Check Out Our Podcast: The Verdict
When a workers’ comp doctor says you don’t need surgery but your body tells you otherwise, what can you do? In this powerful episode of The Verdict, workers' compensation lawyer Brian Groesser returns to explain how injured workers can get second opinions, challenge biased treatment decisions, and fight for the care they deserve.
Brian outlines the Independent Medical Examination (IME) process, how it works in North Carolina, and why it's often the turning point in getting proper treatment. He and Clark discuss how employer-approved doctors sometimes minimize injuries to save costs, and why having a legal advocate can level the playing field.
You’ll learn how attorneys can communicate directly with treating physicians (while the other side can’t), and how that simple advantage can lead to better outcomes—physically, financially, and emotionally.
Here’s what we discuss in this episode:
0:00 – Independent Medical Examination
2:52 – Protecting your body
5:46 – Why it’s important
Workers comp, catastrophic injury, insurance claims, first 90 days, attorney
Learn more about how Speaks Law Firm can help you: https://www.speakslaw.com/
Schedule your FREE case review: https://www.speakslaw.com/our-team/r-clarke-speaks/#contactFormTarget
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SPEAKERS
Clarke Speaks, Brian Groesser
Clarke Speaks 00:00
I'm Clark speaks the catastrophic injury lawyer, welcome to the verdict. Welcome back to the verdict. I'm Clark speaks, and I'm continuing my conversation with Brian. Grocer, Brian, you talked a little bit about after workplace accident, the insurance company has the legal right to send you to the doctor of their choosing, and how the insurance companies will keep notes on doctors and will have opinions about this doctor is more likely to be real conservative in their treatment and real conservative in their call for surgery or their diagnosis. You know their report saying that they need you need surgery, or very quick to send you back to work, and in sending you back to work and not receiving surgery is potentially it could be a good thing. But if, if you need surgery and they say you don't, or if you don't need to go back to work and they say you do, that's a problem. It reduces value that should be assigned to your case, and it subjects you to permanent injury. It subjects you to danger at work. It could cause a variety of problems. So let me ask you this from your perspective, as when that something like that, you see something like that going on in one of your cases. What can you do to counter that and put the client in the best possible position? Well,
Brian Groesser 01:11
there's two mechanisms that we're allowed to utilize within the comp system under the statutes for second opinions, one of which isn't really relevant to your question, but the other one is a full fledged ime under 9725 and what that allows you to do is to we've talked about how you don't have control. Sorry, you said IMU, independent medical examination, a second opinion, is essentially what it is. And even though you don't have control for most of the claim in terms of your medical treatment, the insurance carrier, carrier is telling you who to see and when to see them. You do have control in this aspect. If you ever want a second opinion, you can have one under this statute. Now it's got to be something that you agree with the other side about. So it's got to be a doctor that both sides feel comfortable. But this is a way to maybe this one doctor is not recommending surgery, but you still feel like you know my back is killing me. I cannot get up in the morning without my right leg giving out on me. I need somebody else to give me an opinion. You go get that second opinion. Second Opinion. Doctor says, Well, yeah, the reason why you have that is you've got a herniated disc at l4 five. It is impacting your nerve, and it's not going to be fixed unless you have surgery. Well, now you've got a medical provider that is recommending surgery, you've got your authorized treating physician, the one that the insurance carrier was sending you to that's saying no, but maybe that insurance carrier doctor will change his mind now that the second opinion doctor says no, he needs surgery, and this is why, and if they don't, you can go through the medical motion practice, or you can go through a full fledged litigation, which obviously you need an attorney for in order to get that second opinion doctor to be the ruling doctor, then we get his assessment and his diagnosis, the one that the carrier needs to follow well.
