What You Need to Know About IME, the Insurance Company “Exam”

I want to share some vital information about an important part of any personal injury, car accident or workers’ compensation case: your Independent Medical Examination, or IME, with the insurance company‘s doctor.

Let’s face it, the insurance company is sending you to a doctor with the hope that they may show you are NOT as disabled as your doctor says. 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 refuse to use the word “independent” when referring to these exams, even though they are routinely referred to as IME’s. I call them “Insurance Medical Exams,” or better yet, DME‘s or “Defense Medical Exams.” The bottom line is that these doctors are hired for one purpose and one purpose only – to either deny or minimize a claim.

The IME 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.

We routinely send the following list of Do’s and Don’ts for these so-called “independent” exams to clients:

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IME Don’ts

  • Don’t lie. That 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 come to the doctor with hands that look they are dirty from working on a car or changing the oil.
  • Don’t come to the doctor with elaborately painted fingernails (especially if you are claiming carpal tunnel or any other type of chronic pain syndrome).
  • 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.
  • 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.
  • 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 or nurse 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.

What you should DO at an IME:

  • 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. Let the truth come out and we will obtain a more favorable report from the doctor.
  • 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.
  • Ask the doctor to send a copy of his or her evaluation to your treating doctor.

Two important tasks for you:

First, keep track of how long the doctor spends with you. 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 it, but glance at your watch so you can accurately advise us of the time.

Second, 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 do the best you can.

Finally, two more ways to prepare:

Take a look at our FAQs, “Our Answers to Your Legal Questions.” You will find more answers to questions about accidents, personal injury cases and workers’ compensation.

Watch our videotape about preparing for an IME. You can contact our office to set up an appointment to see the videotape before your exam.

My colleagues and I at the Ziff Law Firm don’t represent people that are pretending to be injured. Nevertheless, IME doctors are conditioned to believe that most claimants are malingering, pretending, or exaggerating. That is why you MUST know how to act during this important phase of your case.

Thanks for reading,

Jim
_________________________________________
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

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