Not happy with the company’s doctor’s impairment rating? Get an Independent Medical Exam!

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Did you know that in Iowa, you have the right to have an independent medical examination (called an “IME”) by a doctor of your own choice, that the insurance company has to pay for? Under Iowa Code section 85.39, if the doctor chosen by the company has given an impairment rating that you believe is too low, or is just flat out wrong, as long as you have a work comp claim that is determined to be compensable, you are entitled to an exam by a doctor of your own choice, at the company’s expense, as well as your mileage to get to and from the appointment. If the company’s doctor has not given an impairment rating yet or your claim is denied, you are not entitled to this exam. Know which category your claim falls into!
Even if you are entitled to this exam under the law, this does NOT mean that you should use the opportunity to go to your own family practice doctor to get this exam. While family practice doctors do great work, and generally help their patients, an independent medical examination in the workers’ compensation context encompasses much more than just a visit to your family doctor. A good, quality, independent medical examination consists of the doctor reviewing ALL of the medical records available, evaluating you in person, and answering numerous questions about the evidence, and the law. The questions the doctors must answer can be highly-technical and very-specific so unless you know what to ask the doctor, you probably should have a lawyer help with this process.
Even if you choose a specialist for your independent medical exam, the specialist may still not be able to give you a medical report that is “good enough” to win your case. In Iowa, the impairment rating must be determined according to the 5th Edition of the AMA Guides to the Evaluation of Permanent Impairment. Not all specialists know how to use this book or even if they do, some are not very good at applying it, even though they are trained doctors and excellent surgeons.
If you are hurt in Iowa, and you think you might be entitled to an independent medical examination, you should definitely speak with a lawyer about your rights BEFORE you race off to a doctor on your own. You do not want to blow your only opportunity to get a free report, unless you are independently wealthy! You definitely don’t want the insurance company to choose your doctor for you so don’t fall into that trap, either.
A good work comp lawyer knows which doctors in Iowa, or the surrounding states, are going to be good enough, and qualified, to give you a medical report that is thorough, evidence-based, accurate, and one you can actually use to help your case. Then, once you get this report, it can be used by your attorney to help negotiate for a better deal for your case, or as evidence in trial if a deal cannot be reached.
If you do think it is a good idea to go off on your own and choose your own doctor for an independent medical evaluation pursuant to Iowa Code section 85.39, be prepared to spend anywhere from $2,500.00-$5,000.00, on average, and be prepared to pay that cost up-front yourself, while you wait for the insurance company to pay you back, if it agrees with you that you were entitled to the exam in the first place. Doctors that know what they are doing when it comes to workers’ compensation are busy and since their skill set is highly specialized, they are not cheap. When a lawyer gets involved in a case, most of them will pay the doctor’s cost up-front, with the expectation that it gets paid back later, either by insurance upon request, or as part of an overall settlement later on.
Accordingly, if you are hurt at work in Iowa and you have an impairment rating from the company’s doctor, and you want to find out if you are entitled to more, it is time to call a lawyer! At the very least, please read Iowa Code section 85.39 so you are aware of your rights. The link is pasted below for your convenience!

Jennifer Zupp

Partner, Attorney

Jennifer Zupp is an attorney in Denison, Iowa where she owns Zupp and Zupp Law Firm, P.C. with her twin sister, Jessica. She specializes in Workers' Compensation, Unemployment, and Personal Injury.

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