Clarke Speaks 02:51
So my experience is that that part is extraordinarily helpful to people who are injured and dealing with this kind of situation, you're much more likely to have receive better care, better treatment, a better result, not if you'll remember our our commitment is to help injured people recover physically, financially and emotionally. So physically, you're going to get a better result under these circumstances. Because really, at the end of the day, the way that I look at this is whatever money we get with for people under these circumstances is going to be spent right, but the body that God gave you is going to be there for the rest of your life. So the physical aspect of taking care of somebody becomes even more important than financially. So we have to be vigilant about protecting people under these circumstances. So I find that to be critical is to take care of people under those circumstances. What do you think? What do you think about that
Brian Groesser 03:51
absolutely you only get, like you said, you only get one body. You can change jobs, you can change careers, you can sell cars, you can do whatever to make more money, or whatever it takes, but you only get one body, and that's the thing that we look out for you as well, is to make sure that it may be that you never fully recover. There are plenty of instances where you get injured and you are never back to where you were. You're never back to 100% but the goal to get you as close to that as we possibly can, without caring about whether or not you're back to work or not, or whether or not you're, you know, receiving this benefit that the key is, is to make sure that you are as whole, financially, physically, emotionally, mentally, all of these things by the time that your claim is done. Those are all aspects that we need to focus on when we're handling a claim. And that starts with the treatment, right, making sure that the treatment is appropriate. Because a lot of times people feel like they get, for lack of a better words, the shaft when they are treating within workers comp that their doctor doesn't listen to them. Their doctor doesn't really care. They treat them as a bad apple, in the sense that they just view all workers comp employees as the. Malingering in folks that don't care about returning back to work, or don't care about getting better, they're just in it for the money. I have found that not to be the case. Sure you have a bad apple now or then, that that is their motive, that that is their intent, but the vast majority of folks are average day folks that never intended to get hurt at work that day they got hurt at work, the only mechanism that they have is workers compensation. They're not allowed to go outside of Workers Compensation. They have to be in this system if they got hurt at work, and their goal is to get better so that they can get out of the system and move on with their life. Our job is to facilitate you through that process, to get you out eventually, of the workers comp system, and as whole as we can possibly get you.
Clarke Speaks 05:45
Let me ask you this. So to me, in addition to the value of us being on this side saying, wait a minute, maybe they do need a surgery. May it, wait a minute, maybe they're not ready to go back to work, that may produce another opinion that says, Wait a minute. They're, you know, like I said, they're not ready to do those things. But more than that, it just shows that we're not going to lie down and take whatever it is you give us. And to me, having that advocate on on the other side of the case, keeping them honest through the whole process, letting them know that you're not going to be able to push this client around. You're not going to be able to reduce this claim below what its actual value is. You're not going to be able to deny this client, client, the medical treatment that they need, this injured person, the medical treatment that they need. That's the point of this, of this process, of this, of this, of putting effort into each of these different arguments. Do you agree with that? Or how do you feel about that?
Brian Groesser 06:44
Yeah. I mean, that's absolutely right, and it's a matter of picking and choosing, kind of, you know, seeing what the doctors are saying, seeing what the adjuster is doing in terms of what they are accepting, what they are denying, and knowing having this is where the experience comes in. This is where knowing how adjusters operate come in. This is how knowing how to read medical records, right? Like I remember when I first started practicing, I didn't, I didn't read medical records as part of my law school training. I'm sure you didn't either, right? No. But also, when I first started reading medical records, I didn't really know what I'd read them, but I didn't know what they meant, necessarily, the the importance of some of the things that were in there. I mean, I'm not saying I'm a doctor, but I know how to read medical records. I slept at a Holiday Inn last night type thing, right? So I know how to read the medical records at this point, and to be able to pick up, oh, this is an issue, or, Oh, this is something. And here's the thing, here's the thing about that employees don't necessarily know about comp. We're allowed to talk to the doctors. You know, that is your doctor, so as your attorney, I'm allowed to talk to the doctor the other side is not the other side, even though they can direct the care and tell you what doctor to see, they cannot. In North Carolina, they cannot call up the doctor and say, Hey, don't you think Mr. Jones is full of crap, you know. Don't you think that this guy doesn't you know, he's not really hurt. Or I've got some surveillance for you. Let's take a look at it together and see what they can't do that. It's ex parte communication, and they can't do it, whereas we can. We can talk to the doctor. And if you are telling me, hey, my shoulder is killing me, I don't feel like the doctor is listening to me, I can call the doctor up and say, Hey, man, I'm reading your records. He's telling me one thing I read your records. It doesn't say where seems to be the miscommunication here, and we can get on the same page, because at the end of the day, the goal is to make you as the patient he is. The doctor wants to make you as the patient better, and I, as the attorney, want to make you as my client better, right? We're all on the same page in that regard, and sometimes there's a breakdown in communication. Thankfully, in the world of workers comp, I can communicate directly with the doctor, whereas the other side cannot. It's a big advantage to employees in the workers comp system.
