Real Case: Be Careful with Workers’ Comp Independent Medical Exams

Most Louisiana workers have no idea how multiple details in the law controlling workers’ compensation could make or break your effort to get vital financial assistance if you’re hurt on the job.

One part of the process can include getting an independent medical exam (IME). That’s when you go to a third doctor—not your own doctor or a doctor picked by your employer or their insurance company—for a third opinion on whether your injuries qualify for workers’ comp benefits.

If a workers’ compensation judge orders a new exam, you need to cooperate. Sometimes you could be the one asking for the IME. But you also need to protect your rights when your employer or a workers’ comp insurance company is trying to deny your benefits and pushing for you to get an IME.

This is something most workers would never know about: Your employer has to follow highly specific steps under the law in order to request an independent medical exam for you.

If they don’t follow the steps, you need to stand up for yourself. But possibly the only way you would know what to do is if you’re working with an experienced workers’ compensation lawyer.

Our Louisiana workers’ compensation law firm had a case like this recently—where an employer wanted an IME, and a worker’s ability to get benefits for her physical recovery and financial stability was on the line.

Keep reading to see what happened—and how this situation might apply to you if you’re hurt at work and your boss wants you to see another doctor.

Louisiana Workers’ Comp: When Medical Opinions Conflict

This case started with a health care worker injuring her neck and back while dealing with a disorderly patient at a senior living center.

Her employer, Peristyle Residences, denied that the injury happened and asked for an IME.

The employer and its insurance company, LUBA Workers’ Comp, argued the additional medical exam was needed because the employee’s doctor said her neck problems and back problems were caused by her workplace injury—while the company doctor said she had pre-existing back and neck diseases and no new injuries.

The companies even went as far as suggesting she was pretending to be hurt at work in order to get out of working.

When employers and insurance companies push around hard-working Louisianans like this, the workers’ comp attorneys at Workers’ Compensation, LLC, push back.

Her attorney, Tim Benedetto from Workers’ Comp, LLC, fought this attempt to get another doctor involved—and he succeeded.

Tim succeeded because he was able to call out the assisted living center and insurance company for trying to skip an important step when asking for an IME.

Next we’ll explain how…

How Louisiana Workers’ Comp Rules Decide Whether You Get an IME

The lawyer for the companies directly asked a workers’ comp judge reviewing the case for the worker to get an IME.

But under the workers’ comp rules in Louisiana, if a worker or employer wants an IME, they’re supposed to submit that request to the assistant secretary of the Louisiana Office of Workers’ Compensation.

In this case, Peristyle and LUBA didn’t file that request.

The workers’ comp judge said she can decide on her own to ask for IME, but the parties to the case need to file with the state if they want one.

The judge said if she decides she needs another medical opinion, she’ll order one. But for now, she declined the companies’ request for a new exam.

So the companies took their effort to get this IME to a higher court—the Louisiana Fifth Circuit Court of Appeal.

There the lawyer for the employer tried to argue that conflicting medical opinions require a third opinion under the law.

But the worker’s lawyer, Tim Benedetto, argued anyone wanting an IME still has to follow the process of asking the state Office of Workers’ Compensation to appoint the new doctor.

The appeals court judges agreed—the process in the law is the process you have to follow—and denied the employer’s request to appoint a doctor for an independent exam.

What the IME Ruling Means for People Hurt at Work in Louisiana

This decision will have a tremendous effect on all Louisiana workers’ comp cases in the future.

By ruling out attempts by employers to get IMEs without following the steps outlined in the law, the decision helps eliminate unnecessary delays in getting injured workers the care and treatment they deserve.

In addition to money to pay your bills when you can’t work due to an injury, workers’ comp pays for the medical care you need to recover.

The case demonstrates another important fact about workers’ comp in Louisiana: You should always get care for a job injury from your own doctor, who will look out for your needs better than a company-appointed doctor.

And all along the way, having a skilled workers’ compensation lawyer by your side can help you make sure you get all the help you’re entitled to receive to move forward after a job injury.

If you’ve been hurt at work, talk to the lawyers at Workers’ Compensation, LLC.

(Case: Louisiana Fifth Circuit Court of Appeal, No. 22-C-249, Maria Navarre vs. Peristyle Residences, LLC, and LUBA Casualty Insurance Company.)

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