Could an Anxious Nurse Skip Mental Health IME that Went from In-person to Telehealth?

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Vancouver, WA (WorkersCompensation.com) – An employee in Washington state may be able to justify her failure to attend an IME if she can show she had good cause for doing so. But is the fact that the employer schedules a remote, instead of an in-person IME, a basis for skipping the exam?

One case involving a hospital nurse addressed that issue when the hospital switched her mental health exam to a telehealth visit at the start of the COVID-19 pandemic.

The nurse was injured at the hospital in early 2020. She claimed her physical injury also caused her significant anxiety. Just before her scheduled in-person IME by a psychiatrist, the hospital changed the visit to telehealth due to the pandemic.

The nurse refused to attend, pointing out that a remote mental health visit is not effective. Because she skipped the IME, the Department of Labor and Industries suspended her benefits.

The Department of Labor may suspend workers’ compensation benefits if an employee fails to attend an IME and her failure to do so is considered "noncooperation." If the worker has "good cause" to not attend, however, it is not considered noncooperation. But it’s up to the worker to show she had a good reason for skipping it. 

Was nurse justified in skipping IME?

A. No. She didn’t explain how conducting the exam remotely would impact its effectiveness. 

B. Yes. The board failed to show that the remote exam would have been just as effective as doing it in person.

If you selected A, you agreed with the court in Novalic v. Peacehealth, No. 58451-4-II (Wash. Ct. App. 07/16/24, unpublished), which held that the worker’s failure to attend the exam amounted to noncooperation.

When considering whether a worker has provided good cause, the court noted, it is relevant if the worker has good reason to suspect the employer’s motives for requesting another examination or to doubt the fairness of the IME. 

The court noted that the nurse appeared to argue that she had good cause to refuse her IME because of the inferiority of telehealth for mental health assessments. But she failed to supply any information supporting that contention. 

“Instead, her reason for refusing to attend the telehealth exam appeared to be based on personal beliefs, unsupported by medical expert declarations, that somehow in-person observations were required,” the court wrote.

Further, and especially in light of the burgeoning pandemic at the time, the nurse provided no solid reason for doubting the fairness of the scheduled examination or the motives for conducting it remotely. 

Because the nurse didn’t provide good cause for skipping the exam, the Department of Labor was entitled to suspend her benefits.

The court affirmed the trial court’s decision.

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