Do I have to be examined by the workers' comp doctor to get my benefits?

If your employer’s insurance carrier has recommended you see a doctor, then you probably do need to see that doctor in order to get benefits. It’s unlikely they think you need further (or different) medical care—chances are that the insurance company is contesting some part of your claim. The examination being recommended is likely called an “independent medical exam,” or IME, though the exact names used for the exam and even for the doctor may vary based on the state you’re in.

Different Names - Same Doctor

In California, for instance, the doctor involved in your IME may be called a medical evaluator. In other states, the doctor is usually called an independent medical examiner. There may be other names used for the examining doctor as well. Just remember that they all refer to the same person—the medical professional tasked with examining you, evaluating your injury, and creating a written report regarding the cause of your injury.

Preserving Your Interests During the Exam

Make notes right after the exam about how long the exam took, what the doctor asked you, what the doctor told you to do, how the doctor examined you and whether or not any diagnostic tests were taken (if they were, what kind). You may even be able to bring an unpaid observer to the exam. Check with your workers comp advocate or liaison. All of these steps are intended to ensure that the process goes as smoothly and painlessly as possible. Remember, the point of the exam is the determination of your injury as work-related.

Getting Legal Help

Some of the medical doctors who perform these evaluations or examinations may be more sympathetic to workers - some to employers. The law encourages the parties to mutually agree upon a doctor to do the evaluation. Whether you are represented by an attorney will also affect this process. That's why it is a good idea to consult a lawyer before attending one of these required exams. Experienced workers' comp attorneys are familiar with many of these doctors and can steer you in the right direction when choosing a doctor on the insurer's list.