Any person involved in a Michigan car accident or any other type of injury claim will at some point be requested by the insurance company to attend an Independent Medical Examination (IME). It is important that you understand the purpose of the exam and what to do at your appointment.
What is an Independent Medical Examination?
An Independent Medical Examination (IME) refers to a medical evaluation by a doctor at the request of an insurance company or insurance defense lawyer.
Most insurance policies and court rules require a claimant to attend an exam if insurance benefits are being paid or if the case is in litigation.
Insurance companies carefully select doctors who understand their mission to support either a termination or denial of benefits. It is not surprising to hear about doctors who get paid hundreds of thousands of dollars every year to evaluate an accident victim without the intention to recommend or even provide treatment.
We took the deposition of one Michigan neurologist who admitted to getting paid over ten million dollars over is career from performing insurance company exams.
There is no doctor-patient privilege between the IME doctor and the accident victim. The doctor often asks questions unrelated to medical issues, including how the accident occurred, to help the insurance company and defense attorney dispute liability at trial.
What is the Purpose of an IME?
An Independent Medical Exam has several stated purposes, including to:
- Determine the nature and extent of a person’s injuries.
- Provide an update on the current condition of the injured person.
- Give an opinion as to whether the injury was caused by an incident or accident.
- State whether current medical treatment is necessary, reasonable and appropriate.
- Opine whether the injured person can return to work, with or without restrictions.
- Recommend other testing and examinations of the examined person.
- Provide a prognosis for recovery and the need for additional treatment.
However, the true intentions of the insurance company and examining doctor is often to undermine the case. This is usually done so that benefits can be denied, terminated, or reduced.
The exam is not really “independent” because the examiner is working for the benefit of the insurance company.
What Type of Doctor Performs the Independent Medical Examination?
The type of physician selected for the exam is usually based upon the specialty of the doctors treating the person. For example, a person treating after a car accident with a neurosurgeon will likely be asked to attend an evaluation by another neurosurgeon.
Likewise, a person with a traumatic brain injury will be scheduled for an exam with a neurologist and neuropsychologist. The patient may be requested to undergo neuropsychological testing as well as other neurological tests to determine the cause and seriousness of the head trauma.
Many injury victims treat with a number of specialists for injuries caused by an accident. In these cases, the insurance company may request the injured person to attend multiple exams with different specialists. Of course, all of the examining doctors are chosen based upon their favorable relationship and past histories with the insurance company.
Am I Required to Attend the Doctor’s Exam?
In most cases, you are required to attend the doctor’s exam. The failure to attend can result in a denial of your benefits or a dismissal of a pending lawsuit by the trial court.
For a pending lawsuit in Michigan, Michigan Court Rules (MCR 2.311) provide that the defendant can request a plaintiff to submit to a physical or mental examination with a doctor selected by the defense lawyer. Typically, the time, place, manner, conditions, and scope of the examination are specified by the judge in advance of the actual examination.
Under the Michigan No-Fault laws, an accident victim can be required to attend an independent medical examination. The failure to attend an exam can be deemed a breach of your insurance contract and a violation of the No-fault law provisions and may result in a denial of benefits.
You should definitely discuss with your lawyer the need to attend any exams.
If you do not have a lawyer at the time that you receive a request to appear for an exam, it is suggested that you contact an attorney immediately so you do not make any mistakes during the exam.
Tips when Attending an Independent Medical Exam
There are several things that you should know when you attend your examination.
First, you should show up on time and dressed appropriately. The doctor may take a photograph of you and will certainly report on your appearance and grooming at the time of the appointment.
Second, you should not fill out any paperwork at the exam without first having it reviewed by your lawyer. Many doctors request that you fill out a questionnaire just before your examination. You do not want to put anything in writing unless it is required by law and approved by your attorney.
Third, you should cooperate with the doctor and perform all of the requested tests. You do not want a doctor to report that you did not give maximum effort or that you were faking during the exam.
Fourth, you should not give a description of how the accident or injury occurred to the doctor. Quite often, the doctor will misconstrue your statements to hurt the liability aspect of your case.
The insurance company should provide the accident report to the doctor in advance so you do not have to give your version as to how the incident occurred that caused your injury.
Fifth, be truthful when answering questions about your past medical history. The doctor will likely have reviewed all of your pre-existing medical records and will be looking for you to deny previous conditions or symptoms.
You should give your best recollection of your medical history without worrying if it will hurt your case. Your lawyer can deal with your previous medical issues so tell the truth.
Finally, do not volunteer any information at the exam. Only answer what is asked and do not provide more information. You are not there to help or assist the insurance company doctor.
Do I have to Undergo an EEG and other Tests?
Many courts will not require that you have an EEG or other invasive tests performed on you. If these are requested in advance, you should discuss this with your lawyer. The lawyer may object to this type of testing and go to court to prevent it from happening.
If you are surprised at the exam by a request for invasive type testing, you should politely refuse. You should advise the doctor that you wish to discuss the test with your lawyer and you will return if required by the court or under Michigan case law.
Can I Bring Someone to the Exam with Me?
It is generally a good idea to have a friend or family member accompany you and sit in during the exam. This can be helpful if the doctor reports certain things that are inaccurate about the exam, such as the length of it or the type of tests performed on you.
You should notify the doctor’s office before the appointment that you intend to bring someone in with you.
In addition, your lawyer may want to be present to take notes and observe the exam. In the alternative, your lawyer may send a nurse or paralegal to watch the exam for those same purposes.
Who is Pays for the Medical Examination?
The doctor is paid by the insurance company to perform the examination and issue the report. You should never be asked to pay any money out of your pocket.
In addition, your health insurance company should not be billed for the examination.
Am I Entitled to a Copy of the Report?
You are entitled to receive a copy of the independent medical examination report. This is usually sent to you or your lawyer within a few weeks after the exam.
It is important to review it closely for inaccuracies and misstatements, including the summary of your conversations with the examiner.
You should write down all of the things in the report that are not true or did not happen. This is helpful for your attorney when it comes time to take the doctor’s sworn deposition testimony.
It is also important for cross-examination of the doctor on the witness stand if the case goes to trial.
Are Independent Medical Exams Fair and Impartial?
For the most part, an IME is not a fair and impartial exam. Unlike a treating doctor who has a mission to treat and care or a patient, an IME doctor is paid to provide a benefit to the insurance company.
An IME doctor does not and cannot provide any treatment to the person being examined and can only provide opinions about past and future potential treatment.
What if the IME Doctor Writes a Negative Report?
It is expected that the examining doctor will write a negative, or unfavorable report. While this is upsetting to you, your attorney is accustomed to these reports.
Experienced personal injury attorneys know how to deal with these reports to minimize the negative findings and prove the unfair bias of the examiner.
It is a part of almost every injury and accident case, so you should not feel like you are being singled out by the insurance company. Most judges and juries recognize the bias of the examiner and discount the negative reference and findings from your exam.
Speak to Our Lawyers about your Independent Medical Exam
It is smart to speak to a lawyer before going to your independent medical examination. If you already have one, you should call that attorney as soon as you are requested to attend the appointment.
If you are unrepresented by legal counsel, you should contact our law office immediately to discuss your case. You may cause permanent harm to your case if you attend unprepared and without legal representation.
The Buckfire Law Firm is a top-rated Michigan personal injury law firm and has been in business since 1969.
Our team of experienced and skilled lawyers will answer all of your questions for free. We offer an in-person no-obligation case consultation and are also happy to answer all of your questions on the phone. When you hire us for your case, we charge no legal fees unless you receive a settlement.
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