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Do I Need to Undergo an Independent Medical Examination for my Injury Claim?


Posted On behalf of Pfeifer Morgan & Stesiak on Jan 25, 2021 in Advice

independent medical examAn Independent Medical Examination (IME) is almost precisely what its name suggests: a medical exam. However, it is not exactly independent. That is because the doctor who performs this exam is being paid by the insurance company and is more likely to write a report that favors the insurer instead of an accurate report about the treatment you need for your injuries.

If you are filing a claim and the insurance company is requiring you to undergo an IME, our South Bend personal injury attorneys may be able to help you. Give us a call to learn more.

What to Expect from the Doctor

It is important to understand that the doctor who is performing your medical exam is not your friend. You should know that he or she may be rude and skeptical of your injuries during the examination. 

Remember, this doctor is being paid by the insurance company and the more times he or she says a patient has had enough treatment or is not as seriously injured as the patient claims to be, the more patients the insurance companies will refer to them and the more money they get in their pocket.

These doctors are out for their own interests and your insurers’, Not yours.

What to Say to the Doctor

Knowing what to expect from the doctor helps you understand what you should and should not say during the examination.

First, it is extremely important to be honest when answering questions the doctor asks you during the exam. You should not change your story or exaggerate your injuries. Pain is subjective, so what the doctor believes your pain level should be is something that could be disputed by your attorney later.

When answering the questions during the exam, you should not give additional details that are not relevant to the question being asked. Try to keep your answers as short and to the point as possible.

Imagine this scenario: You go to the IME as required by the insurance company for a back injury that requires extensive physical therapy treatment. The therapies are helping, and you are feeling a lot better, but your doctor says you still need more sessions to be completely healed. During your exam, you are asked about how your sessions are going and you answer honestly, saying you feel better. You leave the exam feeling good about your answers and when the report comes back, you learn that the insurance company will no longer cover future physical therapy treatments.

Scenarios like these happen often, usually because once a patient says he or she feels better, the doctor hired by the insurance company will write a report saying he or she is healed and no longer needs treatment. Even if you still require a few more treatments for a full recovery.

What to Expect from the Report

Even if you believe you are being treated fairly and the doctor is kind, the report that gets written and sent back to the insurance company may conflict with what your doctor says and the claim filed by your attorney.

In this report, there is usually an introductory section where the doctor writes all the basic descriptive data about your exam, including the date of your injuries. The report will most likely include a history of the claim with a thorough review of your medical records and will discuss the conversation between you and the doctor. At the end of the report, the doctor will give his or her conclusions with a diagnosis or prognosis, which is what the insurance company uses to decide whether to continue paying for treatment.

Call an Experienced Attorney

If your IME report conflicts with your doctor’s opinion for treatment and the insurance company is refusing to pay, you may have legal options. It would be in your best interest to have an experienced attorney on your side who is prepared to fight for you.

Our attorneys have decades of combined experience helping injury victims. We do not charge you anything up front and only get paid if we win your case, so there is no risk to you.

Call today to schedule your free consultation: (844) 678-1800