10 things you need to know about IMEs (Independent Medical Evaluations)
The insurance company has the right to send you to a doctor of their choice for a medical opinion. This doctor is not going to provide you with any treatment or become your doctor, but rather only give an opinion. Here are 10 things you need to know:
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The IME is for the benefit of the insurance company, not you.
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The doctor is not required to keep anything you say in confidence; everything you tell him/her, or fail to tell him, will be contained in his report.
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Contrary to the letter you receive from the insurance company, you are not required to bring any test results or medical records with you. It is the insurance company’s responsibility to provide their doctor with the reports they want him to review.
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The IME doctor and his staff will watch how you walk, move, whether you bend down to tie your shoes or pick up a piece of paper you might have dropped, or how you remove a piece of clothing, and they will compare it to the complaints you tell them about during the exam and what is contained in your medical records, so be consistent. And never lie or exaggerate, but rather be specific about what pain you feel or limitations you experience.
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You should tell the doctor about any other accidents you were involved in, whether they happened before or after the work-related injury. Failing to inform the doctor of a prior accident hurts your credibility and makes it look like you are hiding information.
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Do not miss your appointment or arrive late. This could result in the insurance company terminating benefits, such as your lost wages, and the Workers’ Compensation Commission could order you to pay for the missed appointment.
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The doctor does not have the right to perform any invasive tests on you, such as x-rays, injections or EMG/nerve conduction studies.
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A female should never be alone in the examination room with a male doctor, so typically the doctor will have a member of his staff in the room during the examination for your safety.
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The examination will likely be very short (a few minutes), so it’s important that you be as comprehensive as possible about the complaints you have.
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The day of the IME is typically when insurance companies hire a private investigator to video tape you in hopes of “catching you” doing something that is inconsistent with what you tell the doctor or which reveals that you are capable to working. You should be consistent at all times and with all doctors.
