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  • Ny Ime-3 2014

Get Ny Ime-3 2014-2025

SE TO REQUEST REGARDING INDEPENDENT MEDICAL EXAMINATION 1. INDEPENDENT EXAMINER'S NAME AND ADDRESS 2. NAME AND ADDRESS OF PARTY REQUESTING INFORMATION 3. INDEPENDENT EXAMINER'S IME AUTHORIZATION NO. 4. IME ENTITY REGISTRATION NO. (If Applicable) 5. DATE OF INDEPENDENT MEDICAL EXAMINATION 6. CLAIMANT'S NAME 7. CLAIMANT'S WCB CASE NO. 8. DATE OF INJURY 9. DATE OF THIS REPORT Pursuant to Section 137 of the Workers' Compensation Law (WCL), if an independent examiner who has performed or will.

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The IME doctor will prepare a report for the insurance company describing his examination of you, along with his findings and opinions. (Usually it takes 2 weeks and you can request a copy of the report under the FOI).

After the IME, the doctor will write a report with his or her conclusions and opinions, particularly in response to the disputed issues or questions raised by the insurance company. You or your lawyer should receive a copy of this report. The results of the IME can have a large impact on your case.

Unfortunately, yes. While you are not required to return to work, your employer's workers' compensation insurance will typically use the findings of the IME report to stop paying benefits, and your employer may use your absence from work as a basis to terminate your employment.

The maximum number of weeks is set forth in statute as follows: 525 weeks for loss of wage earning capacity of greater than 95% 500 weeks for loss of wage earning capacity of greater than 90% thru 95% 475 weeks for loss of wage earning capacity of greater than 85% thru 90%

After the IME, the doctor will write a report with his or her conclusions and opinions, particularly in response to the disputed issues or questions raised by the insurance company. You or your lawyer should receive a copy of this report. The results of the IME can have a large impact on your case.

The IME doctor will typically conduct a patient interview to learn the history of the accident and medical condition, and then conduct a medical examination. At some point in time, the IME doctor is also likely to consult other medical records provided in relation to the plaintiff's case.

The Carrier will present certain questions to the Independent Medical Examiner, which are disclosed in a filing with the Workers' Compensation Board. The law requires that the Independent Medical Examiner submit a report within 10 days of the examination. The report must be mailed to all parties at the same time.

Once your employer has an opinion contradicting your treating physician's opinion, your employer can refuse to pay additional benefits, authorize additional treatment, accommodate your work restrictions, etc.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232