Independent Medical Examination

Under the Worker's Compensation Act, s. 102.13, an insurance company or self-insured employer may request that an injured worker submit to reasonable examinations by a physician, chiropractor, psychologist, dentist, podiatrist, physician assistant or advanced practice nurse prescriber of its choice. This examination is usually referred to as an independent medical examination.

Insurance companies and self-insured employers can request that the injured worker take an examination of the business's choice when compensation is claimed due to loss of earning.

Many times, this type of examination may be requested by the insurance company or self-insured employer to determine various factors that assist in making determinations based on circumstances of the injured employee. This type of examination eliminates any patient-physician or patient client privilege that could exist otherwise.

Independent examinations every 6 months is a reasonable request, however if there are major changes in an injured employee's medical condition, the insurance company or self-insured employer must schedule additional independent examinations with the same physician unless permission is granted otherwise.

The insurance company or self-insured employer may choose any independent examiner within a 100-mile radius of the injured worker's primary place of residence. If the injured worker is treating with a practitioner whose office is located more than 100 miles from the injured employee's primary place of residence, the insurance company or self-insured employer may require the injured worker to submit to an independent examination in the area where the injured worker's treating practitioner is located.

The insurance company or self-insured employer is responsible for the costs of the independent examination. Payment in completed in advance to the injured worker for all expenses, including transportation, meals, lodging and wage loss, necessary to attend the independent examination. The injured worker is entitled to full wage replacement, rather than the temporary disability rate, for all time lost from work to attend the examination. Mileage reimbursement must be for the total round-trip miles.

Requests for an independent examination must be in advance and in writing and must notify the injured worker of the following:

• The proposed date, time and place of the examination and the identity and area of specialization of the examining physician, chiropractor, psychologist, dentist, podiatrist, or vocational expert.
• The procedure for changing the proposed date, time, and place of the examination.
• The injured worker's right to have his or her physician, chiropractor, psychologist, dentist, or podiatrist present at the examination, at the injured worker's expense.
• The injured worker's right to receive a copy of all reports of the examination that are prepared by the examining physician, chiropractor, psychologist, dentist, podiatrist, or vocational expert immediately upon receipt of these reports by the insurance company or self-insured employer.
• The injured worker's right to have a translator provided by himself or herself present at the examination if the injured worker has difficulty speaking or understanding the English language.
• The injured worker's right to have one observer provided by himself or herself present at the examination.

Once written notification from the insurance company or self-insured employer, the injured worker must go to the independent examination. If the injured worker unreasonably refuses to go to the examination or in any way obstructs the examination, an administrative law judge may bar compensation during the period of refusal.