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Workers compensation claims and independent medical examination

If you have filed a claim for workers' compensation due to a work-related injury in Nevada, you may receive a notice from your employer's insurer asking you to appear for an independent medical examination.

To be perfectly clear, this examination, unlike your regular medical appointments, is not for the purpose of figuring out the best way to treat you. It is to help the insurance company save money by second-guessing your treating physician's determinations.

Why insurers may want an IME

There are various reasons an insurer may want to take a second look at your doctor's conclusions. They may hope to determine your disability does not limit you as much as your doctor says it does or that a treatment your doctor prescribed is not really medically necessary.

Failing to comply with an IME notice can result in lost benefits

The law allows your insurer to make you do this and to suspend benefits if you refuse. However, you should discuss the impending appointment with your attorney to make sure to protect the rights you do have in the matter. Your lawyer can also discuss possible challenges you may encounter during the appointment and help you prepare.

Preparing for the IME

Generally, it is worthwhile to review your records of the injury and make sure you have all the timelines and other facts straight. Misremembering details or inadvertently contradicting yourself can give insurers the foothold they need to question your claim.

New law allows you to opt for an IME of your own

Until recently, if a Nevada worker wanted to schedule an IME with an approved examiner to get another opinion, he or she would have to spend thousands, as neither the insurer nor the worker's health care plan would pay for it.

This summer, Nevada enacted legislation entitling the worker to choose an IME doctor from the state's panel (not the insurer's list of approved doctors) and have the insurer pay for that IME. This can be a valuable tool for workers who want to dispute the insurer's decision or its IME results.

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