Clarke Speaks 08:44
That's great information. Thank you, Brian. When we come back, I'd like to talk to you something about something you mentioned in the first episode, workplace accidents, and what that is. So join us in the next episode where we'll talk about that issue and more. Thanks for joining us. Don't forget to subscribe and follow us to stay up to date with our weekly episodes, we'll see you next time you.
SPEAKERS
Clarke Speaks, Brian Groesser
Clarke Speaks 00:00
I'm Clark speaks the catastrophic injury lawyer, welcome to the verdict. Welcome back to the verdict. I'm Clark speaks, and I'm continuing my conversation with Brian. Grocer, Brian, you talked a little bit about after workplace accident, the insurance company has the legal right to send you to the doctor of their choosing, and how the insurance companies will keep notes on doctors and will have opinions about this doctor is more likely to be real conservative in their treatment and real conservative in their call for surgery or their diagnosis. You know their report saying that they need you need surgery, or very quick to send you back to work, and in sending you back to work and not receiving surgery is potentially it could be a good thing. But if, if you need surgery and they say you don't, or if you don't need to go back to work and they say you do, that's a problem. It reduces value that should be assigned to your case, and it subjects you to permanent injury. It subjects you to danger at work. It could cause a variety of problems. So let me ask you this from your perspective, as when that something like that, you see something like that going on in one of your cases. What can you do to counter that and put the client in the best possible position? Well,
Brian Groesser 01:11
there's two mechanisms that we're allowed to utilize within the comp system under the statutes for second opinions, one of which isn't really relevant to your question, but the other one is a full fledged ime under 9725 and what that allows you to do is to we've talked about how you don't have control. Sorry, you said IMU, independent medical examination, a second opinion, is essentially what it is. And even though you don't have control for most of the claim in terms of your medical treatment, the insurance carrier, carrier is telling you who to see and when to see them. You do have control in this aspect. If you ever want a second opinion, you can have one under this statute. Now it's got to be something that you agree with the other side about. So it's got to be a doctor that both sides feel comfortable. But this is a way to maybe this one doctor is not recommending surgery, but you still feel like you know my back is killing me. I cannot get up in the morning without my right leg giving out on me. I need somebody else to give me an opinion. You go get that second opinion. Second Opinion. Doctor says, Well, yeah, the reason why you have that is you've got a herniated disc at l4 five. It is impacting your nerve, and it's not going to be fixed unless you have surgery. Well, now you've got a medical provider that is recommending surgery, you've got your authorized treating physician, the one that the insurance carrier was sending you to that's saying no, but maybe that insurance carrier doctor will change his mind now that the second opinion doctor says no, he needs surgery, and this is why, and if they don't, you can go through the medical motion practice, or you can go through a full fledged litigation, which obviously you need an attorney for in order to get that second opinion doctor to be the ruling doctor, then we get his assessment and his diagnosis, the one that the carrier needs to follow well.
Clarke Speaks 02:51
So my experience is that that part is extraordinarily helpful to people who are injured and dealing with this kind of situation, you're much more likely to have receive better care, better treatment, a better result, not if you'll remember our our commitment is to help injured people recover physically, financially and emotionally. So physically, you're going to get a better result under these circumstances. Because really, at the end of the day, the way that I look at this is whatever money we get with for people under these circumstances is going to be spent right, but the body that God gave you is going to be there for the rest of your life. So the physical aspect of taking care of somebody becomes even more important than financially. So we have to be vigilant about protecting people under these circumstances. So I find that to be critical is to take care of people under those circumstances. What do you think? What do you think about that
Brian Groesser 03:51
absolutely you only get, like you said, you only get one body. You can change jobs, you can change careers, you can sell cars, you can do whatever to make more money, or whatever it takes, but you only get one body, and that's the thing that we look out for you as well, is to make sure that it may be that you never fully recover. There are plenty of instances where you get injured and you are never back to where you were. You're never back to 100% but the goal to get you as close to that as we possibly can, without caring about whether or not you're back to work or not, or whether or not you're, you know, receiving this benefit that the key is, is to make sure that you are as whole, financially, physically, emotionally, mentally, all of these things by the time that your claim is done. Those are all aspects that we need to focus on when we're handling a claim. And that starts with the treatment, right, making sure that the treatment is appropriate. Because a lot of times people feel like they get, for lack of a better words, the shaft when they are treating within workers comp that their doctor doesn't listen to them. Their doctor doesn't really care. They treat them as a bad apple, in the sense that they just view all workers comp employees as the. Malingering in folks that don't care about returning back to work, or don't care about getting better, they're just in it for the money. I have found that not to be the case. Sure you have a bad apple now or then, that that is their motive, that that is their intent, but the vast majority of folks are average day folks that never intended to get hurt at work that day they got hurt at work, the only mechanism that they have is workers compensation. They're not allowed to go outside of Workers Compensation. They have to be in this system if they got hurt at work, and their goal is to get better so that they can get out of the system and move on with their life. Our job is to facilitate you through that process, to get you out eventually, of the workers comp system, and as whole as we can possibly get you.
