What Is An “Independent Medical Examination”Or An “IME”?
An independent medical examination or "IME" is meant to provide an unbiased and professional medical examination as evidence in legal matters such as disability, personal injury and motor vehicle accidents, and is conducted by a medical specialist who has never previously offered medical care to the individual.
Independent Medical Examination
The technical definition is arguably a misnomer, because a party will request an IME in order to get a medical report that supports their position, whether they're on the side of the plaintiff or the defense, and will choose a doctor who they believe will be partial to their position. Insurance companies typically use the same doctors over and over again to have some control over the outcome of the report. An IME requested by the defense would be called a defense medical.
Can I Record My“Independent Medical Examination”or IME?
You may record the session with the doctor’s consent in order to have an accurate record of the doctor’s questions and your answers. A recording may also determine whether the doctor’s examination techniques are competent and whether their report corresponds with the insurance company’s decision about your claim.
If you have been requested to attend an Independent Medical Examination (IME) by your disability insurance company, in most cases, the examiner will not allow the session to be recorded. You can certainly request it and they may permit it. If you refuse to participate in the assessment on the basis that you were not permitted torecord the session, the insurance company will probably treat that as non-cooperation and may suspend or terminate your disability benefits on that basis.
As Part of the Litigation
When you are in the midst of a lawsuit with your disability insurer, there may be circumstances in which a Defence MedicalExamination (DME) can be recorded as a matter of right. This will likely be resisted, even if compelling arguments are made as to why recording is being requested. The question of whether recording will be permitted in these circumstances is something you should discuss with the lawyer handling your claim to discuss your particular circumstances.
What Type Of Medical Professionals Are Qualified To Conduct “Independent Medical Examination” or IMEs?
That depends on your specific case. They may include but not be limited to:
- Family physicians
Can I Refuse To See The Doctor The Insurer Has Chosen For An “Independent Medical Examination” or IME and Request A Different One?
You can refuse, but the consequences of refusing must be understood. Where the insurance company continues to pay benefits, a refusal to attend an assessment would be construed as non-cooperation, which would likely result in suspension or termination of disability benefits. If there is a specific reason that you are refusing to attend the assessment, you should provide reasons, as if there is an acceptable reason, the insurer may agree to arrange an assessment with another assessor. Where your benefits have been cut-off or your claim has been denied, we would urge you to contact a lawyer to discuss your options before attending any such assessment.
Is It Mandatory To Have An “Independent Medical Examination” or IME If My Insurance Company Has Made A Request?
You always have a choice to decline an IME, but it is important to weigh out the possible consequences.
If your claim has already been denied and you are not receiving any benefits from the insurance company, declining an IME will not affect your situation. However, if your claim is still pending or you are already receiving benefits, refusing to undergo an IME may result in being denied or cut off from benefits. The decision to refuse an IME should be made in concert with your lawyer, who will determine whether the insurance company’s request for an IME is lawful. The insurer has a contractual right to compel a claimant to undergo an IME, and in most circumstances, a claimant has the obligation to attend an examination.
Can I Request ACopy Of The“Independent Medical Examination”or IME?
If your claim has been denied based on an independent medical exam requested by the insurance company, you will want to know why. You do have the right to request a copy of the IME report. If you are unsure whether the report written by the independent medical examiner was legitimate, call our office for answers.
Can Someone Come In The Room With Me During An “Independent Medical Examination” or IME?
You can request this but many assessors will not allow it and if you insist, they will simply not proceed with the assessment, which could result in suspension, termination or denial of your benefits on the basis of your non-cooperation. You could contact the College of Physicians and Surgeons to inquire about your rights in these circumstances.
How Will The “Independent Medical Examination” or IME Ordered By The Insurance Company Affect My Disability Benefits?
Applying for disability benefits can be a long and complicated process, especially when your insurance company tries to deny your claim! Even if your doctor supports your claim for long-term disability, your insurance policy may have provisions allowing the insurance company to have you assessed by a doctor of their choosing in order to establish if you are truly entitled to benefits. While the medical practitioner chosen by the insurance company must be qualified to do a medical assessment and the medical assessment itself must be reasonable, it can often be an area of great concern for those seeking disability benefits because not all doctors agree on diagnoses.
Sometimes a family doctor can feel intimidated by a specialist who has examined you for an insurance company. Still, you can ask your family doctor to refer you to a specialist in the same field as the insurance company’s expert, or in the most appropriate speciality for your condition. The combination of a supportive family doctor and a specialist who agrees with your family doctor’s findings is persuasive and you may have a good chance of winning against the insurance company.
TIPS ON HOW TO PREPARE YOU FOR YOUR UPCOMING IME:
- Arrive early-know the address, where to park, be aware of traffic
- Bring in a written list of your medications, physicians, symptoms, dates, activities, restrictions
- If possible, bring in a list of pertinent medical records and diagnostic imaging reports (x-rays, ultrasounds, scans etc)
- Be honest
- Be polite and courteous
- Dress appropriately
- Bring a family member or friend for support (they are likely not permitted into the examination with you)
- Bring a notebook and pen. Take notes after the assessment to record your impressions
- Do not discuss your legal case with the assessor
If the independent medical examiner agrees that the plaintiff’s medical condition is not disabling, the insurance company may deny the claim for benefits.
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