Independent Medical Exams Are Rarely Independent

By Jason Weinstock on November 3, 2014

 When an injured worker in Nevada gets a letter requiring attendance at an "independent medical examination",  it’s reasonable to assume that the doctor will in fact be independent and objective.  Unfortunately, there is nothing independent about an adjuster choosing which doctor will second-guess  another doctor’s opinion.  For example, if a treating doctor reports that a herniated disc was caused by the work accident, and the adjuster doesn’t like that diagnosis, the adjuster might require that the injured worker attend an "independent medical exam" (IME) with a doctor the adjuster knows will instead diagnose just a lumbar strain. 

I see the same doctors used again and again by some adjusters because they can rely on the IME doctor to give the "right" answers to a letter the adjuster sends only to the doctor.  Not all adjusters engage in this unfair practice, but enough do that it is a problem.  The adjuster should at least be honest about what the exam is and call it a consultation ordered by the insurer or employer. 

Knowing that an IME doctor is not really independent, can an injured worker refuse to attend the exam?  No, unfortunately, not. . Nevada law allows an adjuster to schedule a consultation with a physician the adjuster chooses, and if the injured worker won’t attend the appointment, his benefits can be suspended until he does attend.  NRS 616C.140. 

 If the injured worker is represented by an experienced workers’ compensation attorney, there are various strategies to counter the loaded IME.  One is to file an appeal immediately upon receipt of a letter from the adjuster scheduling with a known defense doctor.  Once the claim is in litigation, an appeals officer could order another IME, but one that is with a doctor agreed upon by the attorneys.  If the attorneys cannot agree on a doctor, the appeals officer usually asks the attorneys to give the appeals officer three names, and the appeals officer chooses the doctor.  The appeal officer will also order that no one but the injured worker speak to the IME doctor, and the IME doctor must answer only questions asked by the appeals officer in a document called an interim order.