Independent Medical Exams (IMEs)
When any person puts his or her physical condition at issue in any case in which compensation is sought, the insurance company or other responsible party defending the case has a right to have a physician of its own choice examine the claimant. The logic of this general rule cannot be questioned. However, the manner in which so-called “independent medical examinations” are carried out is often fraught with controversy. If the client is not properly prepared for what lies ahead, the claim can be lost or seriously damaged.
It is important to remember that the doctor or doctors who are examining you will testify about your injuries for the insurance company or other responsible party who is paying the doctors’ fees. The doctor is examining you, not for the purpose of treatment or to help you find relief from your injuries, but to obtain information which can be useful to the insurance company or other responsible party should your case go to trial. These examinations are often called “adverse” examinations.
PROCEED WITH CAUTION
Although the doctor may be honest, he has been selected to perform the exam because he has a conservative nature and is generally biased against injured claimants. The doctor has been asked to discover information that will reduce your claim by showing that the injuries you claim did not occur as a result of the accident or by finding that the injuries are non-existent or exaggerated. Some doctors work regularly for insurance companies and earn a substantial income for performing these adverse exams.
DON’T TAKE IT PERSONALLY
It is important to go to the exam with the right attitude. Recognition that an independent medical exam is a routine procedure in a personal injury case is helpful in creating the proper attitude. Routine does not mean that the exam is not important, it merely means that many, if not most, claimants have to go through such adverse exams in pursuing their claims.
HONESTY IS THE BEST POLICY
Be polite, cooperative, and above all, truthful. If you lie or fake an injury during the exam, the doctor will recognize your deceit and mention it prominently in his report. Try to appear open and forthright during your exam by providing the doctor with helpful and straightforward answers. Also, attempt to make eye contact with the doctor whenever possible.
Although you need to pay attention to the doctor’s questions so you can answer them carefully, don’t appear nervous. After all, you know the answers to the questions, so try to stay relaxed. As long as you tell the doctor the truth about your injuries, you have nothing to worry about.
PREPARATION & MEETING THE DOCTOR
It is very important that you prepare for your independent medical examination. You need to organize your thoughts so that you can present your medical history to the doctor in a logical and concise, but complete manner.
The doctor will question you in order to formulate opinions about your injuries. The doctor will ask questions about some of the following items:
- Your complete medical history including any prior injuries;
- How the accident happened and what personally happened to you;
- How you were hurt in the accident;
- What areas of your body were injured;
- What are your primary symptoms and have they improved since the date of the accident;
- How severe is your pain or discomfort;
- What treatment have you received for your injuries;
- What movements or activities make your injuries feel worse or cause pain or discomfort;
- What treatment or medication makes your injuries feel better by lessening your pain or discomfort;
- What activities have been affected or limited by your injuries; and
- How do you feel now.
Be honest in your answers, but be careful that you understand each question before you answer it. For example, if the doctor asks “How do you feel now?”, you should find out if he wants to know how you feel that minute or at this point after the accident. You may feel pretty well at that particular moment, but may have had pain associated with your injury earlier in the day, so it is important to be specific and accurate in your answers. Take time to answer all questions carefully. If a question is unclear or confusing, don’t be afraid to ask the doctor to explain or rephrase the question before you answer. Don’t be rushed into answering without thinking. If you make a mistake, correct it immediately.
YOU MAY NOT KNOW ALL THE ANSWERS
You should assume that the doctor doing your exam has access to all of your medical records. The doctor will have reviewed your records or a summary of your records that include all of your medical visits, including chiropractic treatments, not just treatment related to your current injury or claim.
There may be some questions that the doctor asks you that you do not know or cannot remember. For example, the doctor may ask whether or not you, as a child, had a particular condition, such as asthma. It is possible that you don’t know if you had asthma as a child and you should say that. Or, perhaps he will ask you a question calling for an answer that you don’t remember. Don’t be afraid to tell the doctor you can’t remember. Many times there is information in medical records that you have forgotten. You do not want to emphatically answer a question in one way only to have your medical records reflect a different answer. For example, your medical records may indicate that you were a smoker ten years ago. It is very important that if you are asked if you ever smoked that you respond by saying that yes, you did smoke but discontinued smoking ten years ago. Similarly, you could be asked if you have ever had headaches before the accident. Of course most people have had occasional headaches, but if your headaches are different or have gotten worse, you should say so.
AVOID UNNECESSARY ELABORATION
Remember the doctors hired by the insurance company or the other side are to help their case, not your case. So, while you should always answer a question politely, honestly and completely, don’t ramble on or elaborate unnecessarily. Any facts that are discovered during your exam may be used against you at a later date.
During the exam, you will probably be asked to describe your pain and discomfort. Since pain is subjective and often difficult to describe, it may be best to describe your pain by referring to what areas of your body hurt when you do certain movements or activities. Be as truthful and accurate as possible in describing your injuries and the effect your injuries have had on you. No one likes complainers who exaggerate their injuries. On the other hand, don’t understate your pain and the problems it causes you.
The doctor will be observing you during the exam. He is looking for inconsistencies in your complaints as compared to his observations. For example, you tell the doctor that you can’t turn your head to the right. Later, the doctor goes to your far right and asks a question. You turn your head all the way to the right to look at the doctor. Your physical action in turning your head is inconsistent with your prior response.
THE PHYSICAL EXAMINATION
After taking a medical history from you, the doctor will likely do a physical exam of your body. The exact procedures to be followed during the exam vary based on your injuries and the doctor conducting the exam. It is important to note the amount of time the doctor spends actually examining you.
AFTER THE EXAMINATION
After the examination, after you have left the doctor’s office, please sit down and write your thoughts regarding the exam. This should include an approximation of the time the doctor spent with you doing various things including time:
- Arrived at doctor’s office;
- Appointment time;
- Went to examining room;
- Doctor arrived in examining room;
- Doctor interviewed me;
- Doctor actually did physical examination;
- Examination ended;
- I left clinic.
You should also, in your summary, provide some of the following information:
- What the doctor said to you;
- What you answered;
- What, if anything, was dictated into a tape recorder by the doctor during the exam;
- What tests or procedures the doctor performed on you during the exam;
- Note any inappropriate or unusual questions or comments made by the doctor.
SOLBERG STEWART MILLER
1123 5th Avenue South
P.O. Box 1897
Fargo, ND 58107-1897
(877) 237-3166 – toll free