Stephen Hasner | Workers' Compensation | December 7, 2021
Your employer and its workers’ compensation insurer have the statutory right to ask for an independent medical examination (IME). The employer or insurer chooses the doctor and the examination can include physical and psychological tests.
No one can force you to submit to the examination. But Georgia’s State Board of Workers’ Compensation can suspend your workers’ comp benefits until you get the examination.
With this in mind, here is some information about independent medical exams and how to approach them.
Georgia’s Workers’ Compensation System
All employers in Georgia with at least three regular employees must have workers’ compensation insurance.
Your employer can buy a workers’ compensation policy from an insurance company. An employer can also self-insure by getting a surety bond or letter of credit to cover the potential cost of workers’ comp benefits.
If your employer has workers’ compensation insurance, you cannot sue your employer for on-the-job injuries. Instead, your exclusive remedies come from the workers’ compensation insurer.
If the insurer accepts your claim, you will receive full medical benefits for your injuries. You do not need to pay any co-pay to access these benefits.
Benefits include all reasonable medical treatment to cure or relieve your injuries or restore you to full employment, including:
- Physical therapy
You will also receive income benefits equal to two-thirds of your average weekly wage. You become eligible for income benefits if you must miss more than one week of work due to your injury.
Procedure for Filing a Claim
When you get injured on the job, you file a claim by filling out a claim form and submitting it to the state workers’ compensation board. You will also send a copy of the form to your employer and its workers’ comp insurer.
You must report your injury to your employer within 30 days after you get injured.
You do not need to wait for your claim to get approved before you seek treatment from a doctor. In an emergency, you can go to an emergency room or urgent care for treatment.
In a non-emergency, you need to go to a medical provider approved by your employer’s workers’ comp carrier.
What is an IME for?
An IME allows your employer and its insurer to have someone apart from your treating physician examine you. This examination helps them to verify that you accurately described your injuries. It can also help them determine the cause of your injuries.
Under Georgia law, the employer and its insurer can request an IME at any time while you claim or receive benefits. The employer or insurer must pay for the cost of the IME. It must also schedule the IME at a reasonable time and location.
Is Attendance Mandatory?
According to Georgia’s workers’ comp statute, an injured worker needs to submit to an examination when requested. If you fail to attend the IME, the insurer can file a request with the workers’ compensation board to suspend your benefits.
Tips for IMEs
In many cases, an insurer asks for an IME when it needs medical evidence to deny your claim or terminate benefits. Since you cannot decline an IME, you must take other steps to protect your right to receive workers’ compensation benefits, including:
Have Your Doctor Attend
You have the right to have your doctor attend the IME. The cost of having your doctor at the IME falls on you. However, the cost may be worthwhile, as your doctor can speak to the insurer’s doctor in medical terms.
Meet with a Lawyer
Your workers’ comp lawyer can help you prepare for the IME. An experienced lawyer knows how insurers use IMEs and can guide you through what to expect during the IME.
You endured trauma when you got hurt on the job. You deserve fair benefits for your injury. Preparing for your IME with your doctor and lawyer can help you avoid an unfair denial or termination of your benefits.