What You Should Know About The “Independent” Medical Exam

What is an IME?
In almost every workers’ compensation case, the employer/insurance carrier will send the injured worker for an Independent Medical Examination (“IME”). An IME is a physical, medical examination aimed at determining several important facts: was there an injury, what was the cause of that injury, and was there any resultant disability. At the name suggests, the purpose of an IME is to obtain an “independent” medical opinion. However, as the following will reveal, the exam is anything but “independent.”

Who performs the IME?
Not all doctors agree to perform IMEs. However, those who do generally perform them on a regular basis. Behind the scenes, the employer/insurance carrier is paying that physician a considerable about of money to conduct the exam. In my experience, the cost of an IME can range anywhere from $750 to $2,500 – depending upon the doctor’s specialty. In addition, most doctors will charge an additional fee if the exam requires a review of a large number of medical records. Finally, most doctors will charge yet another fee if they are asked to write a second or supplemental report. As you can imagine, this can provide a substantial amount of revenue for the doctor. For this reason, most physicians who perform these exams want to make the insurance company happy by providing them with a favorable opinion and thereby guaranteeing that they are hired to perform additional IMEs in the future.

Do I have to attend the IME?
Yes. Generally, the employer/insurance carrier only has the right to have you examined once every six months (no more than twice per year). However, additional exams could be required depending upon the nature of your injury or based upon pending litigation.

What if the IME is far away?
Sometimes the exam is scheduled to take place outside of your local geographic area. If that is the case, I encourage my clients to either request that transportation be provided (at the insurance carrier’s cost) or I instruct my clients to keep track of mileage and tolls so that I can seek reimbursement for these costs.

What can I expect during the IME?
When you arrive for the exam, you will probably be asked to complete a few forms, asking about your medical history. Thereafter, a nurse or assistant may take you to the exam room and confirm some of the information about your injury. The doctor will likely spend just a few minutes actually performing the exam. Most of my clients report seeing the doctor for only 10 minutes. After the exam, you are free to leave. Remember, the IME doctor is not YOUR doctor. He/she will not offer you treatment and will probably not even share his/her opinions with you. However, the insurance carrier is required to provide you or your lawyer with a copy of the doctor’s final report, which will include all relevant opinions.

How can I prepare for an IME?
Most doctors (regardless of who is paying them) appreciate when a patient is cooperative. It is also extremely important that you provide the doctor with an accurate history. For this reason, I suggest that you cooperate with the exam and be sure to give straightforward answers to the questions that may be asked. Although the doctor was hired by the insurance carrier, there are certainly occasions when I receive an IME report that is helpful to my client. For this reason, I think it is best to cooperate with the hope of a report that will help your case.

How can that doctor say I wasn’t hurt; or that I am recovered?
The IME doctor is entitled to form his or her own opinion. But remember, the IME doctor is paid by the insurance company – so odds are that the IME opinion will favorable to the insurance company. (Don’t worry – you will have the opportunity to challenge a bad medical opinion in court. When your case is in litigation, you can present evidence from your own doctor to contradict the IME opinions.)

If you have questions about an IME, call Gross Law Office to speak to an experienced attorney and learn more about your legal options.