An independent medical examination (IME) is a pivotal step in the workers’ compensation process—and it’s one you need to prepare for so that your IME will help, not hurt, your claim. Here’s how.
What is an IME?
An IME is a medical evaluation conducted during the workers’ comp claim process by a physician who doesn’t have a pre-existing relationship with you. The physician is supposed to conduct a fair and objective evaluation of your health and provide written findings.
Although the “I” stands for “independent,” many people mistake it for “insurer’s.” There’s good reason for this confusion, as the physician often has a bias toward the insurance company. That’s because it’s typically the insurance company or employer that will request the injured worker to undergo an IME.
What is the purpose of an IME?
The insurance company or employer requests an IME of an injured worker when it’s looking for grounds to deny your claim or give you a low settlement offer.
There are many reasons why the insurance company would request an IME. It could be that the insurance company needs to make a distinction between your diagnosis and the workplace accident so that it can claim the accident did not cause your injuries. Or the insurer may disagree with the proposed treatment plan, level of impairment, work restrictions, or ability to return to work. It could be that the insurance company wants to explore whether you had any pre-existing injuries.
Whatever the reason, it’s important to remember that this physician is not your physician, so no doctor-patient relationship or privileges exist. Indeed, this person’s report will have a significant (often detrimental) impact on the settlement offer you receive.
How can you prepare for an IME?
You must attend the IME if you’re seeking money damages or workers’ compensation benefits. The IME appointment must be conducted at a reasonable time and place, but the insurance company and employer have the right to pay for an IME and require you to attend. You can object to the reasonableness of the IME, such as its scheduling, transportation costs, length of the examination, or a request to bring all of your medical records. If you refuse to attend the IME, however, your potential benefits will be at risk.
Prior to the IME, the physician will receive a copy of your medical records and diagnostic reports. This will typically have been sent over with a cover letter from the insurance company indicating the issues in dispute in your claim.
Before the IME, take the opportunity to consult with your workers’ compensation attorney so that you can discuss the best responses to any questions. You may receive a questionnaire before the appointment, but you should also anticipate the questions you will receive at the IME and prepare your answers.
Typically, IME doctors will want to know about any pre-existing medical conditions. They’ll also ask how the injury happened, what symptoms you have experienced, what medications you’re taking, what treatment you’ve had so far, and how your recovery is going, including your ability to perform daily tasks such as driving, and how the injury has affected your mental health. You should also anticipate questions about how the injury has affected your ability to conduct your pre-injury job duties.
Practice and prepare your responses in advance, but don’t bring written notes with you to the IME. Remember that anything that you say to the doctor can be used in the IME report, especially if it’s likely to help the insurance company. You should be polite, specific, and truthful, but only answer the questions you are asked.
What should you do after the IME?
After the IME, you should take a few minutes to make your own notes about the IME. Include your recollections of the questions you were asked and your answers, how the IME was conducted, and anything the IME doctor said to you about the case or your condition.
Once you’ve received the IME report, which in all likelihood will be unfavorable to you, make an appointment with your workers’ compensation attorney to review the report so you can prepare a detailed and thorough response. A solid response to the IME report is necessary to ensure that you can get the medical care and compensation you deserve.
How can an experienced workers’ comp lawyer help you with an IME?
A workers’ compensation attorney can help injured workers navigate the workers’ compensation process to obtain the benefits to which they are entitled to receive. Not every case requires the help of a lawyer, but some situations are complicated, and it can be reassuring to have a qualified attorney help recover the funds you deserve.