Gary Bell, Jr. and Brad Pollock
Injury Attorneys

Part 1

Workers Compensation Claims & Division-sponsored Independent Medical Exams (DIMEs) Explained

Workers Compensation Claims & Division-sponsored Independent Medical Exams (DIMEs) Explained

Many people hurt on the job may find themselves going to a Division-sponsored Independent Medical Examination (DIME).  This is the first of a series of blogs on DIMEs.

At some point in every workers’ compensation claim, your main doctor will determine that further treatment is no longer likely to improve your condition.  This is called maximum medical improvement or MMI.  At MMI, you have either fully recovered from your injury or occupational disease or you are as good as you are going to get and you will have a permanent physical impairment of some kind.

If you have fully recovered, your doctor will give you a 0% permanent impairment rating.  If not, he or she will assign a permanent impairment based on the American Medical Association’s Guides to Permanent Impairment (3rd Edition Revised).  Once you receive your permanent impairment rating, the insurance company in your case must decide whether to admit for or challenge that rating.  If they challenge it, they must file with the state to request a Division-sponsored Independent Medical Examination (DIME).  If they admit for the rating assigned by your main doctor, then you and your attorney must decide whether you wish to accept the admitted rating or challenge it and request a DIME of your own.

So what exactly is a DIME?  It is a statutory mechanism by which disputes regarding permanent impairment are settled by a physician unrelated to the work-related treatment.

How does it work?  When either party requests a DIME, the parties are given a period of time to try to agree on a doctor to conduct the DIME.  The parties almost never agree because the insurance company predictably wants a doctor who will more likely give an opinion in their favor.  When the parties fail to agree, the state selects three possible physicians to perform the DIME.  These three doctors are referred to as the DIME Panel.  Then each party gets to eliminate one doctor from the panel.  The idea is that the one doctor left is the least biased and most impartial, i.e. the one most likely to provide a straightforward, scientific, and accurate examination and opinion.

In reality, it is difficult to find a physician that would be considered completely impartial.  Most panels have two doctors known to more often favor the patient or the insurance company.  This makes the DIME process a bit of a gamble.  When choosing which physician to eliminate, or strike, from the panel, your attorney may be familiar with the tendencies of the particular doctors on the panel and know exactly which one to strike.  If one or more physicians are unknown, you may request additional information about the doctor—such as each doctor’s professional affiliations—to help make your decision.

Further, the party requesting the DIME must pay $675 to the physician for the examination.  Sometimes the doctor will even ask for additional money if there are a lot of medical records or if the injuries are particularly complicated.  And there is no guarantee that a DIME will benefit you.

A DIME can end three basic ways:

  • The DIME physician may increase your impairment rating, meaning more money for you to compensate for your permanent impairment;
  • The DIME physician could lower your rating resulting in less money for your permanent impairment; or
  • The DIME physician could keep your rating the same, meaning you lose the $675.

Thus you and your attorney must carefully consider the possible benefits or pitfalls of obtaining a DIME before deciding to pay for it.  (Note: Claimants who can prove their indigence may be able to have the $675 fee paid by the insurance company on their behalf.)

Throughout this process, a number of deadlines critical to your case may come and go.  You have a limited time to request a DIME after the insurance company files a Final Admission of Liability.  You have a limited amount of time to try to agree with the insurance company on a physician.  You have a limited time to strike a doctor from the panel.  Seek an attorney to help you with these deadlines and other decisions so that you do not miss your opportunity to get your DIME.  An experienced Denver workers compensation lawyer at Bell & Pollock, P.C. is happy to answer any of your questions.  Call us at (303) 759-5900.

Next in this series: What happens at the Division-sponsored Independent Medical Examination?

Contact Us

Call a trusted attorney at Bell & Pollock, P.C. at (303) 795-5900 to get on the road to recovery now. You can also email our firm via the contact firm on this page.

As proud champions of the people, our lawyers are ready to answer your questions, explain the law and your rights, and help you take whatever steps necessary to recover the compensation you’re entitled to. With us in your corner, you can be confident that you have the legal support and representation necessary to successfully resolve your claim.

Don’t delay your recovery for a second longer – and don’t be misguided into thinking that you have to go through the process alone. Our attorneys are here, ready to help – and you won’t have to pay us anything until (or unless) there is a recovery in your case.

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Case Results

WE KNOW HOW TO WIN

CASE: Client was injured by a drunk driver. As a result of the motor vehicle accident, client was rendered a quadriplegic and needed a life care plan.
Outcome: $9,600,000

CASE: Against Insurance company for failure to pay for property damage after a gas and fire explosion.
Outcome: $1,600,000

CASE: Medical malpractice for failure to diagnose a descending aorta aneurism, resulting in death.
Outcome: $1,300,000

CASE: Neck and back injuries from car accident. Client had ongoing symptoms and needed injections for attempted remediation of pain.
Settled for $485,000

CASE: Client was injured in a 2 vehicle collision. She suffered a traumatic brain injury, concussion and multiple injuries to the neck.
Outcome: $6,000,000

