What is an Independent Medical Exam?

An independent medical exam (“IME”) is an exam conducted by a doctor to verify whether you are truly disabled under your disability insurance policy’s terms.  These IMEs are rarely “independent”, and the doctors conducting them are almost always selected and paid by the insurers. In this post, we will explain what you can expect during an IME, and how you can protect yourself during the IME process.

What Can I Expect During an IME?

The IME doctor will likely begin by conducting an interview to learn about your medical history, the nature of your job, your symptoms, your treatment to date, and your daily activities.  During the interview, the doctor will be looking for signs that you are not telling the truth or that you are exaggerating your symptoms and limitations.  The doctor will pay attention to your demeanor, body language, and general appearance in order to assess your credibility.  The doctor will also compare your reported symptoms and limitations to your medical records, claim forms, and daily activities in an attempt to find inconsistencies.

Typically, the IME will largely consist of a physical examination, and the doctor may also require objective testing, such as x-rays, MRIs, or EMGs.  The doctor will often begin by conducting a general checkup, taking height/weight measurements, listening to your heart and lungs, testing your blood pressure, etc.  The doctor may then perform tests that focus on your disability and require you to provide subjective indications of pain and discomfort. He or she may ask you to bend, lift, or perform simple physical movements, depending on the nature and location of your condition.  Again, the doctor will be looking for inconsistencies or any signs that you might be exaggerating your symptoms.

After the IME, the doctor will complete a report that summarizes the findings of the exam.  The doctor will opine as to the extent of your disability, your ability to return to work, and recommended treatment or further testing.

How Can I Protect Myself in the IME Process?

As explained above, IMEs can be used as a tool for the insurance companies to deny or terminate disability benefits. Fortunately, there are ways you can protect yourself and ensure that you are treated fairly before, during, and after the IME.

Before the IME:

  • Review your policy. Most insurance policies do have a provision that allows the company to require you to submit to a physical exam.  However, these provisions are sometimes unclear as to the exact type examinations that are allowed.  Review the terms of your policy to make sure that your insurer can require you to undergo an IME.
  • Complete intake forms in advance. Your doctor will most likely ask you to complete intake forms, including questionnaires that outline your symptoms and medical history.  If you are nervous or hurried, you may forget to include important information.  Filling out the forms in advance allows you to answer each question carefully and accurately.

During the IME:

  • Bring a friend. If possible, bring a friend or family member to the IME. Not only can your friend provide moral support, but they will also serve as a witness to the exam.
  • Take notes. If possible, take notes during the IME to remember what testing was performed or what types of questions were asked. When you leave, write down your impressions and any issues you think you need to follow-up on.
  • Be cooperative and open.  Be patient and polite with the doctor.  Answer questions in a straight-forward and truthful manner, and if you do not understand something, let the doctor know. While you should be cooperative, this does not mean you need to do anything that causes you pain or injury. You know your body and limitations best, so if something the doctor asks you to do will cause you pain, let him or her know.
  • Discuss your symptoms fully and honestly. Do not minimize your symptoms and do not be afraid to complain.  It is important that your pain levels and other symptoms are documented as accurately and thoroughly as possible.
  • Connect your symptoms to your job duties. Make sure you discuss how all of your conditions impact your ability to practice safely and effectively. Give specific examples of how the conditions interfere with your practice (e.g., you cannot sit or stand for long periods without pain; you cannot manipulate dental instruments due to numbness in the fingers, etc.).

After the IME:

  • Get a copy of the report. After the exam, contact your insurer to ask for a copy of the IME report.  Review the report and compare it to your notes and recollection of the IME.  If anything needs to be clarified or there are any inconsistencies, contact your attorney and/or disability insurer as soon as possible.

If you have been scheduled for an IME, you may want to get an experienced disability insurance attorney involved.  An attorney can protect your rights during the IME process by finding out what the disability policy requires, limiting the test to certain parameters, studying the examiner’s credentials, recording the exam, accompanying you to the exam, and reviewing the final report for accuracy.

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