The insurance company wants you to see their doctor for an independent medical examination, often called an IME. The letter arrived certified mail, giving you a date, time, and location to appear. You’re worried about what this examination involves, whether the doctor will be fair, and how it might affect your claim. These concerns are understandable because IMEs serve the insurance company’s interests, not yours.
Our lawyers discuss how independent medical examinations are rarely as independent as the name suggests. A bicycle accident lawyer can prepare you for the IME process, explain your rights during the examination, and challenge biased reports that don’t accurately reflect your condition.
What An IME Actually Is
Despite the term “independent,” these examinations are arranged and paid for by the insurance company. The doctor conducting the exam works regularly with insurers, often performing multiple IMEs weekly. Their income depends on insurance company referrals, creating inherent bias toward findings that favor their paying clients.
The insurance company selects doctors known for producing reports helpful to defense cases. These physicians rarely find serious injuries or agree with treating doctors’ assessments. Their reports typically minimize your injuries and suggest you’ve recovered or exaggerated your complaints.
IME doctors don’t become your treating physician. They examine you once, spend 20 to 45 minutes with you, and write a report for the insurance company. They don’t provide treatment, follow-up care, or ongoing management of your condition.
Why Insurance Companies Request IMEs
Insurance companies use IMEs when they want ammunition to deny or reduce your claim. If your treating doctors document serious injuries requiring extensive treatment, the insurer seeks a contrary opinion to justify paying less.
The timing of IME requests often coincides with settlement negotiations. When you demand significant compensation based on your doctors’ findings, the insurance company orders an IME hoping for a report that supports a lower settlement offer.
Some insurance policies and state laws allow insurers to require IMEs as a condition of coverage. Refusing to attend can result in suspension of benefits or claim denial, giving insurance companies leverage to force compliance.
Before The Examination
You’ll receive notice of the IME with the doctor’s name, location, date, and time. Research the examining physician online. Many IME doctors have reputations for consistently finding minimal injuries and producing defense-favorable reports.
Contact your attorney before the IME. They can provide specific guidance based on the examining doctor’s background and typical approach. Some attorneys arrange to have the examination videotaped or have a representative present to observe.
Bring a list of all your current medications, medical providers, and treatment dates. Having accurate information available prevents misstatements that could appear in the report. Don’t bring your complete medical records, as the insurance company should have already provided relevant records to their doctor.
What Happens During The Examination
The IME typically begins with the doctor reviewing your medical history. They’ll ask about the accident, your injuries, symptoms, treatment, and how the injuries affect your daily life. These questions mirror what treating doctors ask, but the IME doctor’s focus is finding inconsistencies or reasons to minimize your claims.
The physical examination component varies by specialty and claimed injuries. Orthopedic IMEs involve range of motion testing, strength assessments, and manipulation of affected body parts. Neurological exams include cognitive testing, reflex checks, and sensory evaluations.
During the examination:
- The doctor may push you to do movements that cause pain
- They’ll note when you say something hurts or limit movement
- They observe how you move, sit, and stand throughout the visit
- They watch your demeanor and emotional responses
- They may ask the same questions multiple ways to check consistency
The entire process usually takes 30 to 60 minutes, though complex cases might last longer. This brief encounter stands against months of treatment with your regular doctors.
What To Say And Not Say
Be honest and accurate about your symptoms and limitations. Don’t exaggerate or minimize your condition. Overstating your injuries gives the IME doctor ammunition to call you a faker. Understating your problems results in a report saying you’re fine.
Answer questions directly without providing unnecessary information. If the doctor asks if you can lift your arm above your head, demonstrate your actual ability. Don’t explain your entire shoulder injury history unless specifically asked.
Don’t discuss your case strategy, settlement negotiations, or what your attorney has told you. These topics aren’t medically relevant, and any comments might end up in the report used against you.
If a movement or test causes significant pain, say so clearly. Don’t try to tough it out or push through pain to prove you’re not weak. The doctor needs to understand your genuine limitations.
The IME Doctor’s Report
Within a few weeks of your examination, the IME doctor produces a written report for the insurance company. This document summarizes your history, describes the examination findings, and provides opinions about your injuries and treatment.
Common themes in defense medical reports include claiming your injuries are minor, suggesting you’ve fully recovered, arguing that treatment has been excessive, and stating you can return to normal activities without restrictions.
IME doctors frequently attribute your symptoms to pre-existing conditions, normal aging, or causes unrelated to the accident. They often disagree with treating physicians about the severity of injuries and necessity of ongoing treatment.
These reports rarely acknowledge the full extent of claimant injuries or support claims for significant damages. The conclusions typically align with the insurance company’s desired outcome of paying less.
Your Rights During The IME
You can refuse to answer inappropriate questions about your personal life, finances, or other topics unrelated to your medical condition. The examination should focus on your physical or mental health related to your injury claim.
You’re allowed to bring someone with you to the examination. Having a witness present can prevent mischaracterizations of what occurred during the exam, though the observer typically can’t interfere with the examination itself.
In some jurisdictions, you can record the examination. Check your state’s laws about recording medical appointments and whether insurance agreements allow documentation of IMEs.
You don’t have to sign authorizations for additional medical records at the IME. The insurance company should have already provided the doctor with relevant records. Signing new releases might give them access to unrelated medical information.
Challenging Biased IME Reports
Your treating physicians’ opinions carry more weight than one-time examination reports. Doctors who’ve treated you over months understand your condition better than someone who spent 30 minutes with you.
Your attorney can retain medical professionals to review the IME report and identify flawed conclusions, incorrect assumptions, or findings inconsistent with documented evidence. These rebuttal opinions counter the defense doctor’s report.
Some IME doctors have documented histories of bias, always finding in favor of insurance companies. Exposing this pattern through testimony records and report statistics can undermine their credibility.
After The Examination
The insurance company will use the IME report in settlement negotiations and potential litigation. Expect their settlement offers to decrease if the IME report claims your injuries are minor or you’ve recovered.
Don’t panic when you see a negative IME report. These reports are expected to favor the insurance company and can be challenged with evidence from your treating doctors, your own testimony, and sometimes additional medical evaluations.
Continue following your treating doctors’ recommendations regardless of what the IME doctor says. The IME doctor isn’t treating you and their opinions don’t override your actual physicians’ treatment plans.
Preparing For The Process
Understanding that IMEs serve insurance company interests helps set appropriate expectations. These examinations feel adversarial because they are. The doctor’s role is finding reasons to pay you less, not providing objective medical evaluation.
Knowing what to expect reduces anxiety and helps you present your injuries accurately without falling into traps. Proper preparation prevents common mistakes that result in reports more damaging than necessary.
Getting Support Through The IME Process
If you’ve been scheduled for an independent medical examination and feel anxious about the process, reach out to discuss how to prepare effectively and protect your interests during the examination. Understanding your rights and knowing what these doctors look for helps you navigate the IME while minimizing potential damage to your claim.