Independent Insurance Exam

You are about to have an independent medical examination what should you expect?

independent medical exam

First, it is important to understand that the independent medical examination is usually done by an expert hired and paid for by the defendant. As a result, their findings may be contrary to what your own doctors are telling you.

Sometimes, when more than one aspect of your health is at issue, you may have to undergo more than one IME. For example, if you are being treated by a neurologist, orthopedic surgeon, and an expert in physical medicine and rehabilitation, the defense may seek an IME performed by its own specialists in each of those fields. You are not obligated to take any advice these doctors may give you.

When you are represented by counsel, the IME will often be scheduled by agreement of the parties. The defense will typically send a letter indicating the date of the IME, the name and specialty of the doctor who will perform it, and any request for medical records that you should take with you to the IME.

Be honest, polite, and helpful during the IME examination. Try to communicate to the doctor all information you believe relevant to your injury. And, although the doctor works for the defense, try to think of it as “just another doctor’s appointment,” because usually it is no better or worse an experience than meeting with any new doctor. Remember, these people are professionals and bound by certain ethical standards that will not allow them to mistreat you.

It is a good idea to try to arrive for your examination at least fifteen minutes early.

Most importantly, talk to your lawyer before your appointment. Your lawyer may have special information or advice for you about the specific doctor you will be seeing. Your lawyer may wish to emphasize certain aspects of your injury or disability during the evaluation and will be able to tell you how best to do that. Your lawyer may also want you to follow up with them regarding how the appointment went. This information can help your lawyer discredit the testimony of an IME doctor or other professional who makes a misstep in the examination process.

Your lawyer may also instruct you not to subject yourself to certain tests or procedures which are not appropriate to the IME. No need to let the defense go on a “fishing expedition” when your health and well being are at stake.

Finally, your lawyer will likely wish to instruct you on certain subjects and issues you should not address during your IME such as your communications with your lawyer, the status of settlement negotiations, or your impressions of the defendant’s liability for your injury.

The purpose of the IME is to obtain information and expert opinion for the purposes of litigation and not to provide you with a “second opinion” or with medical treatment. Thus, the IME doctor may have you sign a form indicating your understanding that the examination does not constitute medical treatment.

What the Doctor Looks For

The IME doctor will typically conduct a patient interview to learn the history of the collision along with your medical condition and then conduct a medical examination. At some point in time, the IME doctor is also likely to consult other medical records provided in relation to your case. During this process, the IME doctor looks for a variety of factors about your injuries, including:

General Appearance – The doctor will observe you not only in the examination, but while you walk in the examination room, how you stand, whether you have any difficulty climbing onto the examination table, whether you show any signs of distress while sitting on the examination table, how you dress, your weight and personal hygiene, and anything else that the IME doctor believes relevant to your injuries, health, or condition.

Signs of Deception – The IME doctor will typically be on high alert for any sign of deception or exaggeration by you and can be expected to report any impression that you are intentionally or unintentionally exaggerating any symptoms.

Objective Manifestations of Injury – The doctor will typically review any medical imaging studies, such as x-rays, MRI reports, CT scans, and EMG nerve conduction studies, to try to find objective manifestations of injury (i.e., objectively measurable damage or injury to your body). The doctor will also evaluate whether your subjective symptoms of pain and discomfort are consistent with the objectively verifiable manifestations of the injury.

Subjective Manifestations of Injury – The doctor will often perform tests which require you to provide subjective indications of pain, discomfort, sensitivity or insensitivity. For example, a doctor examining for a lower back condition may have you perform a variety of movements which stretch or turn the back, and note the point at which you start to report pain and the point where movement becomes limited by pain. The doctor may test the subjective manifestations in several ways, or at more than one point during the examination, to see if any claimed pain level or point of disability remains consistent.

Other Contributing Factors – The IME doctor can be expected to inquire about any other ailments or injuries, including any which have occurred prior or since the collision, which may have somehow contributed to the injury, or aggravated the injury or impaired recovery since the time of the collision.

The IME doctor will typically prepare at least one report for the case. Sometimes the defense will ask for a supplemental report on a specific issue or the IME doctor will provide a supplement after reviewing additional medical records. While some IME doctors are highly professional, and seek to actually provide an objective evaluation, a great many doctors know that they are being paid by the defense, and that the insurance companies which pay their bills expect the position of the defense will be improved as a consequence of the IME report. As a result, while bound to tell the truth, many IME doctors may skew their reports and interpret their findings in the light most favorable to the defense.

If the IME doctor prepares a report you believe to be unfair, let your lawyer worry about it. You need to be principally concerned with what your treating health care providers tell you about your condition and getting your life back on track after your collision.

The advice and information contained in this article are for educational purposes only and is not intended to replace a physician or lawyer’s advice. 

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