As an injury victim pursuing compensation, you may wonder about the role of independent medical exams in your personal car accident injury case. These exams, conducted by doctors hired by insurance companies or defendants, often play a pivotal part. Understanding how independent medical exams work can help you navigate this key step. With an exam looming, arm yourself with knowledge. Learn what prompts an exam, how it impacts your claim, your rights during the process, and steps to challenge an unfavorable report. While exams serve to validate or refute injuries, approach yours as an opportunity to provide documentation and get on the same page. Walk into your exam ready to clearly communicate your experience. With preparation and perspective, you can tackle this hurdle smoothly.
Understanding Independent Medical Exams in Personal Injury Cases
The Role of Independent Medical Exams
Independent medical exams (IMEs) are evaluations conducted by doctors who are not involved in a plaintiff's medical treatment. The examiner reviews medical records and conducts an in-person physical exam to provide an unbiased opinion. IMEs are commonly used by defendants in personal injury lawsuits to challenge the opinions of the plaintiff's treating doctors regarding the cause, severity, and prognosis of the alleged injuries.
How IMEs Can Impact a Case
The findings of an IME can significantly impact a personal injury case. If the IME doctor opposes the plaintiff's doctors on key issues like the cause of injury or appropriate treatment, it creates questions of fact that must be resolved at trial. This often motivates plaintiffs to settle for a lower amount to avoid the risk of losing at trial or receiving a smaller award. However, if the IME supports the plaintiff's position, it strengthens their case and leverage to negotiate a higher settlement.
Preparing for an IME
As a plaintiff, being well-prepared for an IME is important to achieving the best possible outcome. Bring copies of relevant medical records, test results, and other evidence to support your position. Be thorough in describing your symptoms and limitations since the accident. Answer questions honestly but avoid speculation. Have your treating doctors provide a summary of their findings and opinions before the IME. While the examiner works for the defense, remain polite and cooperative. Your demeanor and consistency can impact their view of your credibility.
With the right preparation and approach, an IME does not have to be an insurmountable obstacle. While the defense uses IMEs to try and undermine plaintiffs, they can also backfire and end up supporting the plaintiff's case. Understanding the purpose and process of IMEs helps plaintiffs navigate them to their best advantage.
Why Insurance Companies Request IMEs in Injury Claims
Verifying the Claimed Injuries
Independent medical exams allow insurance companies to determine the validity and severity of the injuries claimed by the plaintiff. During an IME, the examining physician will review the plaintiff’s medical records and test results, evaluate the plaintiff’s current condition, and determine whether the claimed injuries are substantiated. If the IME physician finds no objective evidence to support the plaintiff’s claims, it casts doubt on the legitimacy of the case.
Challenging Treatment and Diagnosis
IMEs are also used by insurance companies to challenge the course of treatment or diagnosis recommended by the plaintiff’s treating physicians. The IME physician may find alternative diagnoses or treatment options that are less expensive yet equally effective. This could reduce the damages claimed by the plaintiff for medical expenses.
Determining Causation and Prognosis
In addition to verifying injuries, IMEs establish whether the plaintiff’s claimed injuries were caused by the accident in question and determine a prognosis for recovery. The examining physician analyzes the mechanism of injury to determine if the forces involved in the accident could have caused the types and severity of injuries claimed by the plaintiff. The physician also evaluates whether the plaintiff’s recovery and response to treatment are consistent with the expected prognosis for such injuries.
Negotiating a Settlement
Ultimately, IMEs provide critical information insurance companies need to evaluate liability and negotiate a fair settlement. By casting doubt on the plaintiff’s claims, challenging excessive or unnecessary medical costs, and developing a well-supported alternative prognosis, an IME can significantly strengthen the defense’s position in settlement talks or at trial. While IMEs are not binding, they remain an important tool for managing risk and limiting exposure in personal injury litigation.
Preparing for Your Independent Medical Exam
To prepare for an independent medical exam (IME), review all medical records and reports related to your injury. Bring copies of pertinent records like diagnostic test results, physician notes, and treatment histories to provide context for the examiner. Be prepared to discuss how your injury occurred, your symptoms and their progression, and all treatments you have received.
Gather Relevant Medical Documentation
Compile a timeline of events including the date of injury or initial diagnosis, symptoms, test results, physician visits, treatments, surgeries or hospitalizations, medication changes, and periods of disability. Obtain written statements from your treating physicians regarding their findings, diagnoses and opinions on your condition. Bring contact information for physicians and therapists in case the IME examiner wishes to follow up.
Review Your Medical History
Be ready to provide a concise summary of your medical history as it relates to your injury. Know the details of diagnostic tests, procedures, medications, therapies and how they have impacted your condition. Be prepared for the IME physician to ask probing questions about your condition and treatment. Answer openly and honestly, but do not provide unrelated personal details.
