Understanding Independent Medical Examinations (IMEs)

If you have been injured in a car or rideshare accident, a slip and fall, or due to medical malpractice or negligence, your injuries, diagnoses, medical treatment, and recovery will be at the center of your personal injury claim. How extensive your injuries are, how you comply with a treatment plan, and whether you recover or are permanently disabled are major factors when assigning a dollar value to your claim.  

Although you will be receiving treatment from your healthcare providers as they see fit, their opinions may not satisfy the insurance company. If the insurer wants a second opinion about your injuries, it has the right to ask for one. Moreover, it has the right to decide who delivers it.  

Independent medical examinations (IMEs) are another tool insurance companies can use when they think they can undervalue your damages. Understanding how these work, and how they can be challenged, is important. At Mohammadi & Humayun, LLC, we always want to make sure our clients in Rockville, Maryland, or in the counties of Montgomery, Prince George’s, Howard, or Fredrick, know what’s happening with their personal injury claims. This includes understanding IMEs.  

What Is an Independent Medical Examination (IME)? 

An independent medical examination, sometimes referred to as an independent medical evaluation, comprises a review of your medical records and an examination by a qualified physician other than your treating physician. The insurance company indemnifying the negligent party who caused your injuries may request that you undergo an IME. 

Since the IME is conducted by a doctor other than your own and paid for by the insurance company, the doctor-patient privilege does not apply. In fact, in agreeing to submit to an IME, you agree to waive your right to patient confidentiality. Instead, the insurance company’s hand-picked doctor has access to all your medical records, including those that would disclose any relevant pre-existing conditions. 

The insurance company will advise its physician to look for evidence of certain discrepancies, such as whether your injuries are permanent or whether some extent of your injuries can be attributed to something other than the subject accident or incident.  

Who Needs an IME? 

Insurance companies certainly don’t request IMEs in all third-party liability claims made against their insureds. However, if they dispute such claims as the nature and extent of your injuries, recovery status, or permanent disability, they will pay the examiner of their choice to conduct one.  

The more severe the claim, the more money the insurance company can expect to pay to settle it. Since they want to settle for as little money as possible, they will invest in an IME in an attempt to devalue your claim.  

What Happens During an IME? 

After reviewing your medical records, the insurance company’s evaluator will conduct an examination of you and ask you questions about your health status prior to the accident and current complaints. If your injuries are physical, you will undergo a physical exam. If they involve your mental health, you will be examined by a mental health professional. 

Once the records are reviewed and the examinations are completed, the doctor will submit an “expert opinion” to the insurance company. This opinion must also be shared with you and your personal injury attorney, as well as copies of any and all materials shared with the doctor and correspondence between the insurance company and the doctor. This would include, for example, the reasons why the insurer has requested the IME and what issues they are hoping to disqualify from your claim.  

Why You Should Work With an Attorney 

IMEs can make or break your personal injury claim. The evaluator will testify as an expert witness, and judges and juries tend to place a great deal of weight on their opinions. This is despite the fact that the evaluator is chosen and compensated by the insurance company and that the doctor-patient privilege does not apply. In other words, the doctor who has treated you for your injuries owes you a duty of care and privacy that the company doctor does not.  

An experienced personal injury attorney knows precisely how insurance companies use IMEs against victims injured by their insureds. Your attorney will know how to challenge IME opinions and fight back against them by presenting your own expert testimony, from your treating doctor or even another independent evaluator.  

Moreover, your attorney can either verify or dispute information the insurance company submits to its doctor as factual. Your attorney can make sure the IME is conducted within the proper parameters and that you are fully prepared for what to expect if you are required to undergo one.   

What should you do when your insurance company requests an IME? If you have retained legal representation for your personal injury claim, the company will have to make that request through your attorney.  

Serving You With Diligent Care 

“Independent” is truly an inaccurate adjective when referring to an examination by an insurance company-selected doctor. However, it is allowed as part of the personal injury legal process. That is acceptable, so long as you have us representing you and protecting your best interests. 

Contact Mohammadi & Humayun, LLC in Rockville, Maryland, to schedule an appointment. Consultations are free, so call our office now.