You have been injured on the job or are involved in a personal injury case and the insurer is requiring you to undergo an independent medical examination (IME). These examinations are typically with a medical examiner of the insurer's choice. They are often notorious for minimizing the extent of your injury, thereby limiting the insurer's liability. But there are steps you can take even after you have undergone the examination to ensure that you receive a fair determination.
Read your insurance policy regarding personal injury cases. If there is no language regarding independent medical examinations in the policy, most states will not allow an insurer to request an IME.
Write a detailed summary of the events of the examination immediately afterwards. Note the examiner's questions and your answers, length of the exam, the examiner's extensiveness or lack thereof, and any unusual, hostile or inappropriate comments. You can later compare your report to the report the examiner sends to the insurance company.
Keep a list of any discrepancies. In most states, the insurer needs to inform you that you have a right to bring a witness along for the examination and also the right to decline the examination if it places an undue financial burden on you or is too far away from your home.
Send a certified letter to the insurer. Ask for the curriculum vitae and specialty of the examiner and also ask the insurer to explain why it chose this particular examiner. Ask the insurer to send a copy of the examination report to your primary physician. Challenge the insurer to provide you with an examiner with more background, experience and training for your injury and who treats patients who have been totally disabled by your condition.
- If you fail to appear for the independent medical examination, the insurer can fine you a cash penalty.
- For workers' compensation cases, send a certified letter to the insurer asking how many examinations the examiner has completed and in what percentage of cases the examiner agrees when the patient complains that his or her injury is so severe that it prevents employment.
- During the exam, answer politely but do not offer any more information than requested. In most states, it is legal to record the exam with a voice or video recorder. You can use this as evidence to dispute the examiner's report.
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