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Independent Medical Examinations

Friday, September 27, 2019

Independent Medical Examinations

40,000 people killed in motor vehicle crashes, 4.5 million serious injuries. (Results from the National Safety Council.)

In a personal injury lawsuit, the opposing side has the legal right to retain expert witnesses to examine you. You must attend. This doctor designated as “independent” is selected and paid by that side; i.e. insurance company.

Independent Medical Examination = Misnomer

These insurance or defense examinations are for one purpose only – to either deny or minimize a claim.

The doctor is examining you not for the purpose of treatment, nor to help you find relief from your injuries. Rather, to obtain information that will either allow the insurance company to stop paying benefits or to cast doubt on your claim of injury.

Insurance companies are very deliberate in the physicians they select. They have been selected for a reason. To remain on these panels, many aim to please their master. (Caveat, not all physicians ascribe to this but far too many do.)

Actions Speak Louder than Words

Surveillance is ubiquitous. Assume that everything you say and do while at the examination will be recorded by the doctor or staff. Simply activities, such as sitting on the examining table or removing clothing/footwear will be recorded as part of their mobility testing. Even how long you sit or how you sit is being observed.

Not unheard of is for the physician to drop something to see how you react. Remain observant and vigilant. Don’t fall for one of these ploys.

Be on Time & Don’t Miss the Examination

Your failure to attend may result in your being responsible for payment of the doctor’s fee or the retroactive termination of insurance payments.

Be Honest

Be polite, cooperative, and above all, truthful. The doctor is trained and experienced to look for exaggeration or malingering. Be candid and straightforward but do be certain to inform the doctor of your limitations.

Prepare for the IME Exam

What you should think about:

  • Your medical history, including prior injuries.
  • How the accident occurred.
  • What areas of your body were injured?
  • Your primary symptoms.
  • When your injuries cause you pain.
  • Movements or activities that aggravate your injuries and cause pain or discomfort.
  • Treatment or medication that makes your injuries feel better.
  • Activities that have been affected or limited.

Do not make notes, and do not bring anything with you.

The Interview

The doctor or an assistant will ask questions about how your incident occurred, medical history, and current condition. They will also notate:

  • General Appearance  – How you walk, stand, difficulty on/off the examination table, expressions, your weight and personal hygiene, etc.
  • Answers to Questions  – Understand before you answer. For example, “how do you feel?” You should ask presently, generally, or in the past. Take your time. There is nothing wrong with asking for a question to be repeated or explained. If you make a mistake, correct it. Avoid unnecessary elaboration.
  • Signs of Deception   – The IME doctor is looking for this. It will be documented in the doctor’s report.
  • Diagnostic Results   – Typically reviewed; i.e. x-rays, MRI’s, CT scans, and EMG nerve conduction studies. The doctor will look to see if your subjective symptoms of pain and discomfort are consistent with the test results.
  • Testing at the Examination   – You will be asked to perform routine tests. Be candid in your subjective indications of pain, discomfort, sensitivity. Try to do the test, but don’t overdo it. The doctor may purposefully mix up the order of tests.
  • Contributing Factors   – • Any relevant history should be discussed. However, unrelated conditions are off limits. Lifestyle factors, such as drinking, smoking, overeating, and recreational drug use, may contribute to the injury.

IME Do’s

Be honest, cooperative, and cordial.

Be pleasant, concerned, and serious.

Be brief, succinct, and thorough.

Be accurate in explaining your home, work and leisure activities, such as lifting, bending, stooping, carrying, and walking.

Be candid in any prior related injury/illness.

Be accurate in any disability/limitations; including why you can or cannot, or why you do or do not do certain things.

Answer questions simply; even if a “yes/no”. Never guess! If unsure or don’t know just say that. (Keep conversations with you and your doctor private.)

Wear hand/arm braces and use any rehabilitative assistant devices like canes, walkers etc. at least two days before the exam, the day of, and two days after the exam. Be watchful and mindful as insurance companies like to surveil people around this timeframe.

(If you observe unfamiliar people or cars contact local police. If you are on good terms with your neighbors, ask them to alert you if they are contacted by anyone out of the ordinary. Be careful of strange phone calls.)

Upon arrival start to keep your own, private, notes of time. For example:

  • 2:00 p.m. Arrive at the doctor’s office
  • 2:15 p.m. Appointment time
  • 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

IME Don’ts

  • Do not fill out any forms.
  • Do not let anyone copy your identification; avoid identity theft.
  • Do not try to outsmart the doctor.
  • Do not volunteer what is not asked.
  • Do not discuss how you were injured; other than a general statement.
  • Do not discuss any perceived settlement.
  • Do not allow x-rays or other diagnostic tests.
  • Do not take any written tests.
  • Do not let anyone but the assigned doctor examines you.
  • Do not lie.
  • Do not drive; try to have your spouse, friend or neighbor drive you.
  • Do not talk about your case to anyone in any common area.
  • Do not attend the examiner with dirty hands.
  • Do not attend the examiner with designer fingernails (if a hand/wrist injury).
  • Do not jump on/off the examination table, simple movements.
  • Do not let your clothing distract, avoid tight jeans or elaborate footwear.
  • Do not leave the doctor’s office in haste.
  • Do not use medical jargon or fancy terminology; plain speak.
  • Do not discuss money or plans of retirement.
  • Do not discuss overly personal information, speak in generalities.
  • Do not exaggerate your problems.
  • Do not moan, groan, wince, grimace (if possible).
  • Do not ask the doctor for medication or pain pills.
  • Do not discuss your case, or any of the parties/attorneys.
  • Do not discuss your salary or finances.
  • Do not expect a “fair and objective” report (there are exceptions).
  • Do not deny your pain or discomfort.

IME Don’ts

Once in your privacy, prepare a written summary. Include, as appropriate:

  • What the doctor said to you.
  • What you answered.
  • What, if anything, the doctor dictated into a recorder.
  • What tests or procedures the doctor performed?
  • How much time the doctor spent with you.
  • What was done during each time period.
  • Any inappropriate, unusual questions or comments made by the doctor.

We understand that you cannot remember everything that occurred. Your best effort should help us. After all, the insurance expert is doing the same thing.