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New York Claimants Notice of Independent Medical Examination

State:
New York
Control #:
NY-IME-5
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PDF
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Description

Claimants Notice of Independent Medical Examination

The New York Claimants Notice of Independent Medical Examination (IME) is a document issued to an individual in New York who has filed a claim with the Workers' Compensation Board for an injury or illness. The claimant is required to attend an appointment with a licensed independent medical examiner (IME) designated by the Workers' Compensation Board. The IME will conduct an evaluation of the claimant's medical condition and make a determination whether the injury or illness is related to the claimant's work. There are two types of New York Claimants Notice of Independent Medical Examination: pre-authorization and post-authorization. Pre-authorization Times are conducted before a claim is approved and are generally used to verify the nature and extent of the injury or illness. Post-authorization Times are conducted after a claim is approved and are used to review the claimant's current medical condition, any changes in the condition, and any treatment that has been recommended. Both types of Times are conducted by a licensed independent medical examiner and must be completed before the claim can be approved or denied.

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FAQ

An independent medical examination (IME) is a medical evaluation performed by a medical professional on a patient who was not previously involved in the treatment of that patient, to evaluate the patient's course of prior treatment and current condition.

The IME exam generates a report that is sent to all parties generally within 10 days. The report may or may not agree with your doctor and often will vary, especially in assessing your degree of disability.

If the employee submits a workers' comp claim, the employer's insurance company may ask the injured worker to have an independent medical examination (IME). A doctor chosen by the insurance company will perform the examination.

Under New York Civil Practice Law and Rules Article 31, Section 3121, if the plaintiff's physical or mental condition is at issue, a party to a lawsuit has the right to request an impartial examination of the plaintiff in the form of an IME.

Under normal circumstances, the physician that performed the IME will have the report prepared and mailed to the insurance adjuster within two weeks. Occasionally, if additional records are requested for review, it could take slightly longer.

If the report is well-reasoned and well-supported, regardless of the favorability of the opinion, it is a good report. When evaluating an IME report, consistency matters. Inconsistent reports are not credible and they also make it difficult for the reader to figure out what, if anything, must be conceded on the claim.

An independent medical examination (IME) is an objective medical-legal examination requested (by L&I or self-insurer) to establish medical findings, opinions, and conclusions about a worker's physical condition. These examinations may only be conducted by L&I-approved examiners.

A typical IME takes about 10-15 minutes. However, the appointment may take longer if your injuries are severe. Be patient during your examination. Allow the doctor to run any tests that are needed.

More info

This notice requirement, according to courts, serves to prevent one party from using surprise medical testimony against the other party. You will receive a notification from the insurance company about who will perform the IME and the time and the place of the examination.Send a letter to the claimant and a copy to us. • Be clear about what is being denied. A: At least 28 days' notice is required, except for IMEs to address claim allowance, which is 14 days. Common Questions Regarding No-Fault Insurance Medical Examinations. Print and complete the appropriate IME Provider Account Application packet. In a personal injury case, independent medical exams are designed to help the defense minimize your claim. (c) The carrier may, at its election, contact the claimant directly to schedule a reasonable time for an independent medical examination. Functional capacity exam 2.

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New York Claimants Notice of Independent Medical Examination