Independent Medical Examinations (IMEs) and Worker’s Compensation
They are hailed as independent medical examinations, hence the acronym, IME; our firm refers to them as DMEs or defense medical examinations. They are also referred to as insurance company medical examinations. Generally speaking, the examinations are far from independent; they are designed to gather information so the insurance company has the evidence it needs to either deny your benefits or to defend against your medical claims in court.
Many of these examinations take no more than two or three minutes and may seem like a joke, and (in fact) many of them are that way. The waiting room may seem like a cattle call, with many people waiting hours to be seen. In more serious cases, the exams are conducted more professionally and take more time. They can be conducted by a physician, a chiropractor, an acupuncturist, or a mental health professional.
These examinations are conducted in no-fault, worker’s compensation and disability cases and may directly impact whether your medical benefits continue or not. If the exam is for your liability lawsuit, we may recommend that you have an attorney or advocate present.
Whenever someone has either a no-fault claim or a worker’s compensation claim, the insurance company paying the benefit is entitled to have the injured party examined as often as the insurance company prefers, and by as many different doctors or specialists as the insurance company requests. This is done in order for the insurance company to verify that the injured party still needs treatment, and to identify which types of treatment they require. It is important to advise us when you receive a notice for an examination so that we can guide you accordingly. If possible, you should bring someone with you to the exam. Another set of eyes and ears is always helpful. Regardless of the purpose for the exam, realize that the examiner is NOT consulting with you for your benefit. They are not going to give you advice and are certainly not looking out for your best interests.
If you are appearing for a liability exam, the defendant’s (the party that is being sued) insurance company is entitled to an examination to verify your injuries, whether they are causally related to the events that occurred, to determine if future treatment is needed, and what types of future problems you may have as a result of the injuries sustained. The examiner will have copies of your records and test results in advance. Any questions that they ask should be added to that information.
When it comes to attending these examinations, it is important for you to have information regarding the events that will transpire:
- How should you act?
- What paperwork should you complete (or not complete)?
- Will testing be conducted during the exam?
- Should you be accompanied by someone?
- Should an advocate attend?
On many occasions, we assign an outside, independent company that sends a representative to attend these examinations with our clients to advocate on their behalf. If we were to attend with you, there would be an obvious argument that our perceptions of how the exam was conducted, how long (or short) it was, and relaying comments made by the examiner would be viewed by a judge or jury as likely to be biased and therefore unreliable. Therefore, we may retain an independent advocate to attend your exam. These advocates are trained, have been to many types of examinations, and will intervene to explain to the client what they should say, when they should say it, and how they should say it in order to avoid problems. The advocates also step in to keep the doctor or the doctor’s staff from overreaching in terms of questioning during the examination.
Whenever you have a medical examination relating to your liability, no-fault, worker’s compensation or disability case, you should consult with an experienced personal injury attorney. I have three decades of experience in this field and will guide you through the process for the best result possible.
As always, reach out to us at 631-486-9500 for assistance.
James F. Leonick
Leonick Law, P.L.L.C.
TEL: (631) 486-9500