Independent Medical Examination in Personal Injury: the “IME”

Independent Medical Examination is anything but independent.  The exams, also called an “IME” are also not medical examinations in the sense of a physician performing an unbiased examination seeking clinical findings for the purpose of healing.

IMEs are set up by insurance companies solely for insurance company purposes.  So, the correct term should be ‘Insurance Examination’.  IME reports themselves often state that there is no doctor-patient relationship, clarifying that this is not a clinical visit with your medical benefit in mind.

Do I Have To Go To Independent Medical Examination?

Most often the answer is yes.  But, check with your attorney.  If you do not have one, notice of the Independent Medical Examination brings a wake-up call retain an experienced injury attorney.

Most if not all auto insurance policies impose a duty to cooperate with the insurance company upon those who are covered.  The IME often comes under that umbrella.  More specifically in states with ‘Personal Injury Protection’ or PIP which pays medical bills, insurance policies require the injured person to periodically comply with IME requests.

But, distinguish the person insured and the third party, who has no such duty, unless and until filing of an actual law suit.

Workers compensation claimants also have a periodic duty to go to insurance company medical exams.  Failure to comply can cause termination of benefits.  So, this is nothing to ignore.  Workers compensation claimants also face what is called an ‘impartial medical examination’ which is a unique but potentially case altering event.

What Should I Do?

1.  Never allow a third party access.  Case Managers, Nurse Case Managers and others should never be allowed to go into the IME with the injured person.  They may present themselves in a friendly manner, indicating they want to help.  But, once in the doctor’s office they fire off questions slanted towards forcing seemingly harmless admissions that, together, will help the insurance doctor scuttle the case.

2.  Be careful.  A physician might ‘accidentally’ drop a pen or other item.  Being the nice helpful person that you are, you might reflexively bend to pick it up.  Don’t.  This trick leads to write-ups indicating the injured person can bend and stretch with no apparent limitation or pain.  This is only one of many subtle traps.  There are many others.

3.  Remember at all times the purpose of the IME.  We’re not in the dark ages. Video cameras are everywhere.  It is not unusual for an insurance doctor to have access to direct or video observation while the injured person is walking from car to clinic and even down the halls of the facility.  IME reports have pointed out ‘inconsistencies between subjective complaints of pain and limitation and observation of subject ambulating normally in parking lot’.

These are only a few of many mishaps lurking at IME insurance exams.

Anyone going to an IME has a duty to be truthful, complete and accurate.  But, insurance companies are part of the financial services sector of the economy with a duty to reduce all payouts.  The best way to even the playing field is to consult an experienced attorney before going under the slanted view of the ‘IME’ microscope.

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