What to Expect From An Independent Medical Examination in Louisiana Workers Compensation

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For Independent Medical Examinations, the injured employee can expect:
    • Prepared questionnaires in advance of the examination;
    • Pain scales and drawings during the examination;
    • Detailed questions during the examination; and
    • A detailed Independent Medical Examination Report following the examination.

Prepared Questionnaires in Independent Medical Examinations in Louisiana Workers Compensation

In advance of an Independent Medical Examination, the examiner may give a prepared questionnaire to the injured employee that asks about:

    • Medical history of the employee;
    • Medications of the employee;
    • Surgical history of the employee;
    • Allergies of the employee;
    • Social history of the employee; and
    • Work history of the employee.

Some questionnaires may be specific for certain types of injuries, and ask specific questions on particular body parts in reference to related disability scales.  For example:

    • For back injuries, the examiner might ask question regarding the Oswestry Disability Index;
    • For neck injuries, the examiner might ask question regarding the Neck Disability Index (NDI); and
    • For foot and ankle injuries, the examiner might ask question regarding the Foot and Ankle Disability Index (FADI).

The Independent Medical Examiner may send the questionnaire to employee ahead of time to save time, or may simply ask the employee to complete the questionnaire right before the examination.

It is crucial that the employee's answers to all questionnaire questions are extremely thorough, complete and truthful.

Pain Drawings and Scales in Independent Medical Examinations in Louisiana Workers Compensation

For Independent Medical Examinations, the injured employee can expect pain drawings and scales for the employee to complete.

Pain drawings are drawings or sketches of the human body (usually one front and one back), where the injured employee is asked to circle or mark areas of the body in which the employee is feeling pain.

Pain scales are scales in which the injured employee is present with 11 numbers (0-1-2-3-4-5-6-7-8-9-10), and asked to "circle the number that best describes your pain."

It is absolutely critical that the employee's answers to all these pain drawing questions and pain scale questions are extremely thorough, complete and truthful.

When completing these these pain drawing questions and pain scale questions, it is no time to be a hero (by downplaying at all the level of pain) or to be forgetful or minimizing of the true intensity or locations of the employee's pain.

The Independent Medical Examination Itself in Louisiana Workers Compensation

During an Independent Medical Examination, the Independent Medical Examiner will ask questions about the employee's:

    • Detailed medical history
    • Incident
    • Current symptoms
    • Treatment including therapy, surgery, etc.
    • Medications
    • Past history (chronic medical conditions)
    • Activities of daily living
    • Past surgery
    • Past hospitalizations
    • Military history
    • Social history
    • Work history
    • Education
    • Hobbies
    • Vice habits (smoking, drinking, illicit drugs)
    • Review of systems
    • Psychiatric symptoms

The detailed physical examination will also be:

    • Focused on body part(s) that are affected;
    • Many times consisting of a head to toe exam;
    • Often including a neurological exam; 
    • Often including a mental status exam; and
    • Often involving measurements of joints.

However, the Independent Medical Examination usually does not include measurements of abilities for specific tasks (such as lifting, climbing, etc).

The Independent Medical Examination Report in Louisiana Workers Compensation

Regarding an Independent Medical Examination, the Independent Medical Examiner will provide a report within 30 days.

In fact, depending on the amount of records to review, the report may only take a week or two to complete.

The Independent Medical Examination Report will include identifying information, such as

    • Claimant name
    • Requesting party
    • Demographics
    • Claim number
    • Date and time of exam

The Independent Medical Examination Report will thoroughly report on:

    • Detailed medical history
    • Incident
    • Current Symptoms
    • Treatment including therapy, surgery, etc.
    • Medications
    • Past history (chronic medical conditions)
    • Activities of daily living
    • Past surgery
    • Past hospitalizations
    • Military history
    • Social history
    • Work history
    • Education
    • Hobbies
    • Vice habits (Smoking, drinking, illicit drugs)
    • Review of systems
    • Psychiatric symptoms

The report will likely include behavioral observations of the injured employee, including descriptions such as:

    • Attentive
    • Pleasant
    • Cooperative
    • Dressed
    • Symptom magnification
    • Examiner's observation of pain
    • Any other behavioral observations (such as walking in the parking lot before and after the exam)

The report will likely include the employee's vital signs and measurements, such as:

    • Blood pressure
    • Pulse
    • Temperature
    • Weight
    • Height

The report will likely include details from a physical exam of the employee, including:

    • General observations
      • Nourishment
      • Development
      • Age appearance
    • Head
    • Eyes
    • Ears
    • Nose/Throat
    • Heart
    • Lungs
    • Abdomen
    • Musculoskeletal
      • Extremities
      • Back
      • Measurement of range of motion for specific joints
    • Skin
      • Temperature for certain conditions (CRPS)
    • Genitalia/Rectum

The report may also likely include details from a neurological exam of the employee, including:

    • Cranial nerves
    • Pathological reflexes
      • Babinski
      • Clonus
      • Hoffman
    • Cerebellar function
      • Heel to shin
      • Tremors
      • Gait
    • Muscle strength
      • With 3 repetitions
    • Muscle tone
    • Proprioception
    • Nystagmus
    • Sensory testing
      • Neurotip
      • Monofilament
    • Vibratory sensation
    • Romberg
    • Two point discrimination

The report will also likely include the following:

    • Diagnoses
    • Questions and answers asked by the referring agency
      • Impairment rating
      • Fitness for duty
    • Listing of all records reviewed
      • Medical records
      • Radiographs
      • MRI's
    • Photos or video - digital

The report may also likely include a Disclaimer, stating that the examiner:

    • Did not provide care
    • Examined once (or more)
    • Focused on allowed conditions
    • Reviewed the records listed
    • The findings are accepted

The Disclaimer will also likely state that:

    • The opinions are only the examiner's opinions
      • Based upon review of the records
      • Based upon the medical examination
    • There was an expectation that the materials are true and correct
    • More information may or may not change the opinion rendered
    • No recommendation for claims administration or administrative functions to be made or enforced

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