Tara Reck, Managing L&I Attorney at Reck Law PLLC - Workers' Compensation Attorneys

L&I Claims and the Bias in Independent Medical Exam (IME) Reports

Independent Medical Examinations (IME) are part of every L&I claim and workers’ compensation claim in Washington State. Doctors that perform IME exams must have a certification from the Department of Labor and Industries (L&I). When performing IME tests, doctors have to abide by certain rules and regulations. These rules are available in L&I’s Medical Examiner Handbook.  However, if that’s the case, then why is there bias in IME reports?

 

Bias in workers’ compensation IME exams

As a workers’ compensation attorney, in my experience, IME doctors often demonstrate clear bias. In many cases, they ignore relevant sections of the law and ignore accepted conditions under the claim. Furthermore, it’s common to see internally inconsistent exam notes and reports. Interestingly, L&I still accepts the results of bad IME tests. Even though they are undoubtedly contrary to the law and to the facts of cases and claims. Personally, I’m fed up with this trend, which neither helps L&I nor work injury claimants.

 

The reality of IME exams in L&I claims

Here are some examples of issues from actual cases.

Clearly biased 

I recently cross-examined an IME provider who opined that the work injury claimant did not want to return to work. An opinion like that is nothing but biased, especially when it comes to the facts of the case. Looking at the facts, my client has been working and maintaining a job since the time of the examination.

 

Ignoring the law 

In another workers’ compensation claim, the IME doctor states that the injured worker doesn’t need additional treatment. Furthermore, the doctor said that if the claimant needs a new MRI, then the MRI is not a treatment rather it’s diagnostic. The doctor’s response made my blood boil. In Washington State, people that suffer a work injury are eligible to receive necessary and proper health care services.

 

Ignoring accepted conditions 

I recently received and reviewed an IME report. I was shocked when I saw the IME provider arguing that the complex medical condition does not exist. All while the work injury claimant is receiving ongoing treatment for the condition on a monthly basis. On top, L&I accepted the condition as final and binding years ago. At this point in the L&I claim, it’s very possible that L&I will accept the IME’s opinion. I won’t be surprised if L&I uses the wrongful report to make adverse determinations in this workers’ compensation claim.

 

Internally Inconsistent 

I came across yet another IME report the other day. Here, L&I asked the IME examiner to consider 3 possible jobs for my client following the work injury. All three jobs require prolonged standing on feet, which the work injury claimant can’t tolerate because of their industrial injury.  In the report, the IME examiner disapproved 2 of the jobs. However, for reasons unclear to me, the IME doctor approved the 3rd job. Even though it also requires prolonged standing. L&I terminated time-loss compensation benefits and closed the workers’ compensation claim.

 

Some personal notes and conclusions

IME exams are now big business in Washington State. Unfair and biased exams don’t help L&I because as an L&I attorney, I’m ready for a legal fight. The fight is very costly to L&I. These IME reports also don’t help people that had a work injury. It stalls their L&I claims and their ability to return to work.

 

I believe that L&I needs to revisit the misuse of IME exams. They need to employ corrective measures. That means obtaining unbiased and consistent opinions. IME tests must rely on the facts and the reality of cases and claims. They must also comply with workers’ compensation law in Washington State.

 

4 Comments

  1. Michael

    As I read your comments – all are true. I have been victimized by these so called IME doctors. Claim canceled because of the every day harassment from the city’s attorney and human resource supervisor. My doctor closed my he told me as I came in on an emergency from my left arm paralyzed from a head injury and two criminal attacks I received from three coworkers at work. My files X-rays of my neurologist and other doctors are missing. Fraudulent doctors staff nurses falsely documenting records on my behalf 18 years. I suffer from a severe brain injury as my brain doctor from the UW has told me .

    If you can help me find a way to get the facts straight to L&I in Olympia don’t hesitate. I recently spent about 25,000 and got no where because of the true facts of what’s been going on and my attorney refused me of the truth. I was told that the city’s attorney pays whatever it takes for these IME doctors to lie about your injuries. And that’s why my claim has been closed an that I can’t get it reopened. I have even been threatened by three of the city’s supervisors not to get any MRI to support my case. If you have any idea how to help me please call me. Thanks for letting me contact you -Mike

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      Ampy

      Did any one help you??

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        L&I attorney

        Hello Ampy. I am unable to provide legal advice here on the website. If you wish to have a free consultation and speak with an attorney, please call us at the numbers provided on the homepage at https://tarareck.com .

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    Ampy

    I am willing to stand with whom ever is willing to stand up to L&I. I am more than determined to help. What L&I does to its injured workers, jumping through hoops to get any real help till you say lawyer. Shameful! It seems that they feel as though they don’t pay pain and suffering they can let you painfully suffer while they may approve any real medical help. Constantly blocking and saying my injury (2 large herniated discs) and numbness in my left arm and pins and needles in my left hand, with shock waves from hands to neck and back, is a “new” injury. Those conditions was the reason I went in after my work injury. It has been my injury issue from the start.

    Took over 6 months before they would allow an MRI. Even though the MRI images shows large herniated disc in my neck. They dismiss it. Because i’m old, it just happens. It happens to old people out of no where?? Uhhm what??? I am only 45, 44 at the time of the accident. I had a display rounder full of linens hit my head at a unknown velocity. While my left arm was out stretched to push the button to adjust the unit and my right extended out holding the out bar of the rounder display full of linens. Etc…

    L and I gave me the run around every turn when my doctors request approval for treatment. Saying that my injury is not work related. Even though I have never had any issues or pain before my work accident. Only will accept an unknown head injury and thorax strain. The system is broken and needs fixed!

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