What is an Independent Medical Examination?
09.16.2019 Written by: Henningson & Snoxell, Ltd.
Don’t let the name fool you, there is nothing independent about the medical examination arranged for you on behalf of the insurance company. These Independent Medical Examinations or “IMEs” are also referred to as Adverse Medical Examinations.
Why am I being sent to an Independent Medical Examination?
You may have received a notice from the insurance adjuster telling you that you are being sent to an Independent Medical Examination or IME. If you are receiving medical or wage loss benefits from the workers’ compensation insurance carrier or no-fault insurance carrier than they have the right to send you to be evaluated by a doctor of their choice. Generally, you are being sent to an IME because the insurer disagrees with what your treating physician has recommended for your medical care and treatment. The insurer is looking for a legal basis to cut off your wage loss or medical benefits. Frequently, you will be sent to an IME because the insurer feels that you should somehow just be better by now or back to work, despite your doctor’s opinion. Or you may be sent to an IME because your doctor has recommended surgery or another type of procedure. The insurer is looking to cut down costs and does not want to have to pay for surgery or other expensive medical treatment or to continue to pay wage loss benefits. If you are being sent to an IME, be assured that the insurer will begin to contest and play games with your entitlement to work comp or no-fault benefits.
Who performs the Independent Medical Examination?
The doctors who are performing the independent medical examinations are hired by the insurance company and act accordingly. These doctors are typically hired by a medical-legal consulting company, such as Evalumed, ExamWorks, or Integrity. The insurance adjuster contracts with the medical-legal company who provides the doctor. The examinations do not take place where the doctor actually practices medicine, these exams take place at an off-site location or an office specially designed for these examinations. These doctors are paid very well to perform these examinations and a popular doctor may perform as many as 5 a week on behalf of an insurance company. The doctor will inform you that you are not a patient and that no doctor-patient relationship exists or will be established. He or she will report directly to the insurance company. These doctors are professional witnesses and know that their reports will be used for the purposes of litigation. The IME doctors frequently testify in court via deposition or live testimony regarding your medical condition on behalf of the insurance company. An IME doctor is not looking out for your best interests.
What should I do during my Independent Medical Examination?
- Show up on time. While the doctor may show up late and the appointment may only last 15 minutes, you need to be on time.
- Do not cancel unless it’s an emergency. If you cancel and it is not an emergency, you will be charged a very high cancellation fee by the insurer. If you know you will be unable to attend the appointment, either immediately contact your attorney or if you are unrepresented, contact the adjuster.
- Be polite and honest but do not trust the doctor. Remember this doctor is hired by and is working on behalf of the insurance company. You will not convince the doctor that you are injured. Tell the truth and rely on your own treating physician.
What happens next?
You will receive a copy of the IME report which may take a few weeks, depending on the amount of your medical records as well as the doctor’s schedule or how quickly the insurer wants to attempt to cut off your benefits. Rarely will the independent medical examiner find in your favor. If the IME doctor finds that you are not hurt, and if you are hurt, it is not work or accident related, immediately contact an attorney who will be able to fight for your benefits in court.
Contact Attorney Mary Beth Boyce at Henningson & Snoxell, Ltd. at (763) 560-5700 for a free, no-obligation consultation regarding your PERA/MSRS Duty Disability and/or workers’ compensation case for more information about the statutory requirements as well as the application process. Mary Beth is experienced in PERA and MSRS Duty Disability law and repeatedly successfully establishes entitlement to PERA and MSRS Duty Disability benefits for her clients injured in the line of duty.