How Can The IME Doctor Claim I Am Fully Recovered When I Am Not?

Independent medical doctors under the Pennsylvania Workers’ Compensation Act are not “independent”. They are hand picked doctors- not by the presiding Judge, but by the employer or insurance carrier. The IME doctors do not treat an injured worker. They simply examine the injured worker, review medical records, and take a history. Then, they issue a report with their findings.

In many cases, the IME doctor will characterize the work injury as a mere strain or sprain. By characterizing the work injury in this minimal way, it becomes much easier to opine that the injured worker has made a “full recovery”- as sprains and strains only tend to last for a few days to perhaps a few months. They try to bolster their opinion by claiming a lack of “objective findings” to support the “subjective complaints”.

In contrast, the treating doctor- who actually treats the injured worker rather than getting a quick snapshot of their condition-is more likely to recognize the true extent of the injury. Whereas IME doctors like to hang their proverbial hat on “pre-existing degenerative changes” (ie, arthritis) as the cause of the current symptom complex, the treating doctor often opines that the work injury aggravated or accelerated those changes. In addition, the medical experts often disagree about the diagnostic studies and whether certain findings are traumatic or degenerative or a combination of both. In cases where the IME doctor blames “arthritis” for the symptoms, it becomes absolutely critical to understand the injured worker’s pre-work injury treatment, if any, regarding the affected body part so that a logical analysis can be undertaken to determine if that theory makes any sense.

No doctor can step into an injured worker’s body and feel the symptoms. So, what happens is the subjective complaints have to be weighed in the context of the other components of the case such as the history, sequence of events, clinical findings, diagnostic studies, etc- in an effort to determine causation (what is causing the symptoms) and extent of disability.

Since many of the experts cancel each other out with their varying opinions, the Work Comp Judges will focus in on the credibility of the injured worker’s testimony- looking at such things as 1) is the injured worker’s testimony consistent with their doctor’s testimony?, 2) do the diagnostic studies correlate with the diagnoses and symptoms? or, 3) did the injured worker give an accurate history regarding how the injury occurred and any pre-existing treatment or symptoms affecting the same body part in question?

Nothing infuriates an injured worker more than an IME doctor issuing a report stating that they have made a complete and full recovery. Luckily, everyone is entitled to due process and has their chance in court to address the report, and to present medical evidence of their own that demonstrates a different point of view.

If you would like more information about Pennsylvania Work Comp Independent Medical Exams, call or email experienced PA Work Injury Lawyer, Michael Cardamone at 215-206-9068 or email mcardamone@krasno.com

Free consults 7 days a week

“Philadelphia Tough, Pennsylvania Proud”.

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