Thursday, March 5, 2015

What happens if I miss an IME set up by the insurance carrier?

What happens if I miss an IME set up by the insurance carrier?
By Diana Robles, Associate Attorney

Arizona law provides that the insurance carrier can periodically set up an independent medical examination (IME) for you, at a time and place reasonably convenient, by a doctor of its choosing, so long as they give you 14 days advance notice of the appointment. If you miss an IME appointment the carrier can suspend your medical and temporary compensation benefits. In addition, many times the carrier will ask for sanctions to be assessed against you. They often ask that you reimburse the cost of the IME or that they be allowed to take a credit against future compensation owed.  

An IME can cost several thousand dollars.  If you have missed an IME appointment and receive a Notice of Claim Status requesting reimbursement or a future credit against temporary compensation, you only have 90 days from the issuance of the Notice to protest it.  Our firm will argue that these exorbitant costs should not be assessed to the claimant. 

However, it is very important to make it to these appointments and let the carrier know if there is a good reason why you can't attend the appointment. Of course, emergencies occur and if something happens which prevents you from attending the IME you may need to show proof that there was an emergency which prevented you from being at the IME.  More importantly, is the fact that the carrier may accept the opinion of its consulting doctor and base change in your claim status, or the closure of your claim, on that doctor’s opinion.  

Remember, it is your responsibility to understand all notices. If you disagree, you must file your request for hearing with the ICA within 90 days from the date of the Notice of Claim Status or the Notice becomes final.

If you or somebody you know is injured on the job or suffering from a disabling condition, you can call 855-325-4785 for a free consultation. Consultations are free and can be done either in person or over the phone. You may also visit our website at for more information about our firm.

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