Discuss Your Current Condition
Explain your current symptoms and limitations in a factual, objective manner. Provide specific examples of how your injury impacts activities of daily living and your ability to work. Be prepared to demonstrate the range of motion, mobility restrictions or assistive devices you require. Do not exaggerate your symptoms or limitations, as the examiner will determine an objective assessment.
Approaching your IME with thorough preparation and an objective perspective will allow the independent examiner to conduct a fair evaluation of your condition. Provide truthful and detailed information, but avoid emotional displays which could be seen as manipulative. Answer the examiner's questions honestly while advocating for yourself and the proper consideration of your injury. With adequate preparation, you can feel confident your IME will result in an impartial assessment of your claim.
What to Expect During the IME Appointment
During an IME appointment, the insurance company’s examining physician will conduct a thorough medical evaluation to determine the nature and extent of your injuries.
Patient History
The doctor will review your medical records and ask you questions about your medical history, including any pre-existing conditions, the accident that caused your injuries, and your symptoms and treatment since the accident. Be prepared to discuss the details of your accident, injuries, and recovery process.
Physical Exam
The physician will then perform a comprehensive physical exam to assess your current condition. They will evaluate things like your range of motion, muscle strength, balance and coordination, and pain levels. The exam may include stress tests to determine how your condition affects your physical abilities. Be as cooperative as possible during the exam so the doctor can make an accurate assessment.
Additional Testing
If needed, the IME physician may order additional tests like X-rays, MRIs, or blood tests. This helps provide a more complete picture of the nature of your injuries to determine whether they are causally related to your accident or pre-existing. The tests also serve to confirm or refute your reported symptoms.
IME Report
Based on the evaluation, the IME physician will prepare a written report of their findings and conclusions, including whether your injuries were caused by the accident. They will assess your current medical status and determine if further treatment is reasonable and necessary. The report may also find you have reached maximum medical improvement (MMI). Your attorney and insurance company will review the IME report to determine next steps in your claim.
The ultimate goal of an IME is an objective medical opinion on the status of your injuries. While the process can be stressful, cooperating fully with the evaluation is important for an outcome fair to all parties. With patience and honesty, an IME can help resolve even the most complex personal injury claims.
Working With a Texas Car Accident Lawyer to Challenge an Unfavorable IME
If the findings of an independent medical exam do not support your injury claims, it is important to discuss next steps with your car accident lawyer. They can review the IME report to determine if the conclusions seem unreasonable or unfounded. If so, they may be able to challenge the results to prevent the findings from negatively impacting your claim.
Request a Second Opinion
Your attorney may ask the insurance company to allow you to undergo an additional IME with a different doctor. A second opinion from an impartial physician in the same field of medicine may yield different results that counter the initial report. New medical evidence supporting your injuries can be used to dispute the insurance company's position.
Question the Doctor's Qualifications and Methodology
In some cases, a lawyer may argue that the physician who performed the IME lacks the proper qualifications or experience to offer an expert opinion on the types of injuries involved in your accident. They may also claim that the examination was not sufficiently thorough or that the doctor did not have access to all relevant medical records and diagnostic test results to make an accurate determination. Identifying flaws in the methodology or information used can undermine the credibility and conclusions of the initial IME.
Negotiate a Settlement
If challenging an unfavorable IME is unlikely to change the insurance company's stance, your attorney will need to negotiate the best possible settlement under the circumstances. While the findings may limit the value of your claim, a lawyer can still fight to obtain fair compensation for medical bills, lost wages, pain and suffering, and other damages supported by records up until the IME. Accepting a reasonable settlement, even if less than originally sought, may be the most pragmatic solution.
With the help of an experienced car accident lawyer, you have the right to dispute unreasonable conclusions from an IME that do not reflect the reality or severity of your injuries. Through requesting follow-up medical opinions, questioning the qualifications and methodology of the initial exam, and negotiating the fairest possible settlement, your attorney can work to overcome a problematic IME and still obtain proper compensation.
Conclusion
As we have explored, independent medical exams serve an important role in personal injury cases. By providing an unbiased assessment of a plaintiff's injuries and treatment, they help ensure a fair outcome for all parties. While they can feel invasive or unnecessary to plaintiffs, overall IMEs uphold the integrity of the legal process. Looking ahead, we must continue to refine and improve IME protocols to balance plaintiff privacy with the need for objective evidence. With care and wisdom, independent exams will remain a cornerstone of justice in personal injury law from lawyers at Flecther Law. In our discussion, we have seen how IMEs, for all their controversy, serve the greater good when done properly.