NSW workers’ compensation claims: What’s an independent medical examination (IME)?

Peter Little

Peter Little

Founder. Director. Accredited Specialist

NSW workers’ compensation claims: What’s an independent medical examination (IME)?

Everyone has the right to go to work each day, knowing they’ll come home safely. If you’ve been injured or become ill at work you may be entitled to make a claim for workers’ compensation to cover lost wages, medical and rehabilitation costs, retraining expenses or a lump sum payment for permanent injuries.

There have been a lot of changes to arrangements in NSW for seeking workers’ compensation in recent years. You could be forgiven for being a little confused about where to start. After all, workers’ compensation laws and entitlements are already a little hard to keep up with because they vary between states and territories and may be known as WorkCover, CTP or WorkSafe. Compensation and benefits can vary greatly depending on your injury and on the law you’re covered by.

If you’ve been injured at work in NSW, Littles has you covered. This blog explores the requirements around Independent Medical Examinations (IMEs).

Read more here:

Want to know what the process is for claiming workers’ compensation in NSW? Here’s how! – Littles

Do I need a lawyer to run my NSW workers’ compensation claim? – Littles

If you have a workers’ compensation claim, it’s likely that you’ll be asked at some stage to undergo an IME – either by the employer’s insurer, or your own solicitor. We see a great deal of confusion about what IMEs involve – including that their general practitioner, or another treating specialist, will be their IME doctor, or vice versa.

Remember: the IME doctor is not there to treat you, and you are not their patient. The doctor will report back to the insurer, or your lawyer, on the examination, and everything you say during the examination.

We know that being examined by a doctor you are unfamiliar with as part of a legal process can feel stressful and daunting. If you’ve been injured at work in NSW, it’s worth speaking to an experienced law firm like Littles. We’ll be on your side.

What is an IME?

An IME is an examination by a doctor with a specialty relevant to your type of injury. For example, if you have a psychiatric injury, you might be asked to see a psychiatrist IME doctor. If you have a back injury, you might be asked to see an orthopaedic surgeon or a neurosurgeon. If you have a brain injury, you might be asked to see a neurologist.

The doctor is provided with a brief of information by the referrer, be it your own solicitor or the employer’s insurer. The doctor will:

· review that information

· interview you (which may involve asking a range of questions about your medical history, what caused your injury, how the injury affects you now, and the treatment you have received), and

· depending on the type of injury you have: – administer various tests; and/or – carry out a physical examination (if you have a physical injury).

Why have I been referred for an IME?

The insurer, or your solicitor, might need an opinion on:

· what caused your injury

· the medical treatment which is reasonably necessary for your injury

· your capacity for work, or

· the level of permanent impairment you have sustained as a result of your injury.

What happens after the IME?

This depends on who referred you to the IME doctor.

If the IME referral was by the insurer, the doctor will provide a copy of that report (or sometimes just a part of it) to your nominated treating doctor (such as your general practitioner). The insurer will only provide a copy of that report to you if the insurer decides to use the report to:

· decline liability for all, or part of, your claim, or

· reduce your workers compensation benefits.

If the IME referral was by your lawyer (if you have one), your lawyer will review the report and explain to you what it means and how it is to be used in relation to your claim.

Who pays for the IME and associated costs?

The referring party pays for the cost of the report. If the referring party is the insurer, they will also pay for the cost of travel – whether that be flights, accommodation, mileage or meal expenses.

If the referring party is your lawyer, and you have funding from the SIRO for your claim, it will pay the cost of travel – including flights, accommodation, mileage or reasonable meal expenses. If you are an exempt worker (a police officer, firefighter or paramedic) and unable to obtain funding from the SIRO, your lawyer will usually pay the cost of travel, and will be reimbursed by the insurer for these costs at the successful conclusion of your claim.

What if I have a problem with how the IME went?

If you’re not happy with anything during the examination, you should tell the doctor immediately.

If you need to undergo a physical examination, you should not be in pain during, or after the examination. If you feel your injury has been worsened by a physical examination, you should immediately report this to the doctor, the insurer, and your lawyer.

Don’t delay – seek advice now

Clearly, the workers’ compensation system can be complex, which is why it helps to seek quality legal advice as soon as possible. At Littles, we are experts in workplace injuries, and can help manage the process to ensure that you receive all appropriate entitlements and support. With Littles on your side, we can ensure that you get the fair treatment you deserve.

If your workers’ compensation claim has been rejected, or you would like to understand how to claim benefits to support you and your family while you are injured or ill, please get in touch for a no-obligation chat.

Read more here: Help! My NSW workers’ compensation claim has been rejected. What do I do? – Littles

IMPORTANT: There are strict time limits for making and disputing a claim, so take advantage of our FREE initial consultation and get in touch. You have nothing to lose by speaking to one of our compensation law experts. The sooner we determine your eligibility to make or appeal a claim, the sooner we can help you to obtain or continue getting funding from the insurer so your rehabilitation can proceed smoothly.

Free advice and no upfront fees

Not only do we offer a FREE initial consultation we handle most insurance claims on a no win, no fee basis.

The Head of our NSW team, Jessica Cheung, is an expert in NSW workers’ compensation claims. If you think you might have a claim, reach out to Jessica and her team for high quality legal advice

Please note that this information is intended to provide general guidance only. You should not act or refrain from acting on the basis of such information. Appropriate professional advice should be sought based upon your individual circumstances. For further information, please contact Littles.

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