Independent Medical Examination

Do I Have to Be Examined by the Insurance Doctor if I Have a Personal Injury Lawsuit?

Yes. After the defendant’s insurance company attorney asks you questions at your deposition, the defense attorney will demand that you