When you’re involved in a personal injury case, particularly one that involves an insurance claim or a lawsuit, an independent medical examination (IME) may come into play. While the term “independent” might suggest that the evaluation is objective, the reality can be quite different. In fact, many independent medical examiners are hired by insurance companies, raising concerns about potential bias. This article explores the myth of the independent medical examiner and explains why consulting an attorney is crucial to protect your rights during the IME process.
What Is an Independent Medical Examination (IME)?
An Independent Medical Examination, or IME, is an evaluation of an injured person’s medical condition conducted by a doctor who is not involved in the patient’s care. These exams are often requested by insurance companies to assess the extent of the injury and determine whether the injury is as severe as claimed. IMEs can be used in personal injury claims, workers’ compensation cases, and disability claims.
The examiner is expected to provide an unbiased medical opinion, but the term “independent” can be misleading. Many examiners are hired directly by the insurance company, which creates an inherent conflict of interest. After all, insurance companies are often looking to minimize the amount of money they pay out in settlements, and a favorable IME report can significantly reduce their liability.
Why the “Independent” in IME Is a Myth
While the concept of the IME is intended to provide an objective assessment of an injury, several factors can compromise the independence of the examiner:
- Who Pays the Examiner? The examiner is usually paid by the insurance company, which has a vested interest in reducing the amount they owe in compensation. This financial relationship creates a conflict of interest. The examiner may feel pressured—either directly or indirectly—to provide a report that favors the party paying for the examination.
- Selection of the Examiner Insurance companies often select IMEs based on their track record of producing favorable reports for the insurer. In other words, an examiner who consistently downplays injuries or questions the validity of claims may be more likely to get repeat business from insurers. This compromises the objectivity of the IME.
- Limited Examination Time Unlike the treating physician who has an ongoing relationship with the patient and an in-depth understanding of their medical history, an IME doctor often spends only a short time with the injured party. This limited interaction can lead to incomplete assessments and rushed judgments about the injury’s severity or cause.
- Bias in Report Writing IME reports may emphasize evidence that supports the insurance company’s case while downplaying or omitting details that favor the injured party. For example, the examiner may attribute pre-existing conditions as the primary cause of the injury rather than the accident itself, reducing the insurer’s liability.
The Role of an Attorney During the IME Process
Given the potential for bias in an IME, consulting with an attorney is essential to ensure that your rights are protected. Here’s how an attorney can help:
- Preparing You for the IME Your attorney can provide you with guidance on what to expect during the IME and how to present your medical history accurately. They may advise you on how to handle questions from the examiner and what information to disclose. This can help prevent miscommunication or inadvertent statements that could be used against you.
- Monitoring the IME In some cases, your attorney may request that an observer be present during the IME to ensure that the examination is conducted fairly. This observer could be another medical professional, an attorney, or even a family member. Having an observer can discourage improper behavior by the examiner and provide an additional layer of accountability.
- Challenging a Biased IME Report If the IME report is unfavorable or inaccurate, your attorney can challenge its findings. This might involve gathering additional evidence, such as testimony from your treating physician, or highlighting inconsistencies or biases in the IME report. In some cases, your attorney may request a second opinion from a truly independent medical professional.
- Using Medical Evidence Strategically A skilled attorney knows how to use medical evidence effectively in personal injury cases. They can compile your medical records, treatment history, and expert opinions to build a strong case that counters the IME’s findings. Your attorney’s ability to present a comprehensive medical narrative can be the key to securing a fair settlement or judgment.
What to Do if You’re Asked to Undergo an IME
If you’re involved in a personal injury claim and the insurance company requests an IME, it’s essential to consult with an attorney before agreeing to the examination. Here’s a step-by-step guide to navigating the IME process:
- Consult with Your Attorney Contact your personal injury attorney as soon as you receive the IME request. They can advise you on your legal obligations and rights and help you prepare for the exam.
- Gather Medical Records Ensure that your attorney has all your relevant medical records, including treatment notes, diagnostic reports, and any other documentation related to your injury. This information can be used to compare against the IME report.
- Attend the IME On the day of the examination, be sure to attend the IME as scheduled. Failing to attend could harm your case. However, be cautious about how you interact with the examiner. Answer questions truthfully, but avoid volunteering extra information that isn’t directly asked.
- Follow Up with Your Attorney After the IME, provide your attorney with a detailed account of what happened during the examination. Were there any unusual questions? Did the examiner seem dismissive of your injuries? This information can help your attorney evaluate whether the IME was conducted fairly.
- Review the IME Report Once the IME report is issued, your attorney will review it carefully. If the report contains inaccuracies or biases, your attorney may take steps to challenge it, such as requesting further medical evaluations or filing a motion with the court.
Conclusion
The notion of the “independent” medical examiner is often a myth, particularly in cases where insurance companies are involved. Given the potential for bias, it’s crucial to consult with an experienced attorney who can guide you through the IME process and protect your rights. Your attorney can help ensure that the examination is conducted fairly and that any biased findings are appropriately challenged. By doing so, you can safeguard your claim and increase your chances of receiving the compensation you deserve.