Clarke Speaks 05:45
Let me ask you this. So to me, in addition to the value of us being on this side saying, wait a minute, maybe they do need a surgery. May it, wait a minute, maybe they're not ready to go back to work, that may produce another opinion that says, Wait a minute. They're, you know, like I said, they're not ready to do those things. But more than that, it just shows that we're not going to lie down and take whatever it is you give us. And to me, having that advocate on on the other side of the case, keeping them honest through the whole process, letting them know that you're not going to be able to push this client around. You're not going to be able to reduce this claim below what its actual value is. You're not going to be able to deny this client, client, the medical treatment that they need, this injured person, the medical treatment that they need. That's the point of this, of this process, of this, of this, of putting effort into each of these different arguments. Do you agree with that? Or how do you feel about that?
Brian Groesser 06:44
Yeah. I mean, that's absolutely right, and it's a matter of picking and choosing, kind of, you know, seeing what the doctors are saying, seeing what the adjuster is doing in terms of what they are accepting, what they are denying, and knowing having this is where the experience comes in. This is where knowing how adjusters operate come in. This is how knowing how to read medical records, right? Like I remember when I first started practicing, I didn't, I didn't read medical records as part of my law school training. I'm sure you didn't either, right? No. But also, when I first started reading medical records, I didn't really know what I'd read them, but I didn't know what they meant, necessarily, the the importance of some of the things that were in there. I mean, I'm not saying I'm a doctor, but I know how to read medical records. I slept at a Holiday Inn last night type thing, right? So I know how to read the medical records at this point, and to be able to pick up, oh, this is an issue, or, Oh, this is something. And here's the thing, here's the thing about that employees don't necessarily know about comp. We're allowed to talk to the doctors. You know, that is your doctor, so as your attorney, I'm allowed to talk to the doctor the other side is not the other side, even though they can direct the care and tell you what doctor to see, they cannot. In North Carolina, they cannot call up the doctor and say, Hey, don't you think Mr. Jones is full of crap, you know. Don't you think that this guy doesn't you know, he's not really hurt. Or I've got some surveillance for you. Let's take a look at it together and see what they can't do that. It's ex parte communication, and they can't do it, whereas we can. We can talk to the doctor. And if you are telling me, hey, my shoulder is killing me, I don't feel like the doctor is listening to me, I can call the doctor up and say, Hey, man, I'm reading your records. He's telling me one thing I read your records. It doesn't say where seems to be the miscommunication here, and we can get on the same page, because at the end of the day, the goal is to make you as the patient he is. The doctor wants to make you as the patient better, and I, as the attorney, want to make you as my client better, right? We're all on the same page in that regard, and sometimes there's a breakdown in communication. Thankfully, in the world of workers comp, I can communicate directly with the doctor, whereas the other side cannot. It's a big advantage to employees in the workers comp system.
Clarke Speaks 08:44
That's great information. Thank you, Brian. When we come back, I'd like to talk to you something about something you mentioned in the first episode, workplace accidents, and what that is. So join us in the next episode where we'll talk about that issue and more. Thanks for joining us. Don't forget to subscribe and follow us to stay up to date with our weekly episodes, we'll see you next time you.
