Independent Medical Exam (IME)~ When the Insurance Company Sends You to the Doctor
WHAT IF THE INSURANCE COMPANY SENDS ME TO A DOCTOR?Usually such a request is for an Independent Medical Exam (IME).
Generally you are required to go to an IME if sent by the insurance carrier and it involves:
~a Worker's Compensation claim; or
~Social Security Administration Claim; or
~ Group Health Coverage
Generally you are NOT required to go in a car wreck or slip and fall case unless ordered by the Judge. Please consult your attorney.
INDEPENDENT MEDICAL EXAMINATIONOften a Worker's Comp Carrier will scheduled an "IME" (Independent Medical Examination) for you with one of their company doctors.
Often the insurance company obviously believe will find that there is "...nothing wrong with you..."
An "IME" means that you cannot be subjected to "treatment", only an examination.
If you are asked to take "shots" or submit to other intrusive treatment (meaning that they want to "stick something" into your body), you do not have to do so.
You can be asked to have X-rays or other tests run which do not require a needle to be inserted, but you cannot be asked to submit to any type of "intrusive" examination (such as with a needle).
WHAT IF I AM "TOLD TO BRING X-RAYS"?Sometimes the letter or notice "instructs" you to go round up X-rays, prior examinations, or other information. You aren't being paid extra to do this, and the law doesn't require you to do it, so forget about it! (But don't tell the IME doctor that a lawyer told you not to bring anything, just say that you thought that the insurance company was going to take care of all of that).
WHAT SHOULD I SAY AND NOT SAYThere are certain things, which you should discuss, and certain things that you should not discuss:
DISCUSS: Your physical limitations such as not being able to do certain things now that you could do before.
- Tell your doctors what your work consists of. "Paint" a VERBAL PAINTING OF YOUR WORK... EXPLAIN IT:
(1) The number of hours which your type of work requires (INCLUDING OVERTIME which your employer CUSTOMARILY requires you to work);
(2) The TYPE of things that you have to lift (buckets; tools describe them - "wrenches requiring me to pull); Or move ("Bulky items?);
(3) HOW MUCH THEY WEIGH! (Don't say "heavy lifting"... tell the physician "...xx pounds is the AVERAGE weight which I must lift...";
(4) CLIMBING - Tell the physician whether you have to climb in order to perform your work. If so, tell him how MANY stairs/flights/scaffolds, which you have to climb in a NORMAL workday.
(5) LEANING OR STRETCHING? - Do you have to learn or stretch AT A
Explain and tell the truth!Most physicians have never done the type of work which you do...You must give A JOB DESCRIPTION! Be specific. Never assume that the physician knows what you do (because most of them don't).
"EXPLAIN...DO NOT COMPLAIN"! That is the secret!
EXPLAIN to the physician your:
(1) Limitation of range of motion (Forward Flexion - how far forward can you lean your injury. Backward Extension how far backward can you lean your injury. The less the movement the greater the impairment to your injury.
(2) Restrictions in bending, stooping, or lifting (be prepared to give EXAMPLES - can't pick up a 10 pound bag of groceries - can't bend over from the waist - have to bend knees);
(3) tasks which you could perform before the accident which you cannot perform now (example: help with housecleaning - vacuum cleaner; bringing in groceries; playing with children; can't ride in a car for more than ____ minutes without experiencing pain or limitation);
(4) Can you 'stand' on your feet for a
DON'T DISCUSS:(1) Settlement, or your wish to be fairly compensated - DO NOT EVER DISCUSS SETTLEMENT! Most physicians are looking for "money people who aren't really hurt...."
(2) Do not discuss the percentage of your Permanent Partial Disability;
(3) Do not discuss if you have a lawyer, and don't tell them what I am telling you;
(4) Don't discuss anything else, other than what your present physical limits are. If asked, "how did you hurt yourself", say "in a collision, a fall, etc". Tell the company doctor briefly what happened (I was in a truck/car collision and I hurt my back).
Do not go into great detail as to "how the accident happened" (other than saying I got hurt in a trucking collision"), or "old injuries" (other than to say that you have never been injured there (back, knee, whatever), or that if you were injured there before, that you have completely gotten over that injury).
The reason that I say this is that some company doctors try to get you to admit that things that
TO DO AT EXAMINATIONYou can see that the more you say to the company doctor, the more ammunition that you give to him to help the insurance company.
Try not to be evasive or to appear that you don't want to be honest, but just say enough to "get through" the IME, nothing more. Don't let on that you know what is going on, EVER!
TO DO AT EXAMINATION
(1) Note the time that the IME doctor starts to examine you and the time that he finishes his examination of you;
(2) You should take written notes of every test, request for lifting of your legs, bending, flexion, lifting, or any other examination, that you have been asked to perform. You should note whether the doctor even touched you, and what you were asked to do (walk on your toes, lift your legs/arms, bend over), in short everything that you are asked to do.
(3) Take your spouse as a witness.
Remember, this is an "official occasion", with a very UNFRIENDLY OFFICIAL COMPANY DOCTOR. Don't be misled for a second that this is not a very seri
Friends?The company doctor may act "friendly", but you are there because the insurance company knows that his report will in all likelihood be very "unfriendly".
The Spiva Law Group represents no insurance companies and is dedicated solely to the representation of injured and deceased persons.
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