CASE: Client was in her car and was T-Boned by a commercial vehicle. Her cerebral spinal fluid leaked and she suffered a concussion and traumatic brain injury with neck and lumbar (low back) injuries. Her neck injury caused radiating pain, numbness and tingling in her arms.
Outcome: $3,400,000

CASE: Client was driving on a rural road when another car crossed the center line and caused a head-on collision in the snow and ice. Client did physical work for a living. Both knees were injured, along with a neck injury.
Outcome: $2,300,000

CASE: Client was driving on South Parker road when another vehicle rapidly changed lanes and rear-ended the client. That vehicle was cited for careless driving. The collision caused a concussion with traumatic brain Injury. Client missed time from work and had a positive correlation between brain scan and neuropsychological test results.
Outcome: $950,000

CASE: Client was rear ended by a dump truck, was then knocked forward and hit another vehicle. Client had a concussion with traumatic brain injury. Client underwent a brain scan which showed hypoperfusion, correlated with her concussion symptoms. Client suffered neck injuries and injuries to her low back.
Outcome: $650,000

CASE: Client was rear-ended. The mechanism of injury from the forces in the collision caused her neck injury and at the same time, damaged her organs inside her throat. Client had swallowing and choking issues.
Outcome: $1,250,000

CASE: Client was in a motor vehicle accident. Both injections in the neck rendered some temporary relief. The Injections were transforaminal epidural steroid injections. Surgery was recommended on the lumbar (low back). The low back was injured by the forces in the collisions.
Outcome: $933,000

CASE: The client was driving in her car and was rear-ended thereby causing injuries to her lower back and neck. Client also suffered a concussion. Client had to undergo facet injections multiple times, through multiple procedures. Client also had cognitive issues which required cognitive training and therapy.
Outcome: $400,000

CASE: Client was entering a highway from an on ramp and was rear-ended by a commercial van. Client tested positive for Thoracic Outlet Syndrome and failed conservative treatment. Client underwent thoracic outlet syndrome surgey, which involved removal of the first rib to attempt to relieve pressure in the thoracic outlet. Client also suffered a back injury.
Outcome: $750,000

CASE: Client was injured by a drunk driver, who crossed the center line of the road. Client underwent multiple surgeries and could not work. Client was late 40s and needed a modified life care plan.
Outcome: $750,000

CASE: Client was rear ended by a tow truck driver who was a diabetic. The diabetic at fault party was a non-compliant diabetic and claimed he had a syncope episode, and was “blacked out”. Client had a preexisting back condition known and the forces from the collision aggravated, or made worse, the preexisting back condition in addition to, causing neck injuries.
Outcome: $350,000

CASE: Client was a passenger in a car where the driver fell asleep on a country road in the early morning hours. The car rolled multiple times. Client had eye injuries, facial injuries and neck and knee injuries.
Outcome: $850,000

CASE: Client was on the job, driving her own car, when she was rear-ended. She suffered a concussion with traumatic brain injury and pursued Workers Compensation Claim.
Outcome: $150,000

CASE: Client slipped and fell on snow and ice in Central City. He suffered back injuries, that did not require injections.
Outcome: $125,000

CASE: Client slipped and fell on snow and ice on a sidewalk in front of a business. She had to have knee surgery and multiple injections in her back.
Outcome: $175,000

CASE: Client was visiting a friend who was renting a house. Client tripped on untreated, dangerous section of deck and injured his back.
Outcome: $150,000

CASE:Client was rear ended and needed fusion spinal surgery. Insurance proceeds were limited.
Outcome: $125,000

CASE:Client was rear-ended and had to have rotator cuff surgery. Insurance proceeds were limited.
Settled for $65,000

CASE:Client was at Denver International Aiport traveling through Denver, slipped and fell and broke her ankle.
Settled for $118,750

CASE:Client was exposed to mold in a multi-family dwelling that was caused by leaking water.
Settled for $125,000

CASE:Motorcycle accident, reconstructive surgery, post-traumatic stress disorder, neurological injuries
Settled for $1,275,000

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I could not have made a better decision than to call Bell & Pollock with my case. Dana Miller and her team were the best.
Brian B.
THEY WERE VERY PROFESSIONAL, KEPT ME INFORMED AND DID WHAT I WOULD CALL A SPECTACULAR JOB- THEY SEEM TO PREACH "LEGAL GAME PLAN" AND EVEN WROTE A BOOK ABOUT IT- IT BASICALLY MEANS THEY HAVE STRATEGIES FOR YOU AND YOUR CASE AND I MEAN EVERYTHING WAS SOUND AND ANALYZED.
Jason H.
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Aliviya D.
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Kathy T.
He is very professional and we would recommend Mr. Bell to anyone who is looking for an attorney.
Dianna C.
He was kind, compassionate and knowledgeable, but also tenacious when working with the insurance companies.
Michelle K.
I was blessed to be put in contact with Dana, who not only provided me free feedback and counsel when we spoke on the phone, but also took the time to call me back on multiple occasions to check on me.Dana Miller, you are a sweet, caring and amazing person and I appreciate all your help.
Grady C.