Following a work-related accident, there must be a medical exam that confirms the extent and nature of your injuries. This medical exam is the independent medical exam, or IME.
Not only does it give you and your employer insight into your injuries, but it’s also a key document for determining your workers’ compensation benefits.
Read on to find out what it is, what the report can do to your benefits, and which rights Minnesota law gives you before you walk in.
What Is an Independent Medical Exam?
According to the Department of Labor and Industry, an IME is an evaluation by a doctor the employer or insurer selects, performed by someone with no role in your care. In short, think of it as a medical exam performed by your “employer’s physician.”
In an IME, the doctor sees you once. No treatment plan follows and nor is there a follow-up appointment or ongoing relationship.
That single visit produces a written opinion on how badly you were hurt, whether the job caused it, and when you can go back.
Who Chooses and Pays the IME Doctor?
The insurer controls both ends of this arrangement, and two parts of it affect your workers’ compensation claim in Saint Paul.
The Insurer Picks the Doctor
The carrier has a legal right to request an exam with a doctor of its own choosing, at reasonable times and places. You get no say in the selection.
The Insurer Pays the Doctor
Minnesota Rules cap what an IME doctor can bill. The fee schedule allows $275 for the history and exam, $250 for the diagnosis and written report, and $175 for the first 50 pages of records review.
The doctor writing an opinion about your injury has met you once and been paid by the company that decides your benefits.
Why the Insurer Asks for One
Insurers order IMEs before they decide to pay you, and they require one for the following reasons:
- Disputing the cause: The report can say your injury came from something other than work.
- Questioning the treatment: The report can call a surgery or a course of therapy unnecessary.
- Setting work restrictions: The report can clear you for duties your own doctor has not.
- Declaring maximum medical improvement: The report can say you have recovered as far as you will, which ends certain wage benefits.
Each conclusion hands the insurer a medical opinion to cite when it reduces or stops paying. None of them requires your treating doctor to agree, which is how a workers’ compensation claim in Saint Paul can stall while your treatment continues unchanged.
Rights Minnesota Law Gives You at the Exam
Section 176.155 gives you five things you can insist on, and most injured workers never hear about any of them:
- A witness in the room: You can bring your personal physician or an unpaid witness if you ask.
- A location within 150 miles: The exam must be scheduled that close to your home unless the employer shows cause.
- No hotel or motel rooms: The statute bars exams in those facilities outright.
- Travel costs and lost wages: The employer pays mileage, parking, lodging and meals when needed, plus wages you lose attending.
- The report within 14 days: The insurer must serve it on you and your attorney within 14 calendar days of issue.
Can You Refuse to Go?
An IME is a requirement for receiving workers’ comp benefit payouts. It’s not wise to refuse one, and doing so costs you money.
A compensation judge or the commissioner can suspend your benefits when you refuse a reasonable request for an exam, and nothing gets paid while the refusal continues.
Showing up and documenting what happened protects your workers’ comp claim in Saint Paul better than missing the appointment. Note the date, how long you were in the room, and the questions the doctor asked.
Deadlines the Insurer Has to Meet
Under Section 176.155, any insurer is obliged to meet certain deadlines. Three deadlines apply once an exam is requested:
- 14 calendar days to serve the report on you after it is issued
- 120 days after a claim petition to complete the exam and file the report
- Extensions only for good cause, granted by the commissioner or a compensation judge
A missed deadline carries a real consequence. No judge or appeals court considers evidence from the exam unless the report was served and filed the way the statute requires.
Extensions do get granted, and they’re usually for a shortage of specialists or genuinely complicated medical questions. With that said, the statute says an extension cannot be for the purpose of delay, and the insurer must make a good faith effort to meet the original date.
After a Report Goes Against You
If the results or an IME are unfavorable, know that it’s not the end of your claim. Two protections follow it.
A Notice Before Benefits Stop
The insurer must send a Notice of Intention to Discontinue before it stops your wage-loss payments. The deadline to request a conference is printed on that form.
Your Own Doctor’s Opinion Still Counts
A compensation judge reads both reports. Your treating physician has examined you over months, and an insurer’s denial of treatment built on a single visit is something you can dispute.
Consistent records help here, which is one reason the steps after a workplace injury start with reporting and treatment.
Talk to Us Before Your IME, Not After
An early conversation protects your workers’ comp claim in Saint Paul more than a late one, and our Minnesota work injury lawyers can start it whether you have an exam scheduled or a report already in your file.
Our Saint Paul workers’ compensation attorneys can prepare you for the exam, hold insurers to the deadlines in the statute, and use your treating doctor’s records to answer a report that gets your injury wrong.
Contact our law firm today to schedule a consultation and start your comeback journey.