In a previous post here on the NY Injury Law Blog, I explained the truth about “Independent” Medical Examination (IME) with the insurance company’s doctor. In the original post: “IME Doctors Change Diagnoses for Insurance Company Exams”, I explained how some doctors deliver the diagnoses that the insurance companies want – because the insurance companies pay fees to the doctors.
If you bring an injury lawsuit or file a no-fault claim in New York or Pennsylvania, the insurance carrier has a right to have you examined by a doctor of their own choosing. This is usually referred to as an “IME” which is an acronym for “Independent Medical Examination.” Don’t let this phrase fool you. There is absolutely nothing that is “independent” about this examination.
An IME is an examination paid for by the insurance company with the hope that they will be able to get ammunition from their doctor that will permit them to terminate or minimize their obligation to fully compensate you for your injuries.
Because these exams are NOT “independent,” I refer to an IME as an “INSURANCE Medical Exam.”
Let’s face it, the insurance company is sending you to THEIR doctor with the hope that they may show you are not as disabled as your doctor says. This is a Dr. who is paid a lot of money by the insurance company to tell them exactly what they want to hear: namely, that you are not injured.
Therefore, the “independent” medical doctor who you are going to see will try to show that you are exaggerating, malingering, magnifying your symptoms, or just pretending.
I wouldn’t represent you if I thought that you were guilty of any of these situations. Nevertheless, sometimes doctors make a “mountain out of a molehill” because they are conditioned to believe that most claimants are malingering, pretending, or exaggerating. Some doctors automatically find, and will testify that the results of their examination indicate that you are malingering, pretending, etc.
The defendant’s doctor is listening to EVERYTHING you say and watching everything you do. He will dictate a report of what he sees and hears immediately when you leave his office.
HERE ARE SOME OF THE THINGS THAT YOU SHOULD NOT DO OR SAY AT INSURANCE MEDICAL EXAMINATIONS:
• Don’t lie. Ever. A single lie can undermine your whole case.
• Don’t try to outsmart the doctor. You can’t do it.
• Don’t drive yourself to the visit. Try to have your spouse, friend or neighbor drive you.
• Don’t talk about your accident, injuries, insurance company or case in elevators, common areas or doctor’s waiting room.
• Don’t wear dangling jewelry or earrings.
• Don’t jump on and off of the examination table at the doctor’s office.
• Don’t come in tight jeans or cowboy boots.
• Men, don’t come unshaven.
• Ladies, don’t come with make-up on or wearing high heels.
• Don’t leave the doctor’s office in a running trot or quick walk and jump into your car, because the doctor is probably watching you from his or her window.
• Don’t use medical jargon or fancy terminology when discussing your case or describing your symptoms.
• If you are complaining of a neck injury, don’t twist your head back and forth when the doctor is moving about the room in an effort to follow his movements.
• Don’t discuss money or any plans of retirement with the doctor.
• Don’t discuss your marital situation with the doctor unless the exam is for a psychological injury. Your marital situation is not relevant to the present examination. This is a physical examination.
• Don’t exaggerate your problems. Be truthful, but conservative. On the other hand, don’t minimize your problems. Just tell it like it is.
• Don’t moan, groan and wince or grimace in pain every time the doctor touches you. No matter how lightly or heavily the doctor may touch you, be natural, be yourself, tough it out as best you can. However, if what he is doing hurts you, honestly tell him that he is hurting you.
• Don’t ask the doctor for medication or pain pills.
• Don’t talk about your labor union to the doctor.
• Don’t talk to the doctor about the insurance carrier, attorneys or the adjusters.
• If you have a bad back, don’t bend down and untie your shoes. Wear loafers and kick them off/slide them on.
• Don’t allow the insurance company’s representative to be in the examining room with you when the doctor examines you. Simply explain to the doctor that you deem physical examinations to be private and would like to have the representative leave the room. Be polite and sincere when you say this.
