They Want to Pick a Doctor to Examine Me!

Your insurance company may have the right to schedule you for what is called an Independent Medical Examination, or "IME." This is a common practice if you are receiving Personal Injury Protection benefits, or if you have filed a lawsuit to receive compensation for your injuries. The IME will involve giving a medical history and going through a physical exam conducted by one or more doctors chosen by the insurance company.

These examinations may be called "independent," but you should be aware that the doctor is getting paid for the examination by the insurance company. Some doctors make a significant part of their living conducting these examinations for insurance companies.

The PIP IME

If you have Personal Injury Protection (PIP) or Med Pay benefits, your insurance company may want to get a second opinion. The obligation of the company is to pay reasonable and necessary expenses, and if the insurance company is concerned about the amount of your medical bills or duration of your ongoing treatment, they may have the right to send you to a doctor of their choosing.

If this doctor concludes that your treatment is no longer warranted, the PIP carrier may stop paying for your medical treatment. In that event, you may have a right to demand an arbitration or sue your insurance company. A lawyer can advise you regarding these alternatives.

Before attending a PIP IME, be sure to ask your lawyer, if you have one, whether it is in your best interest to attend. If you do not attend the IME, the insurance company will probably cut off further payment of medical bills and/or wage loss. However, in some circumstances it may be preferable to allow this to happen than to go through the IME, especially if litigation is probable.

The Litigation IME

If a lawsuit has already been filed, the insurance company may want to have you examined by a doctor who would be prepared to testify in court if the case goes to trial. The civil rules of procedure in most states allow such examinations, and you will be required to attend. It is probable that the examining doctor will reach different conclusions than your own treating doctor about your condition.

Tips on handling any IME

Here are some suggestions on how to handle an IME:

• Be aware that you may be observed from the moment you enter the parking lot until the time you drive off. We see comments in the reports dealing with how a client got out of a car or walked across the parking lot.
• Do not answer questions dealing with fault in the accident. You should answer only those questions that are directed to medical issues.
• Under no circumstances should you get angry or argumentative with the examiners. If you do, they will probably record that in their report and it will not help your case.
• If possible, have someone accompany you to the exam. Have that person note how long each portion of the exam lasts.
• Describe your pain and medical condition truthfully and completely. Do not let the doctor trap you with questions which attribute pain to areas clearly not associated with your injury.
• Don't be afraid to say "Ouch" when you hurt. If you grimace and the doctor does not see it, your reaction will not be noted.
• Remember: THIS IS NOT YOUR DOCTOR. Anything you tell this doctor will not be confidential and can be used by your insurance company against you.
• After the IME, write down what the doctor said and what the doctor did to you.
• Call your lawyer immediately after the IME.
• You are entitled to receive a copy of the IME report.