What You Should Know Before You Read:
- Disability insurance companies often require Independent Medical Examinations, or IMEs, to evaluate whether you remain disabled under your policy.
- These examinations are rarely independent and are arranged by the insurer to support its position on your claim.
- How you prepare for and respond to an IME can significantly affect the outcome of your long-term disability benefits.
- Dabdoub Law Firm focuses exclusively on disability and life insurance claims, representing clients nationwide with proven results in federal court.
Understanding Independent Medical Examinations
An Independent Medical Examination, or IME, is a medical evaluation requested by your long term disability insurance company. The stated purpose is to obtain an impartial assessment of your condition, but in practice, these exams are often used to gather evidence that supports a denial or termination of benefits.
Being informed and strategic before, during, and after an IME is essential to protecting your rights. The following five do’s and don’ts provide clear guidance on how to approach the process.
1. Do Check Your Insurance Policy First
Before agreeing to an IME, review your insurance policy to confirm that the insurer has the contractual right to require one. Policies differ, and some limit the circumstances or types of examinations that can be requested.
Do:
Verify that the long term disability insurance policy authorizes an IME and identify the specific type of exam permitted.
Do Not:
Assume that the insurance company has an unrestricted right to send you for any examination it chooses. You are entitled to understand the scope of your obligations and to advocate for yourself if the request for an examination is not permitted by the terms of the long term disability insurance policy.
2. Do Ask for Specific Details About the Examination
You have the right to know who will examine you and whether that person is qualified to evaluate your condition. Insurance companies often use physicians who perform frequent evaluations for insurers, not treating specialists.
Do:
- Request the doctor’s full name, curriculum vitae, and professional background in writing.
- Confirm that the doctor has relevant expertise in your specific medical condition.
Do Not:
Agree to an IME conducted by a physician who lacks the proper qualifications. For example, a neurologist should evaluate a neurological condition, not an orthopedic surgeon or general practitioner.
3. Do Engage the Insurance Company in Writing
Communication about the IME should be in writing. Ask the insurer to explain the medical reasons for the requested examination.
Do:
Ask what medical questions the insurer expects the IME to address and for the reason an IME is even needed.
Do Not:
Assume that every IME request is appropriate or permissible. If the request seems unnecessary, redundant, or unrelated to your condition, it should be challenged. The law does not give insurance companies a blanket right to have you examined just because you have a LTD claim.
4. Do Take Thorough Notes and Go Straight Home After the Exam
Your recollection of what occurred during the IME can be a valuable form of evidence. Detailed notes can help clarify any inaccuracies or misstatements made later by the examiner or insurance company.
Do:
- Write down the time, duration, and specific procedures of the examination.
- Note what the doctor asked, how you responded, and whether any tests or observations were performed.
- Go directly home afterward. Insurance companies sometimes conduct surveillance before and after IMEs, and your activity may be used against you..
Do Not:
Rely on the IME doctor to document everything accurately. Your own notes may be essential to correcting false or misleading information later in the claim process.
5. Do Seek Legal Guidance Before and After the Examination
Independent Medical Examinations often serve as the basis for denying or terminating benefits. Consulting with a disability insurance attorney before attending can help you understand your rights and obligations.
Do:
- Call Dabdoub Law Firm before the IME to understand whether you can challenge the request for an IME, what to expect if you go, and how to manage your disability claim with a potential unfavorable IME report..
- Provide our team with detailed notes afterward so that any discrepancies can be addressed immediately.
Do Not:
Assume that the IME report will be neutral or fair. These examinations are conducted for the insurer’s benefit, not yours, and legal representation ensures that your right to long term disability benefits is protected.
How Dabdoub Law Firm Can Help
Independent Medical Examinations are a crucial part of many long-term disability claims. Proper preparation and a clear understanding of your rights can make the difference between approval and denial.
Dabdoub Law Firm assists clients nationwide at every stage of the disability insurance process, including:
- Filing a disability insurance claim when the insurer delays, denies, or underpays benefits.
- Appealing a wrongful termination of benefits following an IME or other review.
- Negotiating a lump-sum settlement when a fair and final resolution is in your best interest.
- Litigating your claim in federal court when the insurer refuses to act in good faith or comply with its obligations under the policy.