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If you were injured at work, then you may need to undergo an independent medical review. These occur if your employers’ insurance company disagrees with the initial diagnosis you received and wants more information about the status of your injury.
It can be overwhelming to face an independent medical review, but you do not need to worry. These reviews are not meant to be intimidating, but, rather, offer a way for you to secure benefits. Here, you can learn 10 tips on handling your independent medical review. Some considerations include sharing information about your medical history, disclosing your symptoms, and being honest about your situation.
What Is an Independent Medical Review?
Before learning what information could support your workers’ compensation claim, it’s important to know what an independent medical review is in the first place.
An independent medical review is a medical evaluation done by a physician hired by your employer’s insurance company. During this evaluation, they will make determinations about what injuries you sustained, such as whether they occurred in the workplace. They’ll also determine whether a certain course of treatment could benefit your condition.
While independent medical reviews can yield the information needed to approve your claim, some are more complicated than others. Some insurance companies purposefully partner with doctors who they know will save them money on treatment care costs. The cheapest course of treatment may not be the best one. So, it’s important to know what measures can give the evaluating doctor “the full story” when reviewing your condition.
These Considerations Could Promote a Smooth Claims Process
These measures could help secure the benefits you need:
Speak About Previous Injuries
It can be tempting to try to attribute all the pain you’re feeling to your current condition. However, you should avoid this. Instead, be honest about your previous injuries and explain how they may relate to your workplace injury. This may involve talking about injuries for which you never sought intensive medical care.
If you try to hide previous injuries, the attending physician could distrust anything else you share. They could also share their distrust with the insurance company, complicating your claim even further.
Be Prepared to Discuss the Circumstances of Your Injury
One of the key aspects of your medical review will be the circumstances surrounding your accident. After your injury, you must report how your injury happened.
Be sure to be consistent when you meet with your medical examiner. Keep your answers concise to prevent yourself from contradicting previous statements that you have made. This does not mean that you should withhold information; it just means that you should only provide what is necessary.
Understand the Treatment You Have Received
After your injury, it is likely that you will undergo treatments from other physicians prior to your independent medical review. Be honest about how these treatments have helped you, or if they have not assisted you much. This helps the reviewer know whether you’re getting treatment that benefits your health.
Bring a List of Your Medications
If you are taking any medications to address your injury’s symptoms, then you should tell the medical examiner. They will want to know what medications you take and why. This will help them determine the seriousness of your injury and whether the medications you’re taking are necessary.
Explain the Symptoms You Are Experiencing
When asked about your symptoms, don’t hold anything back. Be sure to describe:
- How you feel on a day-to-day basis
- Whether you’ve done anything to accommodate your condition
- Whether you’re experiencing side effects from the prescribed medications
- Which parts of the body your symptoms affect
- What tasks you can and cannot complete
Even if something is not bothering you much, you should mention it to your physician anyway. Your doctor may have insight into symptoms that you might write off as “minor.”
For instance, you may share that you’re having memory problems in the aftermath of a serious accident. Memory loss and confusion are two symptoms of traumatic brain injuries, which don’t immediately present symptoms. If the doctor recognizes that you have this condition, this could influence any final decisions they make about the care you receive.
Be Honest About What Does and Does Not Hurt
During your examination, your doctor may perform some minor tests to see if you have decreased mobility or pain from certain movements. If something does not hurt, be honest about that. Just because something is not bothering you does not mean that you are not injured.
Do Not Exaggerate Your Condition
Your medical review is not a time to exaggerate your symptoms. If you do, then you could risk jeopardizing your case.
Be honest about the pain you are experiencing, but also be honest about what has improved since your injury took place.
Present Yourself in a Professional Manner
By this, we mean that you should arrive on time for your appointment, dress appropriately, and be polite to the physician. You may hear stories prior to your appointment about physicians not being fair to people. Still, you don’t want to walk into your appointment with a bad attitude. Your relationship with the attending care provider, no matter how brief, is important to your workers’ compensation case.
Review Your Report After the Visit
After your medical exam ends, your physician will write a report based on their findings and what you said. Make sure to review this report and ensure that all information is accurate. If it is not, then you could discuss your options with an attorney.
Consider Legal Help
You don’t have to manage any part of the workers’ compensation claims process alone. You can partner with an attorney at any time during your case. They can explain what you could expect from an independent medical review and champion your rights.
Contact KJT Law Group Today
If you are preparing for an independent medical review, then the Los Angeles workers’ compensation lawyers of KJT Law Group can help. Call us at (818) 507-8525. We can answer any questions you may have and offer advice on how to handle your exam.
