Independent Medical Examination
Serious injury accidents can involve significant financial compensation, either from:
- The person at fault
- An insurance company
Defendants responsible for paying for physical injuries sustained in an accident want to know the extent of any injuries before a jury makes them compensate the victim for their damages. An evaluation from a doctor other than the victim's doctor may be required in a personal injury case. This is known as an "independent medical evaluation" or, more commonly, an "independent medical examination" (IME).
Reasons for an IME
A victim of a serious accident may be examined and treated by their own doctor after an accident. One concern is that the victim's own doctor may be somewhat biased toward the victim in assessing the extent of the injuries. The party being sued for compensation for the victim's injuries may want to have an independent physician examine the victim or provide a second opinion. This also applies if the victim has not yet been examined.
The independent physician may examine the injury victim to:
- Make sure the victim did sustain injuries
- Affirm that the injuries are as serious as the victim claims
- Make sure the injury claim is not attributable to a different cause
If the accident involves workers' compensation to pay for medical treatment or ongoing treatment for a medical condition, such as a new disability, an independent medical examiner report (IME report) can be required.
The Role of the IME Doctor
An IME doctor is a medical professional who conducts an independent medical examination. Their role is to provide an unbiased assessment of the injured person's physical condition and the extent of their injuries following an accident. This includes:
- A thorough physical examination
- A review of the claimant's medical history
- An analysis of their medical records
The IME doctor's findings are then reported back to the insurance company or court as needed. While the IME doctor's role is to be neutral, they are often chosen by the insurance company. This could influence their findings.
When IMEs Can Be Ordered
If the injured party does not wish to attend an independent medical examination, they may be compelled to do so in certain circumstances. Many states have passed laws allowing insurance companies to compel an independent medical examination when a claim seems questionable.
An IME may only be compelled when the insurance policy contains language requiring the insured party to submit to an exam. The insured may not be required to submit to an exam if the circumstances of the exam would amount to an undue burden, such as requiring the insured to travel long distances from home.
Most states also have court rules which provide that a judge may order an independent medical examination under certain circumstances. Usually, an examination can be ordered if a person's physical or mental injuries are in dispute. If a person claims to have physical injuries but only sues for damages to a vehicle, an examination would not be ordered.
Examinations may also be ordered in lawsuits other than personal injury claims. For example, an examination may be ordered in a child custody dispute to determine whether a parent is emotionally stable enough to maintain custody of a child.
If an IME Is Ordered
If an independent medical examination is ordered, the injured party may be required to submit to more than one exam. The party seeking to compel an examination is often required to pay for the examination. The injured party's attorney may be allowed to attend the examination and hire a videographer to record the exam as well.
Sometimes the party attempting to compel the examination may choose the examining physician. In such cases, it is a bit of a misnomer to call it an independent medical exam. The physician is really the other party's expert witness. Some states' court rules recognize this and instead, call it a "defense medical exam."
At any rate, it is a mistake to assume that the physician chosen by the other party is going to be neutral and independent. It is wise to consult an attorney before attending an IME.
How Does Medical History Play a Role in an IME?
An individual's medical history plays a critical role during an independent medical examination. The examining doctor will need to review the claimant's past health records to accurately assess the extent of the injuries in question.
This includes understanding:
- Pre-existing conditions
- Prior injuries
- Overall health status before the accident
It can also provide context to the injury claim and help determine if the accident is the actual cause of the injury or if it exacerbated a pre-existing condition. An accident victim must fully disclose their medical history to the IME doctor. This is done to avoid discrepancies that might affect an insurance claim/lawsuit.
The Significance of Medical Records
Medical records serve as documented evidence of a claimant's injuries and the treatment they received. They include:
- Reports from the treating doctor or treating physician
- Test results
- Doctor's office notes
These records are essential in a car accident case or any accident case, for that matter. They provide concrete proof of the type of injury sustained and the medical treatments required. The IME doctor will review these records to confirm the validity and extent of your injuries.
What Constitutes "Good Cause" for an IME?
The term "good cause" in the context of an IME often refers to the legitimate reasons an insurance company or defendant may give to request such an examination. This could be suspicions about the validity of a claim, the severity of injuries reported, or inconsistencies in the medical records. Rules of civil procedure usually dictate what constitutes good cause, and a judge often determines whether these conditions have been met in a personal injury lawsuit.
How To Handle an IME as an Accident Victim
As an accident victim, undergoing an IME can be a stressful process. It's crucial to remember that the examining doctor is there to evaluate your injuries, not treat them. They will likely ask detailed questions about how the accident occurred and the symptoms you're experiencing. Their goal is to provide an objective assessment of your injuries for the insurance company or court.
Being honest and straightforward about your symptoms and how they affect your daily life is essential. Over-exaggeration or downplaying of your symptoms can affect the accuracy of the IME report and ultimately harm your case. It's advisable to have your personal injury attorney present during the examination to ensure your rights are protected.
The Relationship Between the Insurance Company and the IME
When an insurance claim is made following an accident, the insurance company often requests an IME to verify the extent and cause of the injuries claimed. The insurance company aims to ensure that the claims are legitimate and that the requested compensation aligns with the injuries sustained. While this process is a standard part of many personal injury cases, claimants should be aware that insurance companies may not always act in their best interests. Hence, the need for legal counsel.
Get Legal Advice From a Personal Injury Lawyer Before an Independent Medical Examination
If you've been injured in an accident and plan to recover money from someone else for your injuries, it is possible that you will be required to submit to an independent medical evaluation. However, in order to better protect your rights, it's in your best interests to meet with a personal injury attorney first. They will put their expertise to work to ensure you get the best possible outcome.
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