may be reasonably necessary. The examination must occur at reasonable times and places while the workers’ compensation claim is pending or benefits are being paid.
That does not mean an employer has unlimited authority to schedule examinations whenever it wants.
Louisiana law generally prevents an employer or workers’ compensation carrier from requiring an employee to be examined by more than one physician in the same field or specialty without first obtaining the employee’s consent.
Questions can therefore arise about whether:
Our Louisiana workers’ compensation attorneys can review an examination request and determine whether there is a legitimate issue that should be addressed before the appointment.
The details depend on your injury and the doctor’s specialty, but an IME will often resemble a focused medical examination.
The physician may begin by reviewing your medical history and asking questions about the workplace accident. You may be asked when symptoms started, which parts of your body were injured, what treatment you have received, and how the condition currently affects your activities.
The doctor may also ask about prior injuries or medical conditions.
A physical examination may include:
The physician may also review imaging studies, medical records, operative reports, diagnostic testing, and your treating physician’s opinions.
The appointment may ultimately result in a report addressing questions posed by the employer or insurer.
The phrase “independent medical examination” can be confusing.
The doctor conducting an employer-requested examination is generally selected for the evaluation and paid by the employer or its workers’ compensation carrier. Louisiana law specifically provides for examinations by a qualified medical practitioner provided and paid for by the employer.
That does not automatically mean the physician’s opinion will be unfavorable.
An IME doctor may agree with your treating physician, disagree with particular recommendations, or reach a substantially different conclusion about your ability to work or need for treatment.
The important point is to understand the doctor’s role. This is not the same relationship you have with a physician who has been treating you over time.
You should approach the examination professionally and honestly while remembering that the resulting report may be used in your Louisiana workers’ compensation case.
You generally do not need to rehearse answers or memorize your medical records.
Preparation should focus on being accurate and familiar with the basic history of your injury.
Before the appointment:
Be prepared to explain what happened at work in straightforward terms.
If you do not remember a specific detail, say that rather than guessing.
Tell the truth and be consistent.
Do not exaggerate your symptoms to make the injury sound worse. At the same time, do not minimize real pain or limitations because you want to appear cooperative.
If an activity causes pain, describe what you experience. If you can perform an activity only for a limited amount of time, explain that limitation accurately.
The doctor may ask about daily activities, work tasks, hobbies, previous injuries, and treatment.
These questions may be used to evaluate whether your reported limitations are consistent with the doctor’s observations and the medical records.
A prior injury does not necessarily defeat a Louisiana workers’ compensation claim. However, hiding a previous medical problem can create credibility issues. It is generally better to accurately explain what existed before the workplace accident and what changed afterward.
The physician and staff may observe more than the formal testing.
For example, observations may be made about how you:
You should not change the way you normally behave because you know you are being evaluated.
Simply act naturally and remain consistent with your actual condition.
Attempting to exaggerate physical limitations can damage credibility. So can telling the doctor that you cannot perform an activity when your normal movements appear to show otherwise.
Yes. This is one reason an independent medical examination deserves careful attention.
The resulting medical opinion may be used to address whether you can return to work, whether additional treatment is necessary, or whether your current condition remains connected to the workplace injury.
If the IME doctor says you can return to work without restrictions while your treating physician disagrees, that conflict can lead to a workers’ compensation dispute.
Likewise, the insurer may rely on an IME opinion when questioning:
An insurer’s reliance on an IME does not necessarily mean the examining physician’s opinion automatically controls the case.
The complete medical record may need to be compared, including treatment history, diagnostic evidence, physician qualifications, and the reasoning supporting each medical opinion.
Medical disagreements are common in workers’ compensation cases.
Louisiana law provides a process for obtaining an additional medical opinion when there is a dispute over an employee’s condition, ability to work, or whether the alleged injury was caused by the work accident.
The significance of competing medical opinions depends on the circumstances.
A treating physician may have examined the employee repeatedly over months, while another doctor may have performed a single evaluation. On the other hand, an examiner may have specialized expertise relevant to a particular injury.
The analysis can include:
A workers’ compensation dispute should not necessarily be reduced to simply counting how many doctors support each side.
Louisiana law provides injured employees with important rights regarding reports from employer-requested medical examinations.
When an employee who is being treated by a provider of their choice submits to an examination requested by the employer or insurer, the employee or their representative is entitled to a copy of the written examination report within 30 days after the requesting party receives it.
Reviewing that report can be important.
It allows you and your attorney to see what the physician concluded and compare those conclusions with your treating doctor’s records.
If the report contains factual errors, an incomplete history, incorrect job information, or conclusions that appear inconsistent with other medical evidence, those issues may need to be addressed.
Ignoring a legitimate examination request can create serious problems.
Louisiana workers’ compensation law provides procedures addressing an employee’s refusal to submit to a required medical examination. A failure to cooperate with a lawful examination may lead to efforts to suspend workers’ compensation benefits until the employee complies.
That does not mean you should attend every appointment without question.
If there is a legitimate scheduling problem, travel issue, prior examination in the same specialty, or another concern about the request, address it promptly rather than simply failing to appear.
Keep copies of the appointment notice and any communications about rescheduling or objections.
A missed IME should not come as a surprise to the employer or insurer when the issue could have been addressed beforehand.
Generally, no.
Louisiana workers’ compensation law recognizes an employee’s right to select a treating physician in a field or specialty, subject to the rules governing physician choice.
An employer-requested examination generally provides another medical opinion.
Continue following the instructions of your authorized treating providers unless there is a lawful change in your treatment arrangement or you receive appropriate legal advice concerning a dispute.
Do not stop treatment simply because an IME doctor expresses a different opinion during the appointment.
Likewise, do not assume anything the IME doctor says informally is the final decision in your case. The written report and the broader medical evidence are usually more important.
After the appointment, write down what happened while the details are still fresh.
You may want to note:
Do not embellish the account. A simple factual summary can help your attorney later compare the appointment with the written report.
Continue attending authorized medical appointments and following documented work restrictions.
If the insurer later relies on the IME to reduce benefits, deny treatment, or attempt to return you to work, the report should be reviewed in the context of the complete Louisiana workers’ compensation claim.
You may be required to attend a reasonably necessary employer-requested medical examination during a Louisiana workers’ compensation claim. However, the employer’s right to request an examination is subject to legal limits, and an IME doctor’s opinion does not automatically replace the evidence from your treating physician.
If you have received notice of an independent medical exam or are dealing with a dispute over medical treatment or workers’ compensation benefits in Louisiana, our attorneys are here to help. Call us today or connect with us online to schedule a consultation.
