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Published: 2008-03-26

Independent Medical Exams



INTRODUCTION

Every year there are more than 99,000 injuries due to motor vehicle accidents in the state of Minnesota. Many of these injuries are too minor to report, but some injuries are serious enough to require medical treatment and the filing of a claim with an insurance company or bringing a lawsuit against the driver responsible for causing the accident.

Under Minnesota law, your insurance company, who is responsible for paying your medical bills, has the right to have you examined by a doctor of its choice when you make a claim for medical payments. This type of exam is referred to as an "Independent Medical Examination" or IME.

An "Adverse Medical Examination" is a physical examination by a doctor chosen and paid for by the at-fault driver's insurance company.

In either case, the doctor who examines you will testify about your injuries for the insurance company who is paying his fee. The doctor is examining you, not for the purpose of treatment or to help you find relief from your injuries, but to obtain information that will either allow your insurance company to terminate its obligation to pay your medical bills or to question your injuries should your case go to trial. In either case, the exam is adverse to your interest.

SCHEDULING THE EXAMINATION

Many insurance companies schedule exams through agencies which supply doctors who are willing to perform Independent or Adverse Medical Examinations for insurance companies. Generally, the scheduling agency is allowed to contact you directly so the exam can be scheduled, you are obligated to attend. Your failure to attend the exam may result in your being responsible for payment of the doctor's fee or the suspension of payment of your medical bills.

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, such as yourself. The doctor has been asked to discover information that will either justify a termination of your insurance company's obligation to pay your medical bills or reach the opinion that you were not injured as a result of your accident. Some doctors work regularly for insurance companies and earn a substantial income for performing exams. Insurance companies hire them because they consistently provide them with opinions that are detrimental to injured claimants and helpful to the insurance company.

Because the outcome of the exam is important to your case, it's only reasonable for you to go to the exam with a certain amount of preparation and care. If you follow the simple guidelines contained in this brochure, you will make the best impression possible and perhaps influence the doctor to write a report that is favorable to you.

DON'T TAKE IT PERSONALLY

It's important to go to the exam with the right attitude. Recognition that an IME or Adverse 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. However, an IME or an Adverse Exam is routine in the sense that it is standard procedure. Most injured claimants are required to go through an IME or Adverse Exam as part of their claim or lawsuit, so don't be defensive during the exam. The exam is a standard procedure in the processing of your claim.

HONESTY IS THE BEST POLICY

If you can "connect" with the doctor during your exam, it's possible he may find that you were injured in the accident, that your injuries are permanent, and that you require further treatment.

The best way to "connect" with the doctor is to 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. If you seem tense or upset, the doctor may think you are trying to hide something or not telling the truth. As long as you tell the doctor the truth about your injuries, you have nothing to worry about.

PREPARATION

One way to strengthen your case and be more relaxed during the exam is to organize your thoughts about the following items so you can present your medical history to the doctor in a logical and concise, but complete manner.

  • Your medical history, including any prior injuries;
  • How the accident occurred;
  • What areas of your body were injured;
  • What are your primary symptoms;
  • When do your injuries cause you pain;
  • What movements or activities aggravate your injuries and cause pain or discomfort;
  • What treatment or medication makes your injuries feel better; and
  • What activities have been affected or limited by your injuries.

Once you have organized your thoughts in writing, review the summary with your spouse, friend or co-worker to see if they notice any items you omitted. Review the summary prior to your exam, but do not bring the summary with you to the exam.

Note the date, time and place of your exam and the name of the doctor who will be examining you.

Arrive early for the exam. By arriving early, you will be more relaxed and have adequate time to fill out any forms.

Plan extra time into your schedule. If the doctor is delayed, you won't feel rushed or upset during the exam. You will also want to have extra time after the exam to prepare a written summary and to call your attorney to discuss the exam.

If you need directions to the location of the exam, contact the office where the exam will take place. Usually, a phone number to obtain directions is provided in the letter from the scheduling agency informing you of the date, time and place of the exam.

MEETING THE DOCTOR

The doctor will ask questions of you in order to formulate opinions about your injuries. The doctor will ask questions about the following items:

  • Your complete medical history including any prior injuries;
  • How the accident happened;
  • 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 you feel now.

Be honest in you 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's 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.

Avoid unnecessary elaboration. Remember that the doctor is hired by the insurance company to help its 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.

Try to remember what goes on during the exam in as much detail as possible, but don't take notes in front of the doctor or bring a tape recorder into the exam. Taking notes in front of the doctor or tape recording the exam will make it appear that you are more interested in obtaining money for your injuries rather than your health.

Focus on answering the questions honestly and accurately. When the exam is over, prepare a written summary. You will be surprised at how much you remember.

During the exam, you'll 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 is turning your head is inconsistent with your prior response.

THE PHYSICAL EXAMINATION

After taking a medical history from you, the doctor will make 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; however, it is extremely important to note the exact amount of time the doctor spends actually examining you.

  • Do not volunteer any information not requested.
  • Do not discuss who is at fault in your case.
  • Do not discuss settlement of your case.
  • Do not allow the doctor to take x-rays or conduct other diagnostic tests.
  • Do not take any written or psychological tests such as a MMPI.
  • Do not go to any other doctors or facilities without your attorney's approval.

TIME

During the course of your exam, without the doctor knowing it, keep track of the time the doctor spends with you and what is being done during each time period. For example:


2:00 p.m. Arrive at the doctor's office.
2:15 p.m. Appointment time.
2:30 p.m. Go to examining room.
2:40 p.m. Doctor arrives in examining room.
3:00 p.m. Interview ends, told to undress, doctor leaves
3:10 p.m. Doctor returns and begins exam
3:15 p.m. Examination over.
3:20 p.m. Leave clinic.

It is extremely important to have an exact record of the time the doctor spends with you and what was done, because the doctor will prepare a detailed report regarding your injuries despite having only spent a short time actually examining you.

AFTER THE EXAM

Once the exam is over and you have left the doctor's office, prepare a written summary of your exam. Your summary should contain the following information in as much detail as possible:

  • 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;
  • How much time the doctor spent with you;
  • What was done during each time period; and
  • Note any inappropriate or unusual questions or comments made by the doctor.

The doctor will prepare a report for the insurance company describing his examination of you, along with his findings and opinions. It is extremely rare for the doctor to determine that you were injured in the accident or recommend any further treatment, because he is working for the insurance company that hired him.

If you feel you have made a good impression on the doctor during your exam, ask him what treatment he would recommend for your injuries. Your questions may prompt the doctor to treat you as a patient, rather than an insurance claim.

CLOSING

By following the guidelines contained in this brochure, you will increase your chances of either having your medical expenses continued to be paid by your insurance company or of being fairly compensated for your injuries and the pain you have endured.