What to Expect

Medical Examinations







If you sustain a NEW INJURY at work, you should do the following:

  1. Notify your supervisor and submit a written incident report as soon as possible. If your employer does not issue a report form, or has not provided one to you, write down a description of your injury, copy it, and provide it to your boss and doctor.
  2. Obtain medical treatment as soon as possible, and provide an accurate description of the injury to your doctor.
  3. Contact your lawyer if you have one.

 


What You Should Do?

First and foremost be totally honest with the doctor in your evaluation. Second, give them as much information as possible concerning your complaints, treatment, medications, and other relevant information. Be sure the doctor knows as much about the injury as possible before you leave. In some cases the doctor’s assistant (e.g. nurse, physician’s assistant, summer intern, etc.) will be doing the “intake” on you and as a result, you might be inclined to not provide very much information, preferring to save the “meaty stuff” for the doctor. Do not do this. In many cases the person taking the “intake” is assisting the doctor in the preparation of the “history” part of the medical report that is generated as a part of the exam. Sometimes the doctors themselves will do this, sometimes an assistant will do this. Either way, whoever is asking, be as thorough and detailed as possible with them. This also applies to any forms that you are completing with regard to a preparation of the examination.

Additionally, if the doctor does anything that causes discomfort, pain, or difficulty, notify them immediately. If they persist on doing it, ask them to stop. In many cases, the doctor is trying to achieve full range of motion, and if they can do so (regardless of your complaints of pain) they can write in their report, that you have “full range of motion”. This implies that your condition has resolved itself, and you are perfectly fine notwithstanding your complaints of pain or difficulty when they are trying to achieve full range of motion. Thus if the doctor asks you to try to touch your toes and you can only “go down a little bit” tell them this and report to them precisely when you experience pain or difficulty in trying to do this. If they try to “help you out” tell them when something hurts or causes discomfort. You are the only person that can provide this information to the doctor, so be up front and detailed in your presentation at all times, and if something they do hurts, say so!!

When you first go to your examination be sure to bring the written notification that you received in the mail scheduling the examination. In some rare cases, there may be a mix-up with the paperwork, the doctor’s calendar, or in the scheduling of the facility itself. In some cases last-minute changes could result in your examination location being switched, without you being notified of same. Further, in rare situations, they may not know who you are or why you are presenting yourself at that particular medical facility. If you have a copy of your examination notice available you can present this to them so that you can prove that you are “not crazy” and are complying with the BWC’s directives. In most cases there will be a phone number, claim number, or other address that the staff member can call in the event that there is a problem with the scheduling of your examination.

If you can not attend an examination, for whatever reason, you must notify the doctor as soon as you can. Do not simply pull a “no-show” on the expectation that it will be re-scheduled. This will not happen. In fact, bad things will happen instead. If you “no-show” on an examination, the claim will be suspended, and all activity (payment of compensation, medical bills, etc.) will stop automatically. You might be charged a “no-show” fee for the doctor’s time in setting up the appointment, and waiting for you. Also, issues concerning your claim will simply not be addressed until you appear for the examination. These are all very bad things in a workers’ comp claim, so be sure to go to any examination that is scheduled, unless you are specifically advised by your attorney not to.

Also note that you are under no legal obligation to provide any x-rays, test results, medical records, or other items in the evaluation. Many workers waste a great deal of time chasing down medical records,x-ray results, MRI films, or CAT scan results around town at various medical providers that have conducted them over the years, only to have them disregarded at the examination, because the doctor is either not interested in them, or already has copies of the films provided to him by the employer. Whether or not to go around town to all your prior doctors to get x-ray films and other results is entirely up to you, but you are under no obligation to do so notwithstanding you being told so in the letter scheduling your evaluation. At Gibson Law Offices we inform our clients that you are under no legal obligation to provide all of this information. The party scheduling the examination is the true individual responsible for providing the doctor with all of the information necessary to do the exam. Any failure on their part to get proper information to the examiner is not the patient's problem.

All examinations that are conducted must have a written narrative report prepared and submitted to the Bureau of Workers’ Compensation in connection with the claim. You and your representative are required to receive a copy of the examination report free of charge. In most cases it can take anywhere from a few days to several weeks for the doctor to prepare the final report. The report itself is used as evidence at all Administrative hearings involving your Workers’ Compensation claim. It will be reviewed by the Managed Care Organization, BWC claims staff, Hearing Officers/Judges, attorneys, and any other interested person involved with the processing of your claim. In many cases if the medical examination is discussed at hearing, the doctor’s credibility, training, and other credentials will also be subject to scrutiny. Unfortunately, however, the length, nature, and extent of the examination itself is rarely an issue that is explored during the administrative proceedings.

Finally, you may be at a hearing, or looking in your claim materials and discover a report from a doctor who “reviewed” your case. A common concern of many Workers’ Compensation claimant’s is that “this doctor never examined me, I don’t remember him”. Workers’ Compensation law allows for the “physician review” to be used as evidence in a hearing. A physician review entails a doctor hired by the BWC to review the medical records and other relevant materials that are in your claim file, and answers specific questions directed to them by the BWC. Employer’s utilize this as well. In some cases this is done without the knowledge or consent of the injured worker. In either event, these “physician reviews” are used as evidence in your claim, and are discussed at the Administrative Hearings section of this web-site. By their very nature, physician reviews in some cases do not carry as much weight legally as a report from a doctor who performed an Independent Medical Evaluation. However the use of the physician review has increased dramatically over the years because of its relative low cost, and potential to contain medical payments in Workers’ Compensation cases. While the law is not as specific concerning physician reviews as it is with regard to medical exam reports, opinions vary on whether you are legally entitled to a physician review. Gibson Law Offices takes the aggressive stance that any physician review conducted on a client is subject to the same rules and regulations as reports of Independent Medical Evaluations, and should be provided to the injured worker’s representative upon receipt.

Another criticism of the IME and physician review is that these are not “my treating doctor” Thus their knowledge, experience, and information concerning a person’s medical situation is limited to the information that has been provided to them. Contrasting this with a person’s own doctor who has a complete medical chart on them, it would seem that the physician of record’s opinion should control every time. This is not the case. In fact, in many instances the BWC and Industrial Commission specifically reject the findings of a person’s own doctor, and instead accept and/or adopt the opinions and recommendations of the examining/reviewing physicians. As unfair as this may sound, this is the law in Ohio. The BWC and Industrial Commission have full discretion to accept or reject any medical opinion that is presented to them, no matter how brief of an examination it was, and no matter how ridiculous the opinion turns out to be.

 

Gibson Law Offices
Main Office: 545 Helke Road, Vandalia, Ohio 45377 | Phone: (937) 264-1122 | Fax: (937) 264-0888
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