Step 2 (maybe): Rule 35 hearing

If you have been receiving workers compensation long enough, it is inevitable that the workers compensation insurance company is going to ask you to go to an "Independent" Medical Evaluation (IME). I've written several posts on the many problems with IME's before, which you can view here. The main problem is that there is no guarantee that the evaluation is truly independent since the insurance company pays for the evaluation.

Now, many patients have no idea this is the case and go to the evaluation as they are told. The IME doctor often concludes the patient is not disabled and/or that the work injury is unrelated to the current problems. The insurance company then uses the IME results to cut the patient off from benefits. Does anyone see a problem with this?

So what is the patient to do? If you refuse to go to the evaluation, the insurance company will cut you off anyway, right? Not necessarily. There is a legal procedure called a Rule 35 hearing that makes an insurance company need to go before a judge to make a ruling on whether there is just cause to do an IME. This is another reason why you need a lawyer.

If you have a biased IME doctor, the lawyer can file a motion to ask the court to produce the income derived through the lawyer's work for the particular insurance company and if you have a good judge, ask to get his reports. His reports are typically held at the IME brokerage house that is hired by the insurance company to broker the IME. By analyzing the reports, the judge can assess whether the IME doctor is biased towards judging the case in favor of the insurance company and help you avoid an evaluation by such an individual. Click here for step 3.