All about WorkCover independent medical examinations (IME) in Victoria.
What is an independent medical examination?
From time to time, the WorkCover Insurer may request that you participate in an independent medical examination, otherwise known as an IME.
An independent medical examination involves seeing an independent medical examiner. This is a doctor that is different to your normal treating practitioner.
They are doctors are engaged by the WorkCover Insurance company.
While your treating doctors have the responsibility of treating your injury and helping you to return to work, the role of an independent medical examination doctor is to answer certain questions that have been put to them by the insurance company.
Their job is not to provide any treatment to you but rather to assess your injury and provide a report back to the insurance company.
In most cases, the independent medical examiner will not have any contact with any of your treating doctors.
Anything you say to an independent medical examiner can be used in their report. Do not say anything to the IME that you want to remain confidential.
Who is able to be an independent medical examiner in Victoria?
The WorkCover insurance companies generally will use the same doctors over and over.
These doctors operate in a range of medical fields in a vast array of specialities. Here’s a short list of doctors that you may be asked to see.
Usually the IME’s are doctors that no longer practice, but this isn’t always the case.
Who organises independent medical examinations?
Independent medical examinations for workers compensation matters are almost always arranged on behalf of the WorkCover Insurer.
As such, it is the WorkCover Insurer who also pays for the cost of the appointment.
Do I get a choice as to what IME I see?
No, the insurance company will organise the independent medical examination appointment for you and they will pick the doctor.
That being said however, if you have seen the doctor before and you were not happy with them, you can ask that the insurer reschedule the appointment with another practitioner.
If you have legal representation, you can pass your concerns on to them and they can discuss the issue with the insurer on your behalf.
Is there anything that I should not say to an IME?
You should not exaggerate the symptoms of your injuries. You should also avoid saying more than you should.
Avoid asking the doctor that you see for a diagnosis and for treatment advice although some doctors will offer this to you.
In what instances might I be asked to attend an IME?
You may be asked to attend an independent medical examination in the following circumstances; if the insurer thinks they need an opinion on the nature of the injury, whether a medical expense you’re wanting to claim is reasonable, whether surgery should be approved, and to assess your work capacity, to assess your whole person impairment rating for the purposes of an impairment benefit (lump sum) claim.
How do I prepare for an independent medical examination?
Prior to the IME appointment, you should make sure you plan your trip and know your way to the appointment location.
This is particularly important if you are travelling from a regional area and the appointment is to occur in Melbourne.
Make sure you know how to get there and allow enough time to travel there.
IME doctors sometimes see many patients on the one day and if you are late, they may not be able to fit you in.
If you miss an independent medical examination, sometimes you can be given a non-attendance fee which can range anywhere from a couple of hundred dollars up to over $1000.
Ensure to bring any relevant scans that you may have had such as MRI, CT or x-rays.
This is of course if you are having an examination of a physical injury. The doctor may not look at them, but it can’t hurt to have them with you.
You may feel under pressure in the appointment and your ability to answer questions maybe be impaired.
For this reason it’s a good idea to make some notes on key things such as what treatment you have and a list of your medications.
Am I entitled to claim costs for attending an IME WorkCover examination?
If the insurance company has organised an appointment for you, then yes you are entitled to claim the cost associated with attending.
You are able to claim travel costs as well as any meal and accommodation costs.
Can my employer legally attend a workers comp doctor appointment?
No, your employer or a representative of the employer should not be attending a workers compensation medical appointment.
How long do independent medical examinations usually last?
The length of assessments usually depends upon the reason for the assessment and the speciality of the doctor.
For example, it is common for a psychiatrist appointment to take longer than say an orthopaedic appointment.
It is also common for an assessment of your work capacity to take much longer than an assessment of your whole person impairment rating for the purposes of an impairment claim.
How long does it take for the doctor to send a report to the insurance company?
Normally, you can expect the insurance company to have the report of the IME doctor within 1 to 2 weeks from the date that they assessed you.
Sometimes It might take longer than this if the issue for which you were being assessed is complex or if for example the doctor requires further information to provide their report.
Will I receive a copy of the IME report?
In most cases the insurer will not provide you with a copy of the independent medical examiners report.
If you do want a copy of the report however, you can ask the insurer for a copy and in most cases they will oblige.
If you have legal representation they can also obtain a copy of the report on your behalf.
I wasn’t happy with the conduct of an independent medical examiner – what can I do?
If you are not happy with the conduct of the doctor you saw, you can lodge a complaint by contacting the insurance company. Ensure to provide them with adequate information about your concerns.
In most cases they will then contact the doctor and ask for a response and you should receive a response within a few weeks.