What is an Insurance Medical Exam?
An Insurance Medical Exam (IME) is a medical evaluation required in a personal injury lawsuit conducted at the behest of the defendant, who selects the examining physician.
While a plaintiff can also undergo an IME with a physician of their choosing, the focus here is on IMEs initiated by the defense. The intent behind such an IME is to prepare the defendant’s expert witness—the examining doctor—to argue that the plaintiff’s injuries are either nonexistent, less severe than claimed, or fully healed. This positioning often aims to prematurely declare a plaintiff at Maximum Medical Improvement (MMI) to halt further medical care. Given defense attorneys’ financial incentives for repeat business, the examining physician may present findings less favorable to the plaintiff. Understanding these dynamics is key to mitigating potential negative impacts from an IME.
The Oklahoma Statute, 12 O.S. §3235 allows the examination:
- Scope: Allows examinations if the condition is contested within the case.
- Procedure: Describes how to request an examination, including timing and notice requirements, and outlines steps to take if there’s an objection or non-compliance.
- Order for Examination: The court can order an examination with demonstrated good cause and specify its details.
- Representative Presence: A representative may accompany the person being examined.
- Report of Examiner: Mandates sharing the examiner’s detailed report with involved parties and notes that obtaining this report waives certain patient privileges related to the case.
How to Handle the Exam Itself
Upon scheduling by the defendant, your attorney will inform you about the IME, including the examiner’s identity and office location.
Given their familiarity with frequent IME physicians, your attorney can offer insights into what to expect. They may also advise on whether they or another representative will attend the IME, as practices vary by jurisdiction.
Be aware that your actions may be observed when you arrive at the facility. Some examiners scrutinize plaintiffs’ movements in the parking lot and waiting room to find discrepancies in claimed injuries. If you allege difficulty sitting for prolonged periods, avoid contradicting this claim by sitting comfortably in the waiting area for extended periods.
Take Note of the Exam Duration
IMEs are often brief, sometimes lasting only about 10 minutes!
Document the start and end times for future reference. You will likely be asked to complete a questionnaire detailing your medical history and current condition.
Consistency in describing your symptoms, as you have with your treating physicians, is crucial. You can refer the examiner to your completed questionnaire if questioned about the same information during the physical examination. This redundancy may be an attempt to identify inconsistencies. Additionally, if the examiner inquires about details irrelevant to your injuries, such as specifics of the accident, consult your attorney before responding.
Do Not Exaggerate
It’s vital not to embellish your symptoms. The examiner may seek to discredit your claims by encouraging exaggeration. Accurately describe your pain and the conditions under which it occurs. For instance, if a shoulder injury causes discomfort in specific movements but not others, report this precisely. Inform the examiner of any pain experienced during the examination, even if not directly asked.
Do Not Socialize
Maintain a professional demeanor during the exam. The examiner, paid by the insurance company, does not need personal details unrelated to your medical condition. Avoid filling out any post-exam questionnaires, as these can be used to undermine your credibility, regardless of the feedback provided.
The IME Report
Review the examiner’s report with your attorney to identify any inaccuracies or omissions regarding your complaints. While the examiner may downplay your injuries or suggest they are unrelated to the accident, focus on factual inaccuracies. Your attorney will address the examiner’s opinions at the appropriate time.
Independent Medical Exam FAQs
What should I do if the IME doctor asks about the accident details?
If the IME doctor inquires about accident specifics unrelated to your injuries, politely decline to answer until you consult your attorney. This ensures that you do not provide information that could be used against your case.
Can I refuse to answer specific questions during the IME?
You can refuse to answer questions you feel uncomfortable with or unrelated to your medical condition. It is advisable to consult with your attorney to handle such situations.
How can I ensure my symptoms are accurately reported during the IME?
Describe your symptoms and the impact of your injuries consistently and truthfully, both on the questionnaire and during the exam. If the examiner suggests symptoms or injuries you do not have, do not agree for the sake of conformity.
What happens if the IME report contains inaccuracies?
Discuss any discrepancies or omissions in the IME report with your attorney. They can help address these inaccuracies and ensure your case is accurately represented.
Is it necessary to bring someone with me to the IME?
While not always necessary, having a representative from your attorney’s office, such as a paralegal or videographer, can provide additional oversight. This varies by jurisdiction and attorney preference.
How should I prepare for the IME?
Review your medical history and any previous statements about your injuries to ensure consistency. Consider bringing notes if you have difficulty remembering specific details.
Can the IME doctor refuse to let my attorney’s representative attend the exam?
Policies on attendance by a plaintiff’s representative during the IME vary by jurisdiction. In Oklahoma, attorneys are allowed to view the exam. Your attorney will advise on the rules applicable to your case and the best approach.
What if I’m uncomfortable during the physical examination?
Inform the examiner immediately if any part of the examination causes discomfort or pain. This is important for accurately documenting the effects of your injuries.
How long after the IME will I see the report?
The examiner’s written report is typically provided to your attorney within a month after the exam. Your attorney should review the report with you to identify any issues and inconsistencies.