Is An Independent Medical Examination Really Independent?

What do you think? NO an independent examination is not independent but rather ADVERSE to your interests and those of your treating physicians.

I have previously posted on this issue months ago but it is such an important issue, I think it's necessary to discuss this issue once again. There is NEVER a good intention on the part of an insurance company in having you seen by THEIR doctor for an "independent" medical examination. The intent is to cut off your benefits and limit their exposure PERIOD!

As a former insurance company attorney I have schedule hundreds of "independent medical examinations" for injured workers. The term independent medical examination is not always accurate. Though there are reputable doctors who will perform a thorough examination and write a neutral report, there are many who will do and say almost anything. Many defense attorneys believe it is their job to chose the " doctors who will do and say almost anything"!

When I worked as a defense attorney I thought having a neutral independent doctor was truly important. It helped me assess and fully understand the injured worker's claim. It also established credibility before the compensation judges. Later in my career as a defense attorney I began to get flack from a kool-aide drinking "old time" defense lawyer who chastised me for choosing these independent physicians and telling me I needed to get on board and work with the "adverse examiners". Despite the fact that this attorney had only gone to a full hearing a handful of times in the past decade, he was going to try his hardest to win a case at almost any cost! This didn't sit well with my years of experience and the reputation I developed. This was one of the reasons I now represent only injured workers and share these stories.

An employer and workers compensation insurer have the right to have you seen for an independent medical examination or adverse examination regardless of whether your claim is admitted or denied. They need to reimburse you for your expenses and must schedule it within 150 miles of your home. Keep in mind that this doctor is not nor will he ever be your treating physician. There is no doctor patient confidentiality, everything you tell the doctor will be shared with the employer and insurer. Sometimes the examinations last a few minutes and other times they can take close to an hour with an extensive physical examination and questions.

You will usually receive the report as an attachment to a service of Maximum Medical Improvement or a Notice of Intent to Discontinue Befits in the mail. As this is the goal of the adverse examination, your medical and/or wage loss benefits will likely be stopped as the result of your "independent medical examination". In addition the report will likely maintain that your current medical treatment is unnecessary.

As a defense attorney I understand the flaws in these reports and the mistakes that can be made in preparation for the same. As your attorney I will surgically dissect these reports and the accompanying letters providing the physician with "foundation" or their opinion. My job is to look for contradictory medical evidence and obtain an opinion from your own treating physician and if necessary a truly independent doctor. If you would like to discuss your claim in more detail, feel free to contact me directly at 651-324-9514. All calls are returned within a few hours. Don't be afraid to contact me after hours as I personally return all calls.

You may also visit our website at www.mndisability.com

Who Pays For My Medical Bills When I'm Injured At Work?

Under Minnesota's workers compensation laws, an employee sustaining a work related injury is entitled to reasonable and necessary medical treatment. Given this rule many injured workers assume that the Minnesota employer and workers’ compensation insurer will automatically pay for the injury and the related medical expenses. This is unfortunately often not the case.

Many injured workers then go without treatment which allows the same employer and workers compensation insurer to allege that the lack of treatment is an indication you were NOT injured or injured that bad. Given some cases can take anywhere from a few months or even up to a year before a judicial determination is made on the dispute, it is VERY important that you find some way to get the treatment you deserve and need.

If you have private health insurance and your workers compensation claim or treatment has been denied, Minnesota law requires the health insurer to provide coverage under their policy and seek reimbursement from the workers compensation insurer. Many of my clients have overlooked this right as nobody who works for the insurance company is willing to share this secret.

If, however, you are without health insurance you are not alone. Nearly 700,000 Minnesotans receive health care through the state’s three publicly funded basic health care programs — Medical Assistance (MA) — Minnesota’s Medicaid program, General Assistance Medical Care (GAMC) and MinnesotaCare. For more information click here. Even with these programs in place,over 453,000 Minnesotans go without health insurance according to the U.S Census Bureau.

The Minnesota Department of Human Services (DHS) administers these programs and pays all or part of enrollees’ medical bills for:

Medical Assistance (MA) (Minnesota’s Medicaid program) is the largest of the health care programs, providing health care coverage and prescription medication coverage for a monthly average of 507,000 low-income senior citizens, children and families, and people with disabilities in fiscal year (FY) 2007.

General Assistance Medical Care (GAMC) provides medical care for a monthly average of 33,000 (FY 2007) low-income Minnesotans who don’t qualify for MA or other state and federal programs — primarily low-income adults, ages 21 and 64, who do not have any dependent children.

