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What is an "Independent Medical Examination"?

If you have filed a personal injury lawsuit, at some point in the process the other side's insurance company will likely ask you to submit to an “independent medical examination” (IME) by a doctor of their choosing. The insurance company is well within their rights to make this exam a required part of the lawsuit process. During this exam, the doctor will ask you questions about the underlying accident and the specifics of your injuries. Once the exam is complete, a report will be prepared and sent to the insurance company.

Keep in mind that this particular doctor is examining you not for the purpose of treatment, but to obtain information for the insurance company concerning the extent and nature of your injuries. (Learn more about The Role of Insurance in Settling an Injury Case.) It's important to take this exam seriously and to make the best impression possible. Here are some tips on preparing for and attending the IME.

Preparing for the Independent Medical Examination

Keep your appointment. Your failure to attend the exam may result in the suspension of payment of your medical bills.

Know what you're getting into. Remember that this doctor has been selected to perform the IME because of a pre-existing professional relationship with the insurance company. This is not to suggest that any doctor who performs an IME is biased against injured claimants, but it's safe to assume that the doctor is not exactly in your corner. In part, the doctor is keeping an eye out for any indication that your injuries are attributable to some pre-existing condition (not the underlying accident), or that you're not hurt as badly as you say you are.

Honesty is the best policy. Be polite, cooperative, and above all, truthful. If you appear to be embellishing an injury during the exam, or if findings from the exam don't jibe with your stated symptoms, the doctor is likely to mention that prominently in the report.

Get organized. One way to feel more confident during the exam is to gather your thoughts on your medical history, the accident that led to the claim, your resulting injuries, and the effect those injuries are having on you. Write notes and bring them to the exam if it helps. Here are some topics to touch on:

  • your medical history, including previous injuries

  • how the injury occurred

  • what areas of your body were/are affected

  • when your injuries cause you the most pain (including movements or activities that aggravate your injuries)

  • treatment or medication that has been effective for you, and activities that have been affected or limited, including your job, hobbies, family life, etc.

Practice talking with someone about your injury ahead of time, describing the topics listed above and explaining how the injury has affected your life.

Note the date, time and place of your exam and the name of the doctor who will be examining you. Get any directions you need well ahead of time.

Arrive early. You'll be more relaxed and have time to fill out any forms.

Meeting the Doctor

The doctor will probably start out by asking a series of questions about the accident and your injuries. It's best to answer these questions the same way you'd respond in a personal injury deposition. For example:

Make sure you understand each question before you answer it. For example, if the doctor asks, "How do you feel now?" you should find out if he wants to know how you feel that minute or at this point after the injury. You may feel pretty well at that particular moment, but may have had pain associated with your injury earlier in the day, so it's important to be specific and accurate in your answers.

Take time to answer all questions carefully. If a question is unclear or confusing, don't be afraid to ask the doctor to explain or rephrase the question before you answer. If you make a mistake, correct it immediately.

Avoid unnecessary elaboration. Remember that the doctor has been hired by the insurance company and will likely end up testifying for the other side (if your case gets to trial). So, while you should always answer a question politely and honestly, don't ramble on or start providing unsolicited information.

Be precise. During the exam, you'll be asked to describe any pain and discomfort you've been experiencing as a result of the accident. Since pain is subjective, you need to paint a clear picture of what you're experiencing. Describe your pain by referring to specific areas of your body that hurt, categorizing the type of pain you're experiencing (sharp, searing, aching, dull), and relating movements and situations that make the pain worse. Don't understate your pain and the problems it causes you, but don't exaggerate either.

Behave consistently. You'll know when the doctor is examining you, but don't forget that he or she will also be observing you, and it's safe to assume that any inconsistencies between your behavior and your stated symptoms will be noted for the IME report. For example: You told the insurance adjuster that you can't turn your head to the right. But the doctor stands to your right and asks you a question. You turn your head in that direction to look the doctor in the eye while answering, and you've just given the insurance company a reason to doubt your story.

The Physical Exam

Specific examination procedures in an IME will vary depending on the nature and extent of your injuries and the doctor's preferences and practices. But here are a few things to avoid:

  • Do not allow the doctor to take X-rays or conduct other diagnostic tests.

  • Do not take any written or psychological tests such as a MMPI.

  • Do not agree to go to any other doctors or facilities without your attorney's approval.

It's important to note the exact amount of time the doctor spends actually examining you, because the doctor will prepare a detailed report regarding your injuries despite having spent a short time actually examining you.

You may want to keep a timeline in your head of what happens, and when. For example:

  • 2:00 p.m. Arrive at the doctor's office

  • 2:15 p.m. Appointment scheduled

  • 2:30 p.m. Go to examining room

  • 2:40 p.m. Doctor arrives in examining room.

  • 3:00 p.m. Interview ends, told to undress, doctor leaves

  • 3:10 p.m. Doctor returns and begins exam

  • 3:15 p.m. Examination over

  • 3:20 p.m. Leave clinic

You'll want to ask for copies of any medical reports prepared by the examining doctor.

Always count your x-rays and other records before you give them to the doctor and after you get them back. Make sure you leave with the same number of documents you had when you arrived.

After the Exam

Once the exam is over and you have left the doctor's office, prepare a written summary of everything that happened, while it is still fresh in your mind, including:

  • questions the doctor asked

  • answers you provided

  • what, if anything, the doctor dictated into a tape recorder during the exam

  • what tests or procedures the doctor performed

  • the rough timeline we touched on in the last section (including how much time the doctor spent with you)

  • any inappropriate or unusual questions or comments made by the doctor.

The doctor will prepare a report for the insurance company describing your examination, along with his or her findings and opinions. But keep in mind that after an IME, it is extremely rare for the examining doctor (who is chosen and paid by the insurance company, remember) to determine that:

  • the claimant's injuries are as extensive as they say

  • the claimant's injuries are all attributable to the underlying accident, and

  • the claimant is going to continue to experience physical limitations and ongoing discomfort.

So be prepared for some bad news in the IME report, but don't forget to keep in it context, considering the source.

You'll also want to schedule an appointment with your own physician immediately after the IME. Try to make sure your physician's report is the latest one the judge sees.

Robert A. Johnson is a partner at Mansfield Tanick & Cohen, a Minneapolis firm that provides legal services to individuals, families, businesses and organizations nationwide. His practice areas include personal injury cases and motor vehicle accidents.

From Lawyers  By Robert A. Johnson | Reviewed by David Goguen, J.D., University of San Francisco School of Law

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