When an employee is injured on the job, the workers’ compensation process helps cover medical expenses, lost wages, and other costs associated with the injury.
One of the key components of this process is the medical exam. Medical exams play a vital role in determining the extent of an injury and ensuring that the injured worker receives appropriate benefits. Understanding what to expect from medical exams during a workers’ compensation claim is crucial.
In this guide, we will discuss different types of medical exams, why they are important, and how workers’ compensation attorneys can handle your claim to make the process smoother.
What is a Worker’s Compensation Claim?
According to the National Safety Council, work-related injuries are common, with 4,695 people accounting for preventable work deaths in 2022. A worker’s compensation claim is a legal request made by an employee who has been injured or become ill due to their job.
A worker’s compensation claim allows the employee to seek benefits such as medical expenses, wage replacement, and rehabilitation costs from their employer’s insurance. This type of claim provides financial support and covers necessary treatment while the employee recovers, without requiring them to prove the employer’s fault for the injury.
What Are Medical Exams in Workers’ Compensation?
Medical exams in workers’ compensation are assessments conducted by doctors to evaluate the injury or illness a worker has sustained due to a workplace accident. These exams help to establish the severity of the injury and guide the decisions regarding the compensation benefits. The results of the medical exam are usually sent to the insurance company or the workers’ compensation board, which uses them to determine, if any, the benefits the injured worker is entitled to receive.
Medical exams are important because they provide an objective assessment of the injury, helping to avoid disputes about the extent of the damage. In some cases, multiple exams may be required to track the progress of the recovery or determine the long-term effects of the injury.
Types of Medical Exams in Workers’ Compensation
There are several types of medical exams that an injured worker may need to undergo during a workers’ compensation claim. Each type serves a specific purpose in assessing the worker’s health and determining the benefits.
Independent Medical Examination (IME)
An Independent Medical Examination (IME) is done by a doctor who is not the treating physician, usually at the insurance company’s request. Its goal is to provide an unbiased assessment of the worker’s injury, confirm its severity, and determine if it was caused by a work-related incident. The IME can influence decisions about benefits, treatment plans, or disputes between the worker and the insurance company.
Functional Capacity Examination (FCE)
The Functional Capacity Examination (FCE) evaluates an injured worker’s physical abilities in relation to their job tasks. It measures factors like strength, flexibility, and endurance to determine if the worker can return to their original job, needs modified duties, or requires more rehabilitation. The FCE helps identify any work restrictions needed.
Impairment Rating Examination (IRE)
An Impairment Rating Examination (IRE) assesses the permanent effects of an injury and gives a percentage to the worker’s impairment. This rating helps decide the extent of permanent disability and the benefits due. IREs are done after the worker reaches maximum medical improvement, where no major improvement is expected with more treatment.
What to Expect During a Medical Exam
Generally, the exam will involve a discussion with the doctor about the injury, symptoms, and medical history. The doctor may also perform physical tests to assess the injury. Depending on the nature of the injury, additional tests such as X-rays, MRIs, or blood tests may be required.
It’s important for the worker to be honest and detailed when describing symptoms to the doctor. Providing accurate information helps ensure that the medical report reflects the true extent of the injury.
The Role of Workers’ Compensation Attorneys
Navigating the workers’ compensation process can be complicated, especially when it comes to understanding the requirements of medical exams. Workers’ compensation attorneys can handle your claim by guiding you through the process, ensuring that all necessary medical documentation is provided, and representing you if there are disputes. An attorney can also help you understand your rights and ensure that the medical exams conducted are fair and unbiased.
