Did you know that you can file a complaint against an IME doctor if the doctor does not perform his or her professional duties? And that L&I takes these complaints very seriously? This applies for both L&I claims and self-insured employer claims.
The role of the IME doctor
One of the most common complaints I receive as an attorney for injured workers has to do with Independent Medical Examinations (IMEs) . L&I and self-insured employers can compel injured workers to attend IMEs, and failure to attend an IME when requested can result in suspension of benefits. However, IMEs are designed to establish clinical observations and conclusions about an injured workers’ condition. L&I expects IMEs to be high quality, and to help protect the rights of workers and employers in Washington state by enabling accurate and even-handed industrial insurance benefit payment.
According to the Department of Labor and Industries (L&I), IMEs should provide unbiased, accurate and comprehensive information, and should be carried out with dignity and respect for the worker. Therefore, whenever I hear a report that an injured worker has had an un-dignified experience during an IME, I recommend filing a written complaint with L&I so that the undignified behavior is documented and investigated. The complaint form can be found here: http://www.lni.wa.gov/forms/pdf/F245-053-000.pdf .
IME Statistics for 2018
Because I am a member of WSAJ (The Washington State Association for Justice), today I received a summary of a recent Labor and Business committee meeting in which IME complaints were discussed. I was very interested to learn that when data from 2018 was studied, it was discovered that 21,431 independent medical examinations occurred
on state funded claims in 2018. Those exams were performed by 448 approved IME examiners. Out of over twenty-thousand examinations preformed, 419 complaints were logged, mostly regarding orthopedic, neurologic and psychiatric examiners. However, even more interestingly, of the 419 complaints logged, 48% of the complaints came from case managers and occupational nurse consultations, while only 38% of the complaints came from injured workers. This statistical data suggests that L&I is genuinely interested in having IMEs conducted in an appropriate manner and actively takes steps internally to document inappropriate IMEs.
Were you mistreated? File a complaint!
In addition to documenting IME complaints, L&I has an occupational nurse consultant whose job is to review IME reports, to investigate complaints, and to conduct random reviews. The occupational nurse consultant will also review
the companies that perform IMEs through site visits to learn about on-boarding and examiner training. Moreover, the consultant will review confidentiality and chain of custody for sensitive medical information, provide quality oversight, review scheduling, and address the requirement for 14 day turn around for IME reports and addendums.
However, to a certain extent, L&I’s ability to ensure quality in IMEs is only as good as the information it receives. L&I has dedicated resources to implement quality assurance in the IME process. Therefore, it is important for injured workers to document any IME behavior that deviates from L&Is goals of having dignified, respectful, unbiased, accurate and comprehensive IMEs, by filing a written complaint so that L&I can investigate. In addition to completing L&I’s IME comment form, complaints can also be submitted via email to email@example.com. However, it should be noted that the IME complaint will likely be shared with IME examiner so that
they are given an opportunity to respond to the complaint.