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What Is an Independent Medical Examination?

If you’re dealing with a personal injury claim or applying for disability benefits, you’ve probably come across the term “Independent Medical Examination” or IME. We get it; the idea of seeing a doctor picked and paid for by an insurance company can feel like a bit much to process.

To help you feel more prepared, here’s our New York attorneys’ breakdown of what an IME is, why it happens, and what you can expect.

What Is an IME?

An Independent Medical Examination (IME) is a medical assessment often required for insurance claims, especially in personal injury cases. Contrary to what the name suggests, these examinations aren’t really independent. The insurance company picks the doctor, and that doctor gets paid by them, so there’s a chance the exam might be biased in the insurance company’s favor.

IMEs aren’t meant to treat you or give medical advice, just to evaluate how serious your injuries are and whether you qualify for benefits.

Are They Required? Can You Refuse to Attend?

In most cases, yes, you must attend an IME if you want to keep your benefits claim moving forward. Skipping the exam could mean having your no-fault benefits denied, and that denial might even go back to the date of your accident, which means you could lose the money you were otherwise owed.

That said, you’re allowed to reschedule the IME once if you have a valid reason. Just make sure to let your attorney know right away if something comes up or if you have any concerns about the appointment.

What Happens After an Independent Medical Examination?

The IME doctor will write a report with their findings and send it to the insurance company. Based on what the IME says, they might approve your benefits, reduce them, or deny your claim altogether.

If your claim is denied or your benefits are cut because of the IME, your attorney can appeal the decision if necessary.

When Can You File a Lawsuit After Settling?

As mentioned above, you generally can’t sue after settling your claim, but there are a few exceptions where you might still have that option.

How Is It Different From a Regular Medical Exam?

The main difference is the purpose and how in-depth the exam is. When you see your own doctor, they take the time to go over your full medical history and focus on diagnosing and treating you based on your specific needs.

An IME is usually quick and not as thorough. It might only last 5 to 15 minutes. During that time, the IME doctor will briefly review your records and do a limited physical exam. Because it’s so short, many people feel their condition isn’t fully understood or adequately represented.

What Is the Purpose of an Independent Medical Examination?

The main goal of an IME is to give the insurance company an outside opinion on your medical condition. As mentioned above, it’s used to help them decide if your claim is valid and if you should get benefits. IMEs typically look at things like:

How serious your injury or disability is
Whether you still need medical treatment
If your injury is actually related to the accident

What to Expect at an IME

Before you go, it’s best to prepare yourself mentally and physically. Rest assured, a good attorney will help familiarize you with how everything works before you attend. It can also help to bring a friend or family member with you to provide emotional support and serve as a witness during the exam.

Dos and Don'ts

Because the IME process can be delicate, your lawyer may prepare you with a few rules to keep in mind during it.

Do: Always tell the truth about your injuries and symptoms. Exaggerating or leaving things out could end up hurting your case. Additionally, try to stay calm and professional throughout the examination. How you present yourself could sway your IME doctor’s perception of your case.

Don’t: Only answer what’s asked. Giving too much information could work against you in the long run. You should also avoid discussing the specifics of your accident. Instead, focus solely on your medical condition.

How the Exam Is Performed

An IME typically begins with the claimant filling out a medical history form. The IME doctor will then review this information and perform a brief physical exam. They may ask you questions about your symptoms and any treatments you’ve had. The entire process is usually pretty quick, and tends to only last a few minutes.

How Does an IME Affect New York No-Fault Lost Wage Benefits?

In New York, no-fault insurance is meant to cover lost wages and medical bills after an accident, but if your IME doctor says your injury is only a mild partial disability, your wage-replacement benefits could be reduced.

If you feel the IME doesn’t reflect your condition accurately, make sure to talk it over with your attorney.

How Does an IME Affect New York No-Fault Medical Benefits?

Similar to lost wage benefits, your no-fault medical benefits can be affected by what the IME report says. Insurance companies use these reports to decide if you really need more treatment. If the IME disagrees with what your doctor recommends, the insurance company might deny or discontinue your prescribed treatment.

Frequently Asked Questions

Can You Request a Different Doctor for the IME?

In New York, the insurance company typically selects the IME doctor, and claimants generally don’t have the right to choose a different physician. However, there are certain rights and protections in place to ensure fairness in the IME process. It’s best to talk to your attorney to see what your options are in your specific situation.

Why Would an Insurance Company Schedule Multiple Exams with Different Doctors?

Is It Possible to Overturn the Decision?

What Does a No-Fault Denial Mean?

Key Takeaways

An Independent Medical Examination (IME) is a medical assessment frequently mandated for insurance claims.

The primary goal of an IME is to provide the insurance company with an unbiased, external evaluation of your medical condition.

In most instances, participating in an IME is mandatory to ensure the continued processing of your benefits claim.

Think You Have a Personal Injury Case? Contact Us!

At Field Law Group, we’re dedicated to protecting our clients’ rights and making sure they receive the benefits they’re entitled to.

If you have questions about your IME or need help with your claim, Contact us today or call 212-739-7278 to schedule a FREE consultation with our firm.

About the Firm: With over a decade of experience, Field Law Group has been helping personal injury victims across New York since 2013. We’re dedicated to protecting the rights of accident victims and fighting to get them the compensation they deserve.

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