Independent Medical Exams in Personal Injury Claims

In many personal injury claims, the defendant (usually an insurance company) will want and independent medical examination of the injured claimant.

When you file a lawsuit and seek compensation for physical or mental injuries, the person or entity being sued (the "defendant") or an insurance company may request an independent medical examination (sometimes referred to as an "IME"). There are a few reasons behind this request. The defendant or insurance company may be concerned that your injuries are not as severe as you claimed, or they may just want to know the exact  scope of your injuries.

Qualifications for Conducting an Independent Medical Examination

After an accident, an initial medical examination is often performed by a doctor of the injured person's choosing. Naturally, the defendant or insurance company will want a second opinion and may request an IME. The qualification requirements of a medical professional performing the IME will vary from jurisdiction to jurisdiction. In general, an IME should be performed by an M.D. or D.O. For example, a psychiatrist cannot perform a IME, but can administer an "Independent Psychological Examination."

Additionally, the person performing the IME should have qualifications in two areas: (1) medical knowledge or training in the specific area relating to the subject case and (2) experience, training, and preferably special credentials in the area of IMEs.

These qualifications are not required in all cases, but are recommended to attain the best quality IME.

Steps and Requirements for Requesting an Independent Medical Examination

When an injured person does not wish to submit to an exam, he or she may be compelled to do so in certain situations. Generally, a court can compel a person to attend an independent medical examination where physical injuries are alleged. For example, a person cannot file a lawsuit, claim extensive physical injuries, and then refuse an IME. Upon a court motion by the defendant or on the court's own initiative, the plaintiff can be compelled to submit to the IME.

Standards for IMEs vary by state, but there are several general requirements:

  • The defendant or insurance company must give the injured person reasonable notice of the time, manner, location, and scope of the examination;
  • Unless there is good cause for further exams, only one IME is permitted;
  • The defendant or insurance company must pay for the IME; and
  • The independent medical examiner must be available to be cross-examined by the plaintiff's attorney at a deposition or trial.

Structure of an Independent Medical Examination Report

A report should be completed after the IME, and both parties have a right to review it. There should be an introductory section with basic descriptive data, including injury dates and a summary of the conclusions. A history of the claim should be reported. A thorough review of the medical records is important. The report should also thoroughly describe the initial conversation between the medical examiner and the injured person. Finally, the findings of the physical examination should be documented with detail, and a diagnosis must be given.

Insurance Companies and Independent Medical Examinations

Often, it is an  insurance company, and not a defendant, that requests an IME. Many insurance company policies will contain clauses relating to requirements regarding IMEs. Insurance companies request a large number of IMEs per year and will likely use the same doctors multiple times. Bias is a real concern in these cases. These medical examiners can be accusatory and act like an insurance claims adjuster and not a medical examiner. In many jurisdictions, a person submitting to an IME is permitted to bring a witness or his or her own physician to the exam.

Preparing for the Exam

Preparation is important with an IME -- especially when dealing with an IME relating to an insurance claim. You should be punctual and bring any relevant medical records. Your attorney will thoroughly prepare you for the examination. If you are not represented by an attorney and are submitting to an IME requested by an insurance company, it is advisable to keep answers very concise and answer "yes" or "no" if possible. However, do not be difficult or unresponsive. Questions should be answered truthfully and it is important to get all health complications in the record.

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