If you're involved in a personal injury or workers' compensation case in Connecticut, you may be asked to undergo an Independent Medical Examination (IME). An IME is a medical evaluation performed by a physician who is not involved in your treatment, typically selected by the insurance company or the opposing party. The purpose of this examination is to provide an objective assessment of your medical condition, the extent of your injuries, and the necessity of ongoing treatment.

Understanding when and why IMEs are required in Connecticut is important for anyone navigating personal injury or workers' compensation claims. These examinations can significantly impact the outcome of your case, influencing decisions on compensation and the approval of medical treatments. This article explores the circumstances under which IMEs are mandated in Connecticut, the laws governing them, and what you can expect during the process.

Legal Framework for IMEs in Connecticut

In Connecticut, the requirement for an IME is often rooted in state statutes and regulations, particularly concerning workers' compensation cases. According to Connecticut General Statutes § 31-294f, an injured employee must submit to an examination by a reputable practicing physician or surgeon upon the reasonable request of the employer or at the direction of the administrative law judge. This examination aims to determine the nature of the injury and the resulting incapacity. The physician is selected by the employer from an approved list prepared by the chairperson of the Workers' Compensation Commission and is paid by the employer. The statute also stipulates that refusal to submit to a reasonable examination can result in the suspension of compensation rights during the period of refusal.

When Are IMEs Required?

Workers' Compensation Cases

IMEs are most commonly required in workers' compensation claims when there is a dispute about the severity of an injury, the necessity of medical treatments, or whether an employee can return to work. Employers and insurance companies may request an IME to verify the claims made by the injured worker and assess whether the proposed treatment plan is appropriate.

Personal Injury Lawsuits

In personal injury lawsuits, such as car accidents or slip and fall cases, the defendant's insurance company may request an IME if they dispute the extent of the plaintiff's injuries. If a plaintiff is seeking compensation for medical expenses, lost wages, and pain and suffering, an IME can provide evidence to challenge or support these claims. Courts may order an IME if there is conflicting medical evidence presented by both parties.

Insurance Disputes

In cases where an insurance company is handling a claim for disability benefits or medical expenses, they may require an IME to confirm the legitimacy of the injuries being claimed. Insurance providers use IMEs to determine whether the injury is as severe as claimed and whether it warrants continued coverage for treatment or disability payments.

What to Expect During an IME

If you are required to undergo an IME, it is important to understand what to expect during the process:

• Selection of the Doctor: The insurance company or employer usually selects the doctor, who is expected to provide an objective evaluation.
• Medical History Review: The physician conducting the IME will review your medical records, previous treatments, and any diagnostic tests related to your injury.
• Physical Examination: The doctor will conduct a physical examination to assess your current medical condition.
• Report and Findings: After the examination, the doctor will prepare a report that may be used as evidence in your case.

Since the IME doctor is chosen by the insurance company or employer, their assessment may not always be in your favor. Therefore, it is beneficial to consult with an experienced attorney who can guide you through the process and ensure your rights are protected.

Call Brandon J. Broderick for Legal Help

Undergoing an Independent Medical Examination may be a pivotal moment in your case. If you have concerns about the IME process, its fairness, or its impact on your claim, consulting with an attorney can provide the support and legal guidance you need. Brandon J. Broderick, Attorney at Law, has a team of CT personal injury lawyers who can help.

Contact us today for a free consultation.