Independent Medical Examination: Medical and Legal Issues

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What is an IME?  

An independent medical examination (IME) is a second opinion exam that may be conducted by a non-interested physician to obtain an independent opinion of an individual medical condition.  Insurance companies and personal injury attorneys have the right to choose the doctor who would examine the claimant to determine the cause, extent, and medical treatment of an injury that has been disputed at trial.

Independent Medical Examination Anatomy of muscular man

Independent Medical Exams May be Required for Medical Cases

 

Also, an independent medical examination is conducted to assure whether an individual has reached a benefit from treatment, and whether there is any permanent damage despite treatment.  Thus, independent medical examination opinions should be provided by addressing medical and legal issues for the purpose to either deny or diminish a claim.

 

Insurance Claims  

Every state has different laws and insurance companies work differently.  Specifically, in workers’ compensation cases, when an employee is experiencing a medical condition, such as pain from a back injury, or injury from an accident, an insurer or an attorney will seek an independent expert opinion of a physician to corroborate such injures.  If the doctor performing the independent medical examination determines that a patient’s physical issues are not related to a remunerative event, the insurer may deny the claim; and thus, the cost of the injury.

 

Personal Injury Claims  

Moreover, an independent medical examination expert witnesses can provide informed, objective opinions and testimony in the resolution of injury litigation claims. Then, the physician who performed the exam will testify about the disputed injuries that would probably allow the defendant to terminate its obligation to pay for the medical bills or to cast doubt on the claim of injury at trial.  For instance, if the claimant is not cooperative and truthful with the doctor and lies during the examination, the doctor will know about it and write it down conspicuously in the report.

Independent Medical Examination Doctors Examining Xrays

IME’s Assist in Determining If Conditions Support the Claim

Thus, if an individual is lying and does not require time off, benefits and treatment, the employer can refuse payment.  However, if the expert who performed the independent medical examination concludes that the claimant is in deed injured, the physician will write this in the report and recommend an appropriate treatment.

 

Failure To Attend IME  

Although, the retaining party pays for the medical expert’s fees, failure to attend the scheduled exam may result in the claimant liability for those fees or the suspension of payment of the medical bills.

 

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