Retired Judge Says Medical Examiners Often Favored Employers in Workers’ Compensation Cases
Employers and workers’ compensation insurers hire independent medical examiners (IMEs) to review workers’ compensation claims and help determine if a worker should receive benefits.
Unfortunately, IMEs tend to favor the employer and not the worker, according to retired administrative law judge Joe Schaeve, who spent 30 years hearing workers’ compensation cases in Wisconsin.
Schaeve often knew what certain IMEs would say about a case before he even read the reports they wrote. For instance, he often had a strong suspicion that a report from an IME would say the worker’s injury was in his or her head or not related to his or her job.
Schaeve says some IMEs examined injured workers for as little as three minutes, while others did not examine the worker at all. These IMEs tend to file reports saying the personal injury the worker claims occurred at work was actually preexisting.
There are also cases when the IME claims the worker had already healed, was exaggerating his or her symptoms, or had medical issues that were unrelated to a verified work injury.
Schaeve has found the vast majority of office notes from treating physicians to be generally reliable and honest. However, IMEs tend to side against injured workers and support denying the claim or downplaying the severity of the injury.
Another of Schaeve’s criticisms of IMEs is that some of them are from outside of the state. This is allowed under Wisconsin law, but out-of-state IMEs tend tend to favor the insurance companies and employers.
There are also IMEs who attack the credibility of injured workers, which is not the job of an IME, according to Schaeve.
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