Quick Definitions: Independent Medical Evaluation (IME)

An Independent Medical Evaluation, or IME, is a one-time examination that can be requested by either the Employer/Insurer or the Claimant. An IME is simply a way to obtain additional evidence, or simply some evidence to support the position of either party in the workers' compensation claim. For instance, if the Claimant's authorized treating physician (ATP) gives the opinion that the Claimant's injured back is fully healed, a Claimant may want to obtain an IME to contradict the ATP's diagnosis. This evidence can come in extremely handy at a hearing or during settlement negotiations.

I disagree with my authorized physician's diagnosis. Can I get a second opinion?

If effect, yes. Under Georgia law, a Claimant is allowed to seek a second opinion with a physician of his or her choosing (in other words, it is not limited to a care provider listed on the panel of physicians) at the expense of the Employer so long as several criteria are met. This one-time second opinion is known as an Independent Medical Evaluation (IME). Again, this is a one-time evaluation--not a change in the authorized physician. Unless you seek an official change of physicians, you will continue treating with your authorized treating physician (ATP) after the IME. 

The criteria are spelled out in O.C.G.A. 34-9-202(e):

1. The injury at issue must be an "accepted compensable injury." Basically, this means that the Employer must not be disputing that the injury is covered by workers' compensation coverage.
2. The examination is being sought within 120 days of the receipt of any income benefits (either TTD, TPD, or PPD benefits).
3. The examination must take place at a reasonable time and place, within Georgia or within 50 miles of the Claimant's residence.
4. The examination must be performed by a duly qualified physician or surgeon.
5. The Claimant must give advance notice, in writing, to the Employer of the examination.
6. The examination cannot repeat any diagnostic procedures that have already been performed on the Claimant since the injury, unless the costs of the procedures which are in excess of $250.00 are paid for by a party other than the Employer or Insurer.

An IME can be an extremely valuable tool for a Claimant when negotiating a settlement. Because a Claimant only has the ability to obtain one IME, it is imperative that great care be taken when choosing the IME physician. If you are dissatisfied with the care you are receiving from your treating physician, please contact us to discuss your options.

My doctor gave me two impairment ratings for the same body part. Which one applies?

It is not uncommon for an ATP to assign two separate PPD ratings pertaining to the same body part. For example, if you injured your shoulder, you physician may assign a 15% impairment rating to your shoulder and a corresponding 7% impairment rating to the "whole body." In situations like this, the rating which yields the highest number of weeks of payable benefits is the applicable impairment rating.  This is an extremely important thing to remember when discussing a potential settlement of your claim.

In this example, the 15% shoulder rating would be used to calculate the number of weeks that PPD benefits are payable, because it yields 33.75 weeks of benefits, compared to 21 weeks for the 7% "whole body" rating. As you can see, this would make a huge difference in the total amount of PPD benefits you receive! For more information on how PPD benefits are calculated, please look here.

It's important to note that this post only pertains to those situations where the impairment ratings relate to the same body part. In other words, the rules are different if you suffer an injured leg and an injured arm in the same work accident, and your doctor assigns separate ratings for each of those body parts.

Did You Know? (Surveillance Edition)

Did you know that the insurance company of your empoyer can hire a surveillance company to follow you around to try to obtain footage of you acting in a way that might undermine your workers' compensation claim? I'm not posting this to scare anybody, but it's an important thing to be aware of if you're involved in workers' compensation litigation. Seems pretty sneaky, but it's legal.

Now, it's one thing if the surveillance company catches you lifting heavy weights for an hour at the gym--but from my experience, surveillance footage is usually from a distance and only captures the target for very brief periods of time. Accordingly, it can be taken completely out of context and not be an accurate depiction of how you really feel at any given moment. This is precisely why you need to make sure that your interests are represented if the employer tries to use surveillance footage against you, whether it's at trial or during settlement negotiations. Having an experienced workers' compensation attorney on your side can make all the difference in these types of situations. If you have any questions about your claim, even if you're not in the Athens, Georgia area, give us a call and we'll do everything we can to help you.

Do I get compensated for pain/suffering/disruption of lifestyle in the workers' comp system?

Unfortunately, workers' compensation law does not provide any sort of remedy for pain and suffering associated with your work injury. Workers' compensation law does not provide any monetary relief for the general disruption of your lifestyle and the aggravation or inconvenience which was caused by your work injury. This is obviously a very difficult reality to face, because oftentimes the financial remedies that are provided by the law don't come close to compensating you for the difficulties faced after a life-changing injury.

If you've sustained a work injury, there are only three kinds of relief that can be provided in a workers' compensation context: (1) lost wages (TTD or TPD benefits); (2) permanent impairment of physical capabilities (PPD benefits); and (3) medical care.

If you have any questions about your workers' compensation case, please let me know. Even if you're not in the Athens, Georgia area, we will gladly do everything we can to assist you with your claim.

Judge: Online Privacy is just "wishful thinking"

“Privacy is no longer grounded in reasonable expectations, but rather in some theoretical protocol better known as wishful thinking.”

Pretty harsh—but also pretty accurate. This is the language from the judge in a recent ruling in the New York case, Romano v. Steelcase Inc., 2010 WL 3703242 (N.Y.Sup. September 21, 2010) regarding online privacy. I found this case on Twitter through @internetcases, which is the profile of Evan Brown, an attorney in Chicago. You can read his summary of the case here.

In essence, this case addressed whether information on the Plaintiff’s Facebook and Myspace pages could be withheld during discovery, irrespective of her privacy settings. (“Discovery” is a legal term describing a period of time during which the parties use various methods to gather as many facts as possible about the case). As you can tell from the quote at the top of this post, the judge determined that all of the contents had to be turned over to the other party.

Tip:  While this isn't a Georgia case and doesn't pertain to workers' compensation, there's nonetheless an important lesson to be learned here: social media sites can affect your case in a negative way, and courts aren’t allowing people to hide harmful information. And based on this ruling, this is true even if you think you have “hidden” it from the public in your personal privacy settings, or if you have deleted certain content! (Yep, Facebook and Myspace store deleted information). So, again, be careful what you broadcast to the public, because it may very well come back to bite you.