The answer, unfortunately, is “yes.” Your employer or their attorney or insurance carrier can request that you submit to an examination by their own selected physician. You have some ability to object to the physician selected by your employer, but most Administrative Law Judges will make you undergo the examination itself, absent a truly compelling reason.
Challenges From Your Employer
Even in an otherwise accepted workers’ compensation claim, your employer can contest certain aspects of your medical treatment. For example, your employer may challenge any of the following regarding your medical treatment:
- Your need to receive continued medical treatment.
- Your physician’s decision to perform surgery.
- Your physician’s determination that you should remain out of work.
- Your physician’s determination that you have a permanent injury.
Although workers’ compensation is not designed to be adversarial between the injured employee and the employer, issues often arise regarding a claimant’s medical care and treatment that prompt an employer to seek its own physician’s opinion.
Respondent’s Medical Examination
At any time while you are receiving workers’ compensation benefits or while you are claiming the right to obtain workers’ compensation benefits, your employer may request that you submit to an examination by a different physician than your attending physician. This request is known as the Respondent’s Medical Examination (“RME”). This examination is fully paid for by your employer’s workers’ compensation insurance carrier. The purpose of the RME is to determine the nature or the extent of your injury and whether the current course of treatment is both reasonable and medically necessary. The RME physician will examine you, and they will then write a formal report that will state their opinions about your injury, your treatment, and your prognosis.
The RME used to be called the IME (or “Independent Medical Examination”). Although, in theory, this examination was an “independent” assessment of your injury and treatment, the examination was hardly independent in practice. Your employer’s insurance carrier paid for the examination and usually had its own roster of doctors who specialized in performing examinations for insurance carriers. The results of the examination were typically less than desirable from the employee’s perspective. The physicians who were helpful to the insurance carriers by questioning the employee’s injuries or treatment were used again and again. Frankly, these doctors knew who buttered their bread.
Thankfully, most of those physicians are no longer participating in workers’ compensation examinations. After some internal reform throughout the system concerning the nature of the employer’s examinations, the RME physicians can confirm, object to, or suggest alternatives regarding your diagnosed injuries or your recommended medical care and treatment. Their written reports must be furnished at the same time and in the same manner to both the employee and the employer (or their respective legal representatives) within thirty (30) days of the completion of the examination. Our attorneys have found, more often than not, the results of the RME can assist the employee in resolving the case. Think about it. If your employer’s insurance carrier’s own doctor agrees with your treating doctor, your case is made.
Under our workers’ compensation laws, you must submit to the employer’s medical examination upon a “reasonable” request. Reasonable is a term of legal art. Who can truly say what is reasonable or what is unreasonable? For purposes of workers’ compensation RMEs, a request is only considered unreasonable when it involves lengthy or difficult travel or the selected physician has a verified conflict of interest with the claimant.
Undergoing the RME
Refusing to be examined in an RME without cause may suspend your eligibility for continued workers’ compensation benefits, including wage replacement benefits and payment of your continuing medical bills.
When you are requested to undergo an RME, you will be notified of the date, place, the examining physician, the scope of the examination, and what materials you need to bring with you (often your diagnostic films like x-rays or an MRI). If you intend to object to the RME, you must do so in writing by requesting an Informal Hearing before the Administrative Law Judge. There are several reasons why you might object to the RME. First, you might have actual difficulty in traveling to the examination if the RME physician practices in a different area of the state. Second, if you have a conflict of interest with this physician, you have a reason to object. Examples of conflicts of interest include if the RME doctor is friendly with your ex-spouse, or perhaps you once sought treatment from the RME physician for another injury, and you did not get along. Another reason to object would be if the RME physician has a different specialty than your attending physician. Even if the objectionable physician is removed by the Administrative Law Judge, you can expect that another physician will be designated by your employer. Ultimately, you will likely need to submit to the RME.
Employer’s doctor’s examinations raise complications to your workers’ compensation case. The results of the examination could impact your benefits. If you receive notice of an RME, contact our attorneys right away.