Surviving Your Med-Legal Evaluation
Over the years, we have had many lessons taught to us the hard way here at LLG. There are some definite dos and donts for successfully participating in a med-legal evaluation. These evaluations are a key element in determining the issues in your workers’ compensation claim. We want this process to go as smoothly as possible for you. In this article I will give you some great ideas on how to understanding and survive the process without losing a lot of sleep.
As a thoughtful commentator once said “Half of success is just showing up.” Just getting a med-legal set up on our end now takes months of work and it is a big deal. Failure to make your appointment will set your case off by months more and could result in missed appointment gees ranging from $250 to $500.00 charged against your permanent disability. So Rule #1 is to make sure you get to the church on time! Carefully plan your trip to the doctor’s office the day before. Use MapQuest or give us a call for directions and consider the effects of potential traffic congestion in larger metropolitan areas. You only have two years of temporary disability coverage now thanks to Arnold; we need to make every day count.
Your evaluation starts in the parking lot. Some doctors have a keen eye pointed towards folks entering their building. Sneaky gumshoes sent by their insurance handlers know where you are going to be that day, so cameras could be rolling as you enter and exit the building. Arrive at least 30 minutes early. If you are late, your appointment could be cancelled. If you have x-rays or MRIs for your condition, remember to bring them to your evaluation. Waiting rooms can be packed. Be respectful if you are not called on time; these doctors are busy people on a mission.
You might be asked to fill out a questionnaire about your medical history; I am OK with that as long as you are absolutely accurate in what you put down. If you are sent the questionnaire before your evaluation, make sure it is completely filled out before you get there. Normally the doctor will first take a history of your injury and overall medical condition. He/she can ask all the questions they deem appropriate; the only limitation they must respect is the attorney-client privilege. Refuse to answer any questions regarding our discussions.
Many clients ask if they should take their pain meds before the examination. Personally, I would rather a doctor see you without them. Pain meds tend to mask symptoms and unduly lubricate range of motion testing. However, I am not a doctor and that is not my call; it is up to your good judgment. Consider having someone drive you if you have to take meds.
The second part of the evaluation will involve a physical examination of the involved body part. The doctors will employ standard range of motion, neurological testing and take measurements during this time. Do not over dramatize your condition. Doctors call that “pain behavior.” On a good day, you have only get 3% for pain under the AME guides; don’t let it overshadow what you will really be evaluated on; impairment of body function and its effect on your Activities of Daily Living (ADL’s). Part of an evaluation is just having the physician “buy you” as a human being so the best tactic here is to be straightforward and honest. Be mindful of the type of tests a doctor employs Some doctors employ “distraction testing” where they conduct a test that should not really produce a positive result and it does with you!
Credibility is a king in this business. Rarely will a condition keep you from doing a specific activity. Avoid absolutes when you are describing what you can’t do. “Yes, I could do it, but it would be painful,” is not a bad response if you think you could do an activity. You might be asked to describe your pain on a one to ten scale (one being a minor annoyance, ten puts you in the hospital). Think very carefully before you start describing your pain as a 10 all the time. It will seriously hurt your credibility.
One of the ways you can get relief from the draconian effects of the use of the AMA guides is to make sure the doctor knows the consequences your injury has on your ADL’s. If your injury significantly affects those activities, there may be higher permanent disability ratings for you. If you have significant problems walking, standing, sitting, driving, having sex, manipulating objects and the like, make sure the doctor gets your unvarnished take on these problems when they ask. Don’t be a “tough guy.” Remember everything you say regarding your limitations could be subject to a video shoot on you down the line, so be very, very accurate here.
I am going to apologize for the impersonal and sometimes thoughtless treatment you will get from the system. We want you to get well and on with your life as quickly as you can. You have a legitimate injury and deserve to be treated fairly; you can rest assured that the evaluation will be over within about a half an hour or so and you can go home.
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