In a Florida workers’ compensation claim, in almost all situations, the workers’ compensation carrier gets to choose the doctor the injured workers must treat with. Notwithstanding the self-help provision of the work comp statute (a subject for a later blog article), there is one opportunity to get the opinion of a doctor of your choosing in the workers compensation arena – the Independent Medical Examination (IME).
Florida Statute 440.13(5) addresses the workers compensation IME and gives both the workers compensation carrier and the employee the right to an IME. Either party can have an IME to resolve disputes about overutilization, entitlement to medical benefits, compensability, or disability. Thus, if the carrier denies a claim for benefits, the injured employee can obtain an Independent Medical Examination or if the carrier-appointed doctor opines that the injured worker is at maximum medical improvement (MMI) with no impairment, the employee can obtain an IME to dispute the carrier-appointed doctor’s opinions.
However, there are limits to the IME. Under Florida’s workers’ compensation statute, each side is limited to only one independent medical examination per accident. No longer are the parties entitled to an IME per medical specialty. However, each party is entitled to an IME for each covered dispute during the life of the case as long as the IME is performed by the same examiner. Also, no longer is the carrier responsible to pay for all work comp IMEs. Now, the party requesting the examination and choosing the examiner is responsible for all costs associated with the examination—this means the injured employee must pay for the doctor of their choosing (unless the carrier has managed care). Of course, if the employee prevails, the workers’ compensation carrier must reimburse the costs of the IME. Lastly, the IME doctor cannot be a treating physician unless all parties agree to that.
If the injured worker is utilizing their right to an IME, they are required to notify the workers’ compensation carrier of their choice within fifteen (15) days AFTER the date the exam is to take place. If the notification is not timely made, the worker compensation judge can exclude the IME doctor’s findings from the evidence.
There are many other legal issues surrounding IMEs in work comp cases. If you are an injured employee and feel that your medical concerns are not be addressed, you should consult with an attorney who understands the Florida Workers’ Compensation statute before jumping into the selection of an IME doctor.
Attorney Matthew Noyes represents employees injured at work who need assistance in securing their workers compensation benefits. His Clearwater law firm – Perenich Caulfield Avril Noyes – is one of the oldest personal injury law firms in Pinellas County. Call Attorney Matthew Noyes now at 727-796-8282 or simply click here to schedule a free case consultation.