Workers' Compensation Exam Requests

On Workers' Compensation benefits and what does all this mail I'm getting mean? Good question. There are all different types of mailings one could be getting while off for a work related injury two of which I will discuss here : Notice of Ability to Return to Work and Requests for Medical Examinations.

A Notice of Ability to Return to Work (LIBC 757). This is a form created by the Department of Labor and Industry that a Workmen's Compensation Insurance Company will send when they get information from a doctor (could be your doctor or could be one of their own) saying what level of work you are now able to do based on a doctor's opinion. The form was created to comply with the law.

The law behind a Notice of Ability to Return to Work: Section 306 (b)(3) requires that after the insurer receives medical evidence that the injured employee is able to return to work in any capacity, the workers' compensation insurer must provide prompt, written notice (on a form prescribed by the Department) to the employee, which states: 1. the nature of the injured employee's physical condition or change in condition; 2. that the employee has an obligation to look for available employment; 3. that proof of available employment opportunities may jeopardize the employee's right to receipt of ongoing benefits; 4.  that the employee has the right to consult with an attorney in order to obtain evidence to challenge the insurer's contentions.

A request for a medical examination. Section 314 of the Workmans Compensation Act provides that an employer (or it's insurance company) may request an employee to submit to a physical examination by an appropriate health-care provider or other expert at some reasonable time and place at any time after the injured worker gets hurt. The examination is paid for by the employer (or insurance company) and is selected by them as well. Generally speaking the workmens compensation insurance company is entitled to an exam as is reasonable and necessary. A refusal without reasonable cause or excuse to comply can result in depriving the injured worker of compensation or deprive them of compensation for a time.

Generally, what we see most frequently is someone who suffered a work injury and is getting benefits, either medical and/or lost wages. The insurance company for various reasons (which we can discuss in more detail if you speak to an attorney) would like an evaluation by a physician of their own choosing. Following the Insurance Companies Evaluation (IME) often times called an Independent Medical Exam (and most times their not very independent-here I'm letting my bias seep through) they will then send the Notice of Ability to Return to Work. Generally, the insurance company wants to stop paying you. They try to get a doctor to say you can go back to some level of work. They are building up evidence to take you to court and try to cut your benefits. They send the Notice of Ability to Return to Work. It's basically a warning that they are considering taking you to court. If you get one call an attorney. Immediately.

If you or your loved one has questions regarding a work related injury or illness please feel free to contact the lawyers and attorneys at Dugan and Associates, Lawyers Representing Injured People.

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