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Medical Care for Injured Employees and “Independent Medical Examinations” According to Massachusetts Law

Massachusetts workers’ compensation lawyers are familiar with the tactics and strategies used by employers and their insurance companies to deny benefits to injured employees. Often, medical treatment and initial diagnoses serve as the foundation for challenging an injured employee’s claim for benefits.  The insurer selects a doctor for an initial examination of the employee, and according to the law, the employee must submit to this examination, despite the fact that it is not truly impartial.

hospital room

According to workers’ compensation laws, reasonable requests for an exam by an insurance company doctor must be heeded. Known as an “Independent Medical Examination” (IME), this initial examination is not treatment, and the insurance company cannot charge claimants for this visit. Additionally, the insurer should reimburse the claimant for reasonable travel expenses.   Once the claimant has completed their IME, they choose the doctor who will treat them for their health problem.

An “IME” is performed by a doctor who is not necessarily going to serve as the injured employee’s treating doctor. In uncomplicated cases, the insurance company may not request that an employee undergo this examination  It is important to understand that an IME is not necessarily independent, since the doctor has been selected by the insurance company, and the report is intended to allow the insurer or the employer to deny or support the claim for compensation.

Employees are required to attend an IME if it has been ordered by the insurer.  A failure to do so may provide the workers’ compensation insurer with the right to cease payment of weekly disability benefits. Additionally, the insurer is required to abide by rules concerning scheduling and conducting the examination.

Following the IME, employees have the right to choose their own doctor for treatment. When an employer has a “preferred provider,” they may require that the employee see this doctor for the first visit.  Following this initial visit, the employee is free to go to their own doctor.

After a doctor’s visit, claimants should request a copy of their report and all corresponding documentation.  The workers’ compensation insurance company for the employer is responsible for the bill, and employees should not pay co-payments.  Additionally, requests may be made for travel reimbursement costs for travel to and from the doctor’s office.

According to Massachusetts workers’ compensation law, workers’ compensation benefits cover the payment of medical bills related to health problems caused at work, as well as lost pay due to the health problem.  At Pulgini & Norton, our workers’ compensation attorneys represent individuals hurt at work who are pursuing a workers’ compensation claim.   To understand your legal rights and obligations, contact our office at (781) 843-2200 or complete our online form. We can schedule a no-obligation, free consultation with a dedicated workers’ compensation lawyer.

More Blog Posts:

Reviewing Board Recommits Case After Massachusetts Judge Erred in Failing to Consider Injured Employee’s Properly Admitted Evidence and Set Forth Disability Findings Inconsistent with Date, Massachusetts Workers’ Compensation Lawyer Blog, July 6, 2017

Massachusetts Review Board Finds Employee’s Lyme Disease Was Caused by Exposure During Work For First Employer; Causation Established and Closed Period Benefits Awarded, Massachusetts Workers’ Compensation Lawyer Blog, May 25, 2017

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