Everything You Need to Know About an Independent Medical Examination

If you become disabled and need to use your long-term disability insurance coverage, you may be asked to undergo an independent medical examination (IME). There are significant implications for IMEs, so it’s important to know what you’re getting yourself into before you do it.

Here’s what you need to know about an IME:

The Purpose of an Independent Medical Examination

An IME is a health evaluation the insurance company uses to answer questions regarding your disability.

The insurance company may request an IME if they disagree with a decision made by the doctor treating you concerning the medical treatment you are to receive. Your insurance company may request an IME if your doctor recommends an expensive procedure, such as surgery.

Another reason the insurance company may request an IME is if they disagree with the extent of your permanent disability.

What You Can Expect During an IME

Prior to your examination, the IME doctor will receive your medical records and other documents relevant to your disability. The doctor has the choice to review the records before or after your examination.

Suppose there’s a hot topic issue in your case. In that case, the insurance company may write to the IME doctor to summarize your injury, explain the treatment you’ve already received, and ask specific questions regarding your medical condition. These questions help frame the issues for the physician.

Some examples of the questions that may be asked of the examining doctor include:

  • Was your disability correctly diagnosed?
    • Do you genuinely have the ailment you say you do?
  • Does your disability require additional medical care or testing?
    • If so, what kind of care?
      • If the doctor treating you suggests surgery, is it imperative and appropriate?
  • If possible at all, when can you return to work?
    • Are there restrictions on your working capabilities?
  • Is your disability permanent?
    • If so, to what extent?

If the insurance company sends a letter to the IME physician, you’d be wise to ask if you can read it. By doing so, you can amend any factual errors and ensure that the questions asked are relevant to your case.

When you go for the IME, the physician will probably begin by asking how you became disabled, the details about your relevant medical history, and the medical care you’ve undergone thus far. You may also be asked to go through a physical exam and tests. For example, your grip strength or range of motion may be tested.

There’s No Doctor-Patient Confidentiality

It’s essential to keep in mind that when going through an IME, the doctor who examines you is in no way entitled to the usual doctor-patient confidentiality rules. Anything you say to the IME physician can be used against you to devalue your disability claim.

Similarly, anything the doctor witnesses concerning your health will likely be noted and shared with the insurance company. For instance, if the doctor witnesses you walking with no issues from your car to the office, but then you wince in pain and favor one leg in front of the doctor, these details will be included in the doctor’s report. As you can imagine, a statement like that could severely diminish your credibility.

Note: The insurance company pays the doctor for services rendered. Because of this, IME doctors may be more likely to have loyalties to the insurance companies than the patients they examine on behalf of those companies.

How To Prepare Yourself for an IME

It’s a good idea to prepare yourself for the IME before heading into your appointment. Some of the best things you can do to get yourself ready are:

  • Get Organized
    • In the days before your exam, get everything related to your claim organized and prepared so that you are prepared to answer any questions asked of you promptly and concisely. You can expect questions about your past injuries, how you became disabled, your symptoms, and any prescriptions or over-the-counter drugs you’re taking.
  • Get There Early
    • It’s wise to arrive at your appointment early so that you can find your way around in an unfamiliar environment. Give yourself some extra time so that you can get the jitters out in the waiting room and compose your thoughts. You may also have to fill out forms, which is another reason to arrive early.
  • The IME Doctor Isn’t Your Personal Care Physician
    • Remember, the IME doctor who examines you is not your personal care physician, so this is not the time to ask additional health questions.
  • Be Positive
    • Even though this may be a difficult situation for you, it’s vital to remain positive during your IME. Don’t take anything personally because the IME doctor is simply doing their job.
  • Tell The Truth and Be Respectful
    • Your credibility will be thrown out the window if you lie during the IME. Additionally, it’s in your best interest to be polite and respectful during the examination. People aren’t usually eager to help those who are unkind.
  • Prepare Yourself
    • Talk about your disability with another person before your IME so that you’re comfortable talking about it during your examination. Be sure to explain how the disability has impacted your life.
  • Know Where and When Your Examination Will Take Place
    • Make sure you know the date, time, and location of your examination, as well as the name of the physician who will examine you. Know how to get there well before you leave.

We’re Here to Help

If the insurance company has asked you to go to an IME, it’s in your best interest to seek immediate legal representation. A request of this nature is concerning, and you should not take it lightly. The fate of your benefits could be in the hands of the examining physician, and it’s essential that you’re prepared.

Call Dabdoub Law Firm today at (800) 969-0488 to speak with an attorney about your case.

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