In Wisconsin, when a worker is injured and claims compensation for workers compensation benefits, the workers compensation insurance carrier has the right to send the injured worker to see their “Independent Medical Examiner” under Wis. Stat. Sec. 102.13(1). This type of medical examination can only take place with a physician, chiropractor, psychologist, dentists, podiatrist, physician assistant, or an advanced nurse practitioner. To be clear, these medical appointments are better described as an adverse medical examination because medical treatment is not being rendered. What is being rendered by this doctor is a written medical report that will offer medical opinions as to the cause, extent of the injury, medical diagnosis and prognosis, and reasonableness of medical treatment. Often, the medical report is created solely for the workers compensation carrier with a desired outcome to deny workers compensation benefits. Ultimately, the insurance carrier is hoping for a medical opinion from their Examiner that gives a medical opinion that will allow them to deny the injured worker benefits.
How Should the Injured Worker Behave at The Examination?
In Wisconsin, these appointments are selected and scheduled by the workers compensation carrier, not the injured worker. Again, medical treatment is not going to be rendered to the injured worker at these appointments. This appointment will generally not last longer than 20 minutes. The injured worker should be aware that they are being watched carefully from the moment that they enter the parking lot. It has been said that some doctors will even wait in their vehicle so that they can see the injured worker arrive, park, exit their vehicle, and walk across the parking lot and into the building hoping to see any inconsistencies in pain symptoms and physical restrictions. Creepy and bizarre?! Absolutely yes! In turn, Attorney Lisa Pierobon Mays suggests that the injured worker be a good observer too. Take pictures of anything that seems unprofessional, like a dirty examination room. Also, the injured worker is permitted by law to bring a witness into the examination. The injured worker should never be chatty with the Examiner. Be polite but cautious, be respectful but not friendly, be cooperative but not overly talkative because the more you say, the more what you say can and will used against you.
What Will the Adverse Examiner Do at The Appointment?
The biggest thing that the Examiner wants is to get you talking. They will ask specific questions of you, like:
- What is the date of the injury?
- How did the injury occur?
- Do you have pain symptoms and describe the pain?
- Describe/recite your medical treatment;
- Describe prior injuries and similar symptoms before the work injury occurred;
- What alleviates the pain?
- What aggravates the pain?
These are fair and appropriate questions so be prepared with accurate, complete answers. Remember, you are the best historian of your injury so if you do not know simple things, like your pain symptoms or how the injury occurred in detail, then you will not appear credible to the Examiner and he/she will use this against you in their report that will ultimately be reviewed by the Judge at a potential hearing.
Will the Adverse Examiner Touch Me?
It is very likely that the Adverse Medical Examiner will perform a physical examination of your body so be prepared by wearing appropriate clothing. Wear loose clothing, do not wear tight-fitting clothes, like jeans. Do wear tank tops and shorts under your main clothing because if you are asked to remove your shorts or pants you have a full undergarment on. Never agree to disrobe completely and wear a paper gown. This is an intimidation tactic and completely unnecessary for this type of an examination. Again, keep your witness in the examination room with you so that you do not feel vulnerable and alone with the Examiner who is a stranger to you.
During the physical examination, the Examiner will ask that you sit on an exam table and request to inspect the part of your body that is injured. The Examiner will lightly palpitate, which means examine you with light touching/pressing on the injured area. Verbalize to the Examiner if any touching hurts you. The Examiner will then ask you to perform some movement exercises to test your range of motion. Again, describe truthfully any pain that you experience with such movement. You may be asked to lay on the table on your back, side, and then on your belly for more palpation or range of motion testing. You will be continuously asked if any of the touching/palpation or movements hurts. Be honest and do not exaggerate any pain as the Examiner is looking for such inconsistency or exaggeration of pain to attack your credibility.
When the examination is over, remember that you are being watched as to how you get off the examination table, move, and leave the examiner’s parking. Again, the Examiner and his staff are hoping to see and document anything that puts the truthfulness of the work injury in question. So, if you are restricted from climbing stairs due to a knee injury, then use the elevator, and not the stairs when exiting.
Attorney Lisa Pierobon Mays is Proud to Have Been Involved in Changing Wisconsin Law in Favor of Protecting Wisconsin Injured Workers During Adverse Examinations.
In the past, Wisconsin law allowed the Examiner to meet with the injured worker, male or female, alone and without any observation from a witness, such as a spouse, parent, other family member, or even a friend. This policy was obviously problematic, especially where it was a male doctor examining female injured workers. Often, these adverse medical examinations require a certain level of disrobing and a hands-on physical exam of the injured worker. Such a situation is intimidating, and downright creepy, where a trusted doctor-patient has NOT been selected or even established.
Attorney Pierobon Mays initiated awareness with the Wisconsin Worker’s Compensation Advisory Council pushing for a change to be made in the workers compensation legislation. The Council on December 13, 2021 approved such a change and the agreed upon bill, passed by the Wisconsin Legislature, now allows observers to be present, chosen by the employee, during such examination.
Lastly, the best course of action for the Wisconsin injured worker who is asked to submit to an “Independent Medical Examination” coordinated by the workers compensation insurance carrier is to call Attorney Lisa Pierobon Mays at (608)257-0440 so that she can remind you of these Do’s and Don’t’s and get you properly prepared. Initial consultations are always free.