Visitor Question

Insurance adjuster requesting IME 6 months after injury?

Submitted By: Alisha (Euless, Texas)

I was injured February 24, 2018 on the premises of my apartment complex. I fell on a broken step and injured my back. The apartment complex is not denying liability, but now the insurance company handling the claim wants me to do an IME. It’s 6 months after the injuries and now I’m healed.

I don’t see the point of the IME. This is my second adjuster with this insurance company, and the first adjuster had plenty of opportunity to request this while I was being treated for the injuries.

I was taken off work for about 5 months after the incident due to back spasms. I work as an Agent for American Airlines and regularly have to lift 50-70lbs, and could not perform my duties. My job would not accept me back to work with restrictions, so I stayed off work to heal.

Now I’m back to work and the adjuster is asking for this exam. Do I have to comply? Thank you for any information you can provide

Disclaimer: Our response is not formal legal advice and does not create an attorney-client relationship. It is generic legal information based on the very limited information provided. Do not rely upon the information in our response, or anywhere else on this site, when deciding the proper course of a legal matter. Always get a personalized case review from a local attorney.

Answer

Dear Alisha,

Texas Revised Statutes Section 408.0041 makes clear an Independent Medical Examination (IME) is required when requested by an insurance company, a worker, or the Texas Department of Workers Compensation. A worker who fails to submit to the IME may be denied workers comp benefits until such time as the worker complies with the requirements for the IME.

Section 408.0041 reads in part:

“At the request of an insurance carrier or an employee, or on the commissioner’s own order, the commissioner may order a medical examination to resolve any question about:

(1) the impairment caused by the compensable injury;

(2) the attainment of maximum medical improvement;

(3) the extent of the employee’s compensable injury;

(4) whether the injured employee’s disability is a direct result of the work-related injury;

(5) the ability of the employee to return to work”

You would be well-advised to submit to the IME. If you fail to do so, your benefits may be suspended until such time as your choose to comply with the request for the IME.

Learn more here: Problems with Independent Medical Exams

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from a licensed attorney. Find a local attorney to give you a free case review here , or call (888) 647-2490.

Best of luck with your claim,

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