How to Tell if an IME Doctor is Really Independent

At some point during many disability insurance claims, the claimant is compelled to undergo a so-called Independent Medical Examination, or “IME”.  The purpose of the IME is supposedly to have an uninterested, unbiased doctor examine you to verify whether your condition truly makes you totally disabled under your policy’s terms.  However, IMEs are often used as yet another tool for the insurance company to attempt to deny or terminate your claim.

Though IMEs are labeled “independent”, the doctors performing them are almost always selected and paid by the insurance company.  Further, many of the IME providers are used over and over again by the same companies.  IME doctors that depend on the insurance industry for their livelihood have a strong incentive to give the insurance companies results they desire–medical opinions that support the denial or termination of your claim.

How can you tell if the IME doctor examining you is truly “independent”?  In our experience, the following factors may indicate that an IME provider is not independent:

  1. The insurance company chose the IME doctor itself.
  2. If a third-party company helped find the IME doctor, the insurance company selected the IME doctor from a handful of potential candidates.
  3. Your claims consultant contacted the IME doctor directly to discuss your condition.
  4. The IME doctor does not have a private practice, but only performs one-time medical evaluations for insurance companies, attorneys, and/or government agencies.
  5. The IME doctor has performed numerous exams for the same insurance company.
  6. The IME doctor depends on insurance exams for the majority of his or her income.
  7. The IME doctor has published articles or given educational courses criticizing disability claimants.
  8. The IME doctor is a former in-house employee of an insurance company.
  9. The IME doctor usually finds that claimants are not totally disabled.
  10. The IME doctor has been criticized for bias by a court or courts.

Some of these indicia of bias are more obvious than others, and many won’t come to light unless you have an attorney involved and/or have instituted litigation.  If you have been scheduled for an IME and are concerned that the doctor is less than independent, review our steps for protecting yourself before, during and after the exam.


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