Medical Exam in Auto Accident Injury Case?
Now the insurance co defense attorney wants to make the claimant(injured party) to undergo a 3 hour medical examination by a doctor that the insurance company hired.
1) Is this "normal" procedure for insurance co to do? If yes, what % of plaintiffs are subjected to medical exam?
2) What happens if plaintiff refuses to accept a medical exam? Or is there any cases where basis exists to ask the judge to not grant a medical exam to the insurance co?
6 attorney answers
An independent medical examination (IME) occurs when a doctor/physical therapist/chiropractor who has not previously been involved in a person’s care examines an individual. There is not doctor/therapist-patient relationship.
IMEs may be conducted to determine the cause, extent and medical treatment of a work-related or other injury where liability is at issue; whether an individual has reached maximum benefit from treatment; and whether any permanent impairment remains after treatment. An IME may be conducted at the behest of an employer or an insurance carrier to obtain an independent opinion of the clinical status of the individual. Workers' compensation insurance carriers, auto insurance carriers, and self-insured employers have a legal right to this request. Should the doctor/therapist performing the IME conclude that a patient’s medical condition is not related to a compensatable event, the insurer may deny the claim and refuse payment.
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It is "normal" for an insurance defense lawyer to ask for a medical exam. They try to call them Independent Medical Exams (IMEs). We call them Defense Medical Exams (DMEs). The doctor doing the exam may ask questions about the wreck and may try to interrogate the subject of the exam. We have been successful in having our judges allow another person in the room (and sometimes we are allowed to videotape the exam). This prevents the ins. company doctors from being anything but polite during the exam. When we have been allowed to have a video camera at the examination, the doctors tend to move very quickly through the exam and some refuse to even do the exam (to their own detriment).
If a Plaintiff refuses to undergo the DME, then a judge can order the plaintiff undergo the DME. I always require an order from the judge so that I can insure that there are protections for my client written into the order.
Finally, remember that the examining doctor is not your doctor, and you are not a patient. There is no doctor-patient relationship between you and the ins. co. professional testifier - or what the carriers like to call "independent medical examiners" - ha.
It is standard. It would not be fair to let your doctor testify but not let a defense doctor testify about an exam. Why is it 3 hours though? What type of examination is it? Most are very short. If you refuse, your case can be dismissed or you can be precluded from presenting evidence about your injury. Talk to your lawyer about all this.
I am a former federal and State prosecutor and now handle criminal defense and personal injury/civil rights cases. Feel free to check out my web site and contact me at (212) 385-8015 or via email at [email protected] The above answer is for informational purposes only and not meant as legal advice.
Yes, it is standard.
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My colleagues are correct. I want to add some details for clarification. Once involved in litigation, the defense has the right to ask a plaintiff to undergo what we call a Rule 35 medical evaluation. Some folks call those "independent medical evaluations" or "examinations," but I can promise you most are not independent. The doctors that perform such exams are usually well-compensated by insurance companies based on the volume of cases handled. In Colorado, plaintiffs can usually plan on spending three to four hours at the doctor's office, but much of that time is spent filling out lengthy questionnaires. In fact, there has been significant litigation about the requirement of plaintiff's to fill out such questionnaires.
If you have an attorney, he or she ought to be able to educate you as to this process. If you refuse, the defense will file a motion to compel your presence and they will win it (and most likely some attorney fees).
In no way am I offering you legal advice, and in no way has my comment created an attorney-client relationship. You are not to rely upon my note above in any way, but insted need to sit down with counsel and share all relevant facts before receiving fully-informed legal advice. If you want to be completely sure of your rights, you must sit down with an experienced criminal defense attorney to be fully aware of your rights.
Generally, different doctors have the opportunity to examine a claimant, such as a neuro and ortho. They could just be saying it will take three hours to allow you time to prepare a block. Additionally, it is very rare that attorneys take auto accidents to arbitration. However, if you sue, you will be required to undergo an IME.
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