Workers Compensation Medical Examination

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When you are injured at work, you need to prove that you sustained an injury in order to collect workers compensation. If your injury rendered you unable to work, you also need to prove this temporary or permanent disability.  In some states, this can involve proving a certain level of impairment.

Medical Examinations and Work Restrictions

When you are injured at work, it is important to go to a qualified doctor who can document your condition. If your injury is severe and may result in short term or long-term disability, this is especially important. Worker’s compensation claims can provide you with short term or long-term disability benefits if your doctor deems your disability severe enough to preclude you from working. In some states, this decision is stated in terms of level of impairment.

Your doctor will have to do a comprehensive medical exam, including MRI’s, X-rays and other necessary tests. These tests should all be thoroughly documented. Once your doctor makes a diagnosis, your doctor will usually determine whether you are to be restricted from working, released to work in some capacity, or whether you are capable of doing your normal job. This statement, along with supporting evidence, is used in your worker’s compensation claim.

Although you are entitled to choose your own doctor, in some states the State Worker’s Compensation Board must certify the doctor. Furthermore, you may want to choose a doctor who has experience in worker’s compensation claims, since your doctor will have to make evaluations regarding your level of disability under workers’ comp guidelines.

 In some cases, the workers’ comp insurer may not take the word of your doctor. They may request that you got another exam by a different doctor. This is called an independent exam.

Workers Compensation Independent Medical Examinations

The insurance company usually requests an independent medical exam when a worker’s compensation claim is being contested. Although you have a doctor who has already certified your injuries, the insurance company usually has a right to have those injuries verified by their own medical experts. In some cases, if you are claiming multiple injuries, you may have to have several exams by several different independent medical examiners.

If you have an attorney, the insurance company may negotiate with your attorney to arrange for you to take an independent medical exam. If you don’t have an attorney or you don't agree to take an independent medical exam, the insurer may get a court order requiring you to submit to one. Failure to submit to an independent exam after a court order may subject you to contempt of court and may prevent you from recovering under your claim.

This exam is not conducted for the purposes of providing you with treatment. It is conducted to determine whether you are actually injured, as you claim to be. Your attorney can help you prepare for the exam, and the doctor may scrutinize you carefully for signs that you are lying in some way, either by exaggerating your injury or hiding facts surrounding the cause of injury.

Workers Comp Doctor Examination Requirements

Although you need to receive medical treatment for your injuries, doctor’s examinations for worker’s compensation must also serve a legal purpose. The exams, both by your doctor and by independent medical examiners, must evaluate the extent of your disability in order to determine your benefits.   Because of this specific situation, the requirements for the exam may be different then if you were just going to the doctor on your own because you got hurt.

One specific difference may involve a disability rating or a fundamental capacity exam. These exams are used to determine the extent of your limitations. If you are given a high disability rating, this means that your injury was severe enough to render you unable to work. The same is true if your disability interferes with a sufficient number of fundamental capacities to prevent you from returning to work.

Process of Undergoing Worker’s Comp Exams

The specific process for worker’s compensation exams depends upon your injury. You may have to visit specialists, including orthopedic surgeons or neurologists, depending on the type of claim you make. Any injury you wish to recover benefits for must be examined and documented.

Getting Legal Help

An experienced worker’s compensation attorney can help ensure that you are getting the appropriate medical examinations to prove your claim. A job-injury attorney also will have experience with independent medical exams and can help prepare you so the process is less frightening. Any visit to a doctor when you are hurt can be scary, and there is no reason to feel as though you are alone in the process when a qualified worker’s compensation attorney can help guide you along the way.

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