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| Getting Through Your Independent Medical Examination | | Print | |
| Written by Linda Nee | ||||||||||||||||||
Page 6 of 16
16. Remember the IME physician is not examining you to give you medical advice. He/she will not discuss treatment options with you, nor will he recommend appropriate treatment for your impairment. An IME physician will generally not give you an opportunity to explain what is really disabling you, and will ask only questions requiring a "yes" or "no" answer. It is very human and natural, once you are committed to an IME exam, to want to be believed, and acknowledge the doctor examining you is acting in your best interests. However, once you thoroughly understand the IME physician's role is to represent the insurance company and not you, then you can present yourself appropriately during the exam. Technically, you are patient with a medical problem and you may feel the need to ask the IME physician medical questions about your impairment. It is unlikely the IME physician will tell you anything substantial as an answer.
17. Contact your local Attorney General's office and ask about your rights to record or videotape the IME in your state. Ask the AG to provide you with a photocopy of the law dealing with one-party or two-party recording. Each state is different. If you are allowed to record the IME in your state without the physician knowing you are doing so, do it. Please check the laws in your state first.
1. Never contact the IME physician directly unless specifically instructed to do so in case of a cancellation. You must, to use an accounting term, remain "an arms length" away from the IME physician. Disability insurers have the right to discontinue the IME with a physician if they are contacted by you in any way. You do not have the right to call the offices of the IME physician or request any information from them. If you choose to contact the IME physician you risk having to start all over with another physician assigned by the insurance company.
2. Don't just fail to show up. If you need to reschedule the IME call the claims specialist and explain why you need to reschedule. You should do this way ahead of time and not the actual day of the IME. The disability insurer will consider it adverse to you if you cancel the IME on the same day and ask that it be rescheduled. Consider your ability to attend the exam well in advance. Make every effort to attend the IME when it has been scheduled. Insurance companies take a very dim view of cancelled IME's at the last minute.
3. Be ever-mindful of possible surveillance around the time of the IME. Surveillance teams actually go into the reception rooms where you wait and watch you. When they leave, they follow. If you spot surveillance activity, I recommend you "blow their cover." If you feel comfortable to, go up to them and say, "I notice you have been following and watching me. If you are representing an insurance company, I request that you stop your activity immediately. I will report you to the local police." When you "blow the cover" of an insurance surveillance, it stops immediately. Any report written is no longer any good to the insurance company once you know you are being watched.
4. Prepare a folder and a copy of your medical history with a bulleted list. When asked questions take the paper and give it to the IME doctor. Don't answer the question, "What is a typical day like for you?" Do not be overly optimistic about your work capacity in the future.
5. If an IME physician is overly rude, or actually physically hurts you during an exam, you can ask to stop and request an ambulance. No IME physician wants to have an insurance patient hauled out of his office in an ambulance because he/she hurt you. If the IME physician is rude, document it if you haven't been recording the conversation.
6. Don't keep calling the insurance company to ask about the evaluation report. If the insurance company is still evaluating your claim, they won't give you a copy. A disability insurer is only required to give you a copy as part of your Administrative Record after the claim is denied. Some companies will give you a copy nonetheless. Psyche IME's are sent to your therapist or psychiatrist and are not as a general rule sent directly to you.
7. Don't talk too much. Most people tell insurance companies way too much information. It's human nature to defend yourself, but not good for an insurance claim. Answer the questions honestly and truthfully, but then be quiet. You really need to exercise control over the amount of time you speak during an IME.. Depending on your personality, this could require some effort. Be quiet.
8. Don't fall into the Waddell Sign trap and over exaggerate your pain. Be honest about where it hurts.
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