MinnesotaCare is a publicly subsidized program for Minnesota residents who don’t have access to affordable health care coverage. In order to eligbile you must meet the following:

• Have a Social Security number or be willing to apply for one (unless you have religious objections);
• Live in Minnesota;
• If you are an adult and do not have children living with you, or if your children are over age 21, you must have lived in Minnesota for six months;
• Be a U.S. citizen or non-citizen lawfully residing in the U.S.;
• Not have other health insurance now or have had health insurance (including Medicare), for at least four months except for Medical Assistance enrollees whose health insurance premium was paid for by Medical Assistance; and
• Not be able to get health insurance through an employer who offers to pay at least half the monthly cost.

Assistance in applying can be found here.

The only way an injured worker can get back to work is to get the necessary medical treatment. If you find yourself without medical insurance and the workers’ compensation insurer refuses to pay for your medical treatment, look into contacting the state and/or county for assistance. MinnesotaHelp.info is another great resource for help.

If you have been injured at work, attorney Tom Atkinson is more than willing to discuss your claim. There is NO obligation and he is willing to review your case to ensure you are properly receiving all the benefits you have coming to you. Contact him directly at 651-324-9514 or visit his web site at www.mndisability.com

Your Work Comp Claim Was Denied. Now What Can You Do?

Hire an EXPERIENCED workers compensation attorney. The same fee is paid to every attorney under Minnesota law so why would you hire someone who only who writes wills in the morning and handles DWI's in the afternoon but will also hand your work comp claim. The same goes for hiring an attorney who has been out of law school for a few years? The laws have changed dramatically over the past two decades and these changes can dramatically affect your right to benefits.

At Atkinson Law Office and Minnesota Disability Attorney Tom Atkinson will personally oversee your claim, puncutually returning your calls! When your claim is denied the ONLY way to get benefits paid is to initiate a claim by filing a Claim Petition.

A Claim Petition is a standard form that sets forth basic information about the employee’s claim for workers’ compensation benefits. The Claim Petition contains information about the employee, including his or her name, address, Social Security Number, date of birth, and date(s) of injury. It also lists the name of the employer(s) and insurer(s). The Claim Petition also sets forth the nature of the injury and the average weekly wage at the time of the injury. Finally, the Claim Petition lists the types of claims alleged, including Temporary Total Disability (TTD), Temporary Partial Disability (TPD), Permanent Total Disability (PTD), Permanent Partial Disability (PPD), Rehabilitation Benefits, and/or medical benefits.

The Claim Petition is filed with the Department of Labor and Industry, and copies of the Claim Petition are served on the employee, the employer, the insurer, and any third-party payors, such as major medical insurers. Notice to Potential Intervenors are often served along with the Claim Petition to any medical providers and any third-party payors.

A Claim Petition is generally filed when the employer and/or insurer is denying primary liability, meaning that they admit no responsibility for the injury. A Claim Petition is also filed when there is a claim for monetary benefits, such as Temporary Total Disability (TTD), Temporary Partial Disability (TPD), and/or Permanent Partial Disaiblity (PTD), even if the insurer admits primary liability. If an injured worker has settled his or her case on a full, final complete basis, leaving open future medical benefits, a Claim Petition may be used in some instances where there is a dispute over medical expenses.

Once your Claim Petition has been filed, the employer and/or insurer is generally required to file an Answer to the Claim Petition within 20 days. The employer and/or insurer is required to serve specific responses to the allegations in the claim petition. If an answer is not filed in a timely matter and/or an extension of time to answer is not requested, the employee may request that the matter be scheduled for an expedited hearing.

Typically, after the Claim Petition has been filed, the matter is scheduled for a Settlement Conference at the Office of Administrative Hearings. Prior to the Settlement Conference, if appropriate, the employee’s attorney will often submit a settlement demand to the attorney for the employer and insurer. The purpose of the Settlement Conference is to attempt to discuss the possibility of settlement. Some cases settle at the Settlement Conference, and some do not. If it appears that the parties have reached an impasse, and that further negotiations will not facilitate a settlement, the case may be referred to the Office of Administrative Hearings for the scheduling of a hearing. If either side needs additional information, if the case is not ripe for settlement discussions, or if the sides need additional time to negotiate, the Compensation Judge may also reset a Settlement Conference for a month or two in the future.

If the parties are unable to reach a settlement, the case will proceed toward a Hearing. In Minnesota workers’ compensation, a Hearing is the equivalent of a trial. At the Hearing, both sides will present evidence in support of their respective positions, and the employee will generally provide testimony. After all evidence has been heard, the Compensation Judge issues a decision, which is final and binding on the parties.

The entire process from the filing of the Claim Petition through a Hearing can take anywhere from six months to a year or more. In some instances your case can be expedited due to financial hardship. Let an attorney like Tom Atkinson personally assist you in determining whether your case could possibly qualify. You may reach him directly at 651-324-9514 or email at tom@mndisability. Also be sure to check our the Minnesota Disability and Atkinson Law Office web site at www.mndisability.com