What Is An Independent Medical Exam And Why Is It Important?
After an accident or another event leading to an injury, a victim might file a personal injury claim to recover financially for losses and damages. Compensable damages include lost wages, pain and suffering, emotional distress, and medical expenses.
Medical expenses can be especially costly and might include emergency treatment, diagnostic testing, hospital stays, medication, surgery, therapy costs, and more. You should not have to cover these costs if someone else causes your injuries. Such financial recovery for these bills can help you move forward after an injury in a more secure position. A trusted personal injury lawyer can evaluate your circumstances and advise you if you have a claim for compensation for your medical expenses.
To recover for medical expenses related to physical or mental injuries, you and your personal injury attorney must present medical reports and exam results to insurance companies as evidence of the existence and extent of your injury. Sometimes, these records are fairly straightforward, but insurance companies might challenge one or more aspects of your injuries.
This is why, in certain personal injury cases, the party facing the claim or their insurer will request an independent medical examination (IME). What does this mean? What do you do if you receive this request? Read on to learn more about independent medical exams from our experienced St. Louis personal injury lawyers.
The Basics Behind an Independent Medical Exam
The basic purpose behind an independent medical exam is to have a non-biased review of a plaintiff’s medical condition to:
- Verify the reported injuries are real, and all treatment was necessary
- Ensure that medical records are accurate regarding the extent of physical, emotional, or mental damage that the plaintiff claims
- Confirm the injuries did not arise from a different cause
An IME is not necessary in every case, but there are certain instances when defendants or insurance companies may order this exam as part of the claim or lawsuit process. One common situation is when the insurance policy language requires the injured party to submit to an examination as a condition of receiving payment. Courts may also order an IME when the injury is reasonably in dispute.
How a St. Louis Personal Injury Lawyer Can Help With an IME
Many people are understandably hesitant to see a doctor they do not know, though it might be necessary to complete your injury claim. Always discuss your obligations to attend an exam with your personal injury lawyer. They can advise you whether it is a requirement of your claim.
If you must continue with the medical exam, your lawyer can take steps to prevent bias by the independent physician. Sometimes, the insurance company chooses the doctor, and sometimes, you and your attorney might do so. Your personal injury lawyer can review the situation and ensure you understand your options.
If the insurance company chooses the doctor, your attorney will work to prevent bias in favor of the insurer.
- First, the selected doctor must not have any pre-existing doctor-patient relationship with the plaintiff or a coinciding confidential agreement.
- Second, to ensure the physician can conduct a proper IME, they should have sufficient medical knowledge and training regarding your type of injury and also have experience and special credentials in the same area of medicine.
An experienced personal injury lawyer knows how to ensure that your IME is as fair and unbiased as possible. If the results of an IME unfairly favor the insurance company or defendant, we can take the necessary steps to challenge the exam report.
The Independent Medical Exam Report
The report resulting from an IME should include a basic descriptive portion, including:
- The injury dates and summary of the conclusions
- A history of the claim, including references to the findings and review of the medical records
- All conversations between the independent doctor and the injured party
- The diagnosis from the physical examination.
As the injured party, you can assist in completing the IME report by arriving on time for the examination, bringing all relevant medical records, and complying with the exam by providing direct and concise answers. Your personal injury lawyer can prepare you for what to expect and how to act to improve the chances of accurate results that support your injuries and losses.
Preparing for an Independent Medical Examination
When you prepare for an independent medical examination, get ready to talk about your injuries, symptoms, and how they affect your day-to-day living. Be sure to know the general timeline of your injury and its effects. You can even practice answering questions with your lawyer if need be. Never offer information – only answer the questions. Medical professionals should ask you the appropriate questions and prompt you for any further details.
You don’t need to bring notes, records, or documents. Your only job is to give those forms to the insurance company. It is your insurer’s responsibility to offer the doctor all relevant information. Allow the doctor to base their assessment on what they already know or learn during the examination.
When the insurance company sends little to no information to the doctor, this is a red flag that they are trying to restrict information. This is not your problem. If the doctor forms an opinion based on incomplete information, this reflects poorly on the insurance company. Your best bet is to go to the appointment without anything other than whatever the insurance company or doctor specifically asks you.
Be aware that you will have to fill out paperwork. You may have the option to do this ahead of time or at the start of the appointment. If you have any reservations about what you will have to sign, you can always request to see the forms ahead of time.
More recently, insurance companies hire third-party agencies to arrange assessments. The smooth flow of information through the third-party agency is critical. You will have to sign a release form to allow for the flow of information. Agree with that and sign the form. Any refusal to sign these forms is the same as refusing to attend. Relinquishing consent can always take place afterward. You risk the suspension of your benefits or having them cut off for not cooperating.
Plan so you can arrive on time and safely. The independent medical examination can take a lot out of you. Keep a backup plan in place if you cannot drive yourself home afterward.
Can I Bring Someone with me to the Exam?
One person may accompany you to the exam location. However, no one can sit inside the exam room with you. The only exception is if there is a medical need that the scheduling team is aware of in advance.
Expectations During the Exam
During the appointment, the examiner will:
- Review all medical records and reports before the appointment
- Take a medical history report from you
- Conduct a physical examination
- Order additional tests, if need be
- Write and file a report
The examiner will not treat you, but a copy of the report will go to your usual doctor, who can then review treatment recommendations with you.
How Do You Obtain a Copy of the IME report?
Workers who sustain injuries can access their entire case file, including independent medical examinations. The independent medical examination report is available two weeks after your appointment. You can also request the information from your claim owner. For other personal injury claims, your
How long does it take for the doctor to issue the report?
The amount of time it takes for a doctor to issue a report relies on the number of issues and the case’s complexity. The more complex and the number of questions, the longer it generally takes to receive the complete information. Straightforward questions may only take a week or two before completing the report. An attorney provides you with a copy of the report and discusses the doctor’s conclusions with you once the attorney gets the report.
Do Independent Medical Examinations determine the outcome of the claim?
Physicians do not make any claim decisions. They merely provide a medical opinion to assist the claim owner in arriving at a decision. It is the responsibility of the claim owner to weigh all the available evidence on the claim, as the independent medical examination to arrive at entitlement decisions.
Final Takeaway on Independent Medical Examinations
For the most optimal results, you need to be in the right frame of mind before going into an independent medical examination. Have every intention of cooperating and fulfilling your duties by going above and beyond expectations. You do not want to argue and act defensively due to reading something terrible about the doctor online.
Independent medical examinations tend to cause stress for injured employees. This is because they do not know what to expect. Due to this, it is essential to have an experienced professional lawyer on your side who can fight for your compensation rights. The right attorney will ensure that independent medical examinations do not cause any unnecessary worry on your end.
Contact a workers’compensation lawyers for a free consultation by visiting a trusted law firm’s website. You want to seek legal help as soon as possible, especially if you already filed an insurance claim without legal help.
Proceeding through the insurance process alone increases the chances of mistakes, such as not attending an IME, which can present unnecessary obstacles to receiving benefits or compensation for your injuries. Do not risk complications with your claim – reach out for legal help today.
I represent individuals in Missouri and Illinois in all types of personal injury cases. In my short time here I have obtained a judgment for $2.5 million and settled a large class action lawsuit for a confidential amount.
I love the city of St. Louis and support it and give back whenever I can. Recently I was appointed by Mayor Francis Slay to serve on the Advisory Board for the Gateway Mall.
I am married to my lovely wife Lauren and we have two beautiful daughters, Mia and Bridget.