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| Getting Through Your Independent Medical Examination | | Print | |
| Written by Linda Nee | ||||||||||||||||||
Page 4 of 16
What percentage of the IME physician's practice is devoted to diagnosing and treating patients who are totally disabled from the same condition you now have? How long has the IME physician been employed by the insurance company as an IME physician and what percentages of his decision reports have been favorable to the claimant? 8. Request a copy of the Curriculum Vitae of the IME physician prior to the evaluation.
9. Request copies of any published articles the IME physician has written on the topic of your particular diagnosis.
10. Ask for a written statement explaining the basis for selecting this particular IME physician over others to conduct the exam. This question is especially important if you are being asked to travel a long distance to attend the exam when other well qualified physicians are within your own geographical area. Look up the IME physician on the Internet and verify his credentials.
11. Request copies of the IME report be forwarded to both you and your primary care physician. Remember to send this letter, certified, return receipt requested. In the case of mental or nervous conditions state in the letter it is permitted to send the report directly to you. Some insurance companies send such reports to your psychiatrist or counselor rather than to you.
12. Request a continuance of the date (if appropriate) to allow you and your primary care physician sufficient time to examine the credentials of the designated IME physician. Sometimes IME's are scheduled quickly. You should ask for at least a 30-day notice of the exam.
13. Never attend an independent medical evaluation alone. On the day of the exam, do not engage in any substantial activity. Remain ever cognizant of the fact the insurance company may have requested surveillance. Leave your house accompanied by someone who can assist you during the exam, ask questions for you, and/or take notes of procedures during the exam. If you are required to wear braces, wear them to the exam. If you use a cane, bring it with you, and use it. Bring a camera with you and take a picture of any swollen body part at the IME doctor's office. For example, one person attended an IME with a swollen hand, so she lifted up the hand next to the IME doctor's certificate on the wall, and took a picture. Later, the IME doctor wrote in his report that "there was no swelling", but the claimant's picture said it all. Ask your companion to take accurate notes and to observe how the IME physician treats you during the examination. Take someone with you who is fairly assertive and who would not have a problem asking for a break if you become tired, or need something to drink. Your companion is there to be protective of your personal needs during the exam, and document what took place.
14. Beware of surveillance persons in the waiting room. One particular insurance company, in a letter addressed to the IME physician preceding the exam, asked the doctor to "watch" you in the waiting room and document things such as opening up doors, sitting waiting for the evaluation, walking within the facility, etc. Sometimes the IME physician may drop something on purpose to see if you bend to pick it up. Remain observant and watchful of everything you do when entering the offices of an IME physician. Stay seated and don't walk around.
15. IME physicians use certain exams to trick you. One such test is referred to as Waddell's signs, used by IME physicians to identify psychological factors in patients claiming back problems from trauma, chronic pain and fibromyalgia. So-called "false positives" on these indicators are often at the root of adverse decisions documented by the IME physician. The IME physician will perform a hands-on examination for each test, looking for you to say "it hurts" when in fact it is impossible, given nerve or sensory distribution for it to really cause pain. In other words, the IME physician "tricks you" into saying it hurts when it really shouldn't, given the injury or diagnosis you have. I'm going to try and explain these Waddell signs in layman's language so that you will understand them. |
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