When Can an IME Be Ordered?
An IME can be ordered in several scenarios:
Insurance Policies
Insurance policies are contractual agreements between the policyholder and the insurance company. These contracts often have detailed clauses that set out the rights and responsibilities of both parties. One such common clause pertains to the IME.
For instance, imagine a policyholder named John who’s been in a car accident and claims to have sustained a severe back injury. His insurance company might be skeptical if his medical bills skyrocket or if there’s an inconsistency in his medical reports. The clause in the insurance contract allows the insurance company to request an IME. This ensures that the company is not being defrauded and that they’re compensating for genuine medical issues.
However, the physicians conducting these exams are often contracted by the insurance companies themselves and might have a vested interest in minimizing the extent of injuries.
At the Defendant’s Request
When a personal injury lawsuit is filed, the plaintiff claims certain injuries and asks for compensation based on those claims. The defendant, or the party being accused of causing the injury, has a right to verify these injury claims.
For instance, let’s consider Sarah, who sues a department store after slipping on a wet floor. She claims she’s unable to walk without pain. The store, wanting to ensure they’re only liable for genuine injuries, might request the court for an IME to be performed on Sarah to determine the extent of her injuries. Such a step ensures that while genuine victims get compensated, there’s no room for exaggerated claims.
Court’s Own Motion
The judiciary aims to ensure justice, which requires a clear understanding of the facts. In some jurisdictions, if there are glaring discrepancies in the medical evidence presented or if something seems amiss, the court, acting on its initiative, might order an IME.
Consider a hypothetical case where Emily claims damages after a workplace accident. Her medical reports suggest a minor sprain, but she claims a debilitating condition that prevents her from ever working again. Noticing this stark contradiction, the court might order an IME to get a clearer, unbiased assessment of her injuries. This proactive step ensures that the truth is revealed, facilitating a fair verdict.
What if I Received a Request to Take an Independent Medical Examination?
If you receive a request for an IME, it’s important to be prepared:
Understand the Purpose
An IME isn’t just another doctor’s appointment; it serves a distinct purpose in the context of an injury claim or lawsuit. Take the case of Robert, for instance. After a car accident, he sought treatment from his family physician, who diagnosed a herniated disc. However, when Robert filed an insurance claim, the company requested an IME. Robert should recognize that this physician, while qualified, is often chosen by the insurance company or opposing counsel.
Their evaluation may have an inherent bias, as they might be looking for evidence to minimize the extent of injuries or dispute the claims altogether.
Be Honest
In the world of injury claims, honesty is paramount. Providing false or exaggerated information can not only jeopardize your claim but might also have legal repercussions.
Consider Lily, who had a previous knee injury. After a slip-and-fall incident at a mall, her knee pain intensified. During her IME, she should disclose her prior injury but also stress how the recent incident has aggravated her condition. By being transparent, she ensures her claims are seen as genuine, making them harder to refute.
Document Everything
An IME might be a brief encounter, but its implications are long-lasting. Documenting every aspect is crucial.
For example, Alex, after his IME, took a moment to note down the examination’s duration, the tests the doctor performed, and any specific questions the doctor had about his injuries. A few weeks later, when the IME report inaccurately suggested a comprehensive neurological test that never took place, Alex could contest the report’s accuracy with his notes, lending more credibility to his claims.
Consult Your Attorney
Personal injury attorneys are well-versed in the nuances of IMEs. For example, before attending her IME, Maria consulted her attorney. She was advised on the kind of questions she might face and the importance of mentioning every symptom, no matter how minor. Her attorney also warned her about potential tactics, like the doctor noting her ability to sit comfortably during the entire duration as an indication of minimal back pain. Forewarned, Maria was better prepared and could navigate the IME more effectively.
Challenging IME Results
An IME is designed to provide an impartial assessment of your injuries. However, there may be instances where the results of an IME don’t align with your experience or the evaluations of your primary care physicians.
Before diving into the challenge process, you need to identify valid reasons for disagreement. Common grounds include:
- Bias or Prejudice: If you believe the physician had a bias—maybe due to a frequent professional relationship with the insurance company—that influenced the results, it might be grounds for a challenge.
- Methodological Flaws: If the IME was not thorough, skipped critical tests, or disregarded essential medical history, its findings could be disputed.
Steps to Challenge IME Results
Below, we’ll cover the steps to take when challenging IME results.
Seek a Second Opinion
Before officially challenging an IME, get another medical evaluation from a trusted physician to substantiate your claims.
- Example: Maria visited a renowned orthopedic surgeon who provided a detailed report highlighting the severity of her injury after an IME that downplayed her wrist injury.
Review Your Insurance Policy or Legal Agreements
Before contesting, understand any stipulations about IMEs in your insurance policy or any legal agreements. This will guide your next steps.
Formally Notify the Relevant Party
If you decide to challenge the IME, send a formal letter to the requesting party (often the insurance company or legal counsel) outlining your concerns and providing any supporting evidence.
Consult with Legal Counsel
Given the potential complexities, it’s advisable to have a personal injury attorney guide you. They can provide strategies, draft necessary documents, and represent you if the dispute with an insurance company escalates.
- Example: When Tom found discrepancies in his IME for a slip-and-fall incident, his attorney quickly identified procedural errors in the examination and successfully contested the results.
Do I Need a Lawyer?
During a personal injury case where medical examinations and disputes with insurance companies are involved, having legal representation can be valuable. An experienced attorney can protect your rights, guide you through the process, and advocate on your behalf.
Facing a personal injury lawsuit or insurance dispute? Secure your rights and get the compensation you deserve. Connect with a seasoned personal injury lawyer through LegalMatch today.