• Do not discuss with the doctor the amount of your claim or the amount of wages you used to make. Politely decline to do so by saying that the insurance company has that information.
• Do not discuss with the doctor whether you have any hearings coming up on your case.
• Do not discuss what you deserve for a settlement or your plans for spending the money you may get.
HERE ARE SOME OF THE THINGS THAT YOU SHOULD DO OR SAY AT THE INDEPENDENT MEDICAL EXAMINATIONS:
• Be honest and cooperative with the doctor.
• Be pleasant. At the same time, you should not behave in such a fashion that the doctor can say you were laughing during the examination.
• Be concerned. Be serious. Be polite. Give the doctor accurate, but brief, history on how your accident or injury occurred.
• Give the doctor an accurate history of your job details and what you do in terms of lifting, bending, stooping, carrying, and walking.
• If the doctor asks you about any previous injuries or illnesses you had before the present one, be honest and tell him the nature of any injuries you had, and whether you had surgery in connection with those previous injuries. On the other hand, do not volunteer information.
• If the doctor asks if you have had any previous workers’ compensation claims, you should say to him, “I’ve had previous workers injuries” (if that is true). However, you should always disclose any injury whether it is work related or not if the doctor asks you for a previous history of injuries.
• Be aware that the doctor is sometimes performing the same test on you in more than one fashion and in more than one way. For example, the doctor may test your legs when you are sitting up and when you are lying down. This is the same test. Therefore, if you complain of pain inconsistently, the doctor is going to make note of it. Don’t try in any way to magnify or exaggerate your pain. Let the truth come out and we will obtain a more favorable report from the doctor. If you exaggerate your pain, or if you are inconsistent, or if you try to impress the doctor with the significance of your pain, this will only give the doctor ammunition with which to hurt your case.
• If you are totally disabled, explain to the doctor that if there was any way you could be back at work, you would be there.
• If you have a long work history (a long history is 5 years or more) emphasize to the doctor that you have worked for this employer for a significant number of years and you would like to get back to work.
• If you have a short history of work with the employer and you enjoyed your job, explain to the doctor that although your employment with this employer was brief, you enjoyed working there and would like to return to work.
• When you are giving a history to the doctor as to how the accident occurred, please mention all injuries that you suffered as a result of this accident. For example, if you mainly injured your back when you fell, but you also hurt your knee, mention that you hurt your left or right knee (as the case may be). If, when you tried to stop your fall you pushed out your hands, mention that your primary pain is in your back, but you tried to break your fall with your hands and you also bruised them.
• Remember, the person who tells the doctor that he/she does absolutely nothing all day is less likely to be believed than a person who says, “I try to be active or I try to do some chores, but I suffer for it the next couple of days.”
• Finally, ask the doctor to send a copy of his or her evaluation to your treating doctor.
IMPORTANT: IME doctors will often exaggerate the time they spent questioning and examining you. To combat this, it is imperative that you keep track of the time you spent with the doctor. Do not be obvious about doing so but glance at your watch so you can accurately advise us of the times.
ALSO IMPORTANT: As soon as you are home, sit down and write down every detail you can recall of your exam (i.e. time spent with a nurse or doctor, questions asked by the doctor and your answers, tests performed by the doctor, etc.). We understand that you can’t remember everything but just do the best you can.
If you have any questions your IME, contact us. The Ziff Law Firm even has a videotape to help clients prepare for an IME. Please contact our office for a consultation, and check the post “IME Doctors Change Diagnoses for Insurance Company Exams” to be forewarned about this important part of your injury case.
Thanks for reading and let me know if you have any questions,
James B. Reed, Esq.
Personal Injury & Malpractice Attorney
Ziff Law Firm, LLP
303 William St., Elmira, NY 14902
Tel. (607) 733-8866 Fax. (607) 732-6062
Toll Free 1-800-943-3529
mailto:[email protected] http://www.zifflaw.com
E-mail me at [email protected] for two free books:
NY Car Accidents and NY Car Insurance Secrets YOU Need to Know.