The Role Of The Independent Medical Examination In South Carolina Workers’ Compensation Claims

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In South Carolina, if you are hurt at work, you have a right to receive disability payments and medical treatment while you are injured.  Suppose, though, you are seriously injured.  You now have, at least in your mind, a permanent disability that you will have to live with for the rest of your life.  How is your disability evaluated and what steps can you take to ensure that your disability is rated fairly and truly represents the loss of function you have actually suffered?Medical records and Stethoscope

Medical Treatment

When you are injured, you have the right to seek medical treatment.  What you may not realize, however, is that your employer picks those doctors.  While they are obligated by their license to give you adequate care, many of these doctors are really under the employ of the insurance companies and have negotiated advantageous rates in order to have business put their way.  These doctors are in the unenviable position of serving two masters: you, the patient; and the employers and insurers who are paying the bills.  While in many other arenas one would think this to be a conflict of interest, in workers’ compensation medical treatment, it is the name of the game.  Why is this important?

It is important because it is these doctors who will be making the medical determination of the extent of your disability.  They may soft-sell the extent of your disability and claim that you have abilities that you no longer have.  They may also authorize you to return to work well before you are ready.  You do not have to solely rely on their potentially compromised medical judgment, however.

Independent Medical Examination

You have the right to receive an independent medical examination (IME).  This is basically your ability to have a second opinion.  The IME will typically involve a:

  • Medical record review including all treatment notes, surgical notes and physical and occupational therapy notes;
  • Physical examination that will be used to substantiate or dispute the previous diagnosis; and
  • Radiographic review which will involve a detailed analysis of X-rays, MRIs, CAT scans and other radiographic information.

Typically, the doctor who conducts your IME will be a specialist with experience evaluating injuries and disabilities similar to yours.  They will evaluate all of the information available to them to reach their own diagnosis independent of the ones made by your original doctors.

Using The IME

If the results of the IME differ materially from the impairment rating and disability classification reached by your original care team, the rating can be called into question in court.  Your attorney will utilize this new information at a hearing that will be scheduled to take testimony on your final disability and degree of impairment.  Most likely, both doctors will be called on to testify and questions will be asked to establish the truth behind their findings.  Remember, just because one doctor says something is so does not necessarily mean that that is the case.

The workers’ compensation system’s guarantee of care does not always mean you get an unbiased analysis of your injury and disability.  Sometimes, you have to fight to be treated fairly.  An IME is one tool that a skilled workers’ compensation attorney has at their disposal.  You need experience to use the tool well.  If you have been injured in South Carolina at work, there is help for you out there.  Skilled attorney Dan Pruitt has over 20 years of experience representing clients just like you.  Give him a call today at (864) 232-4273 to set up your free consultation and get the help you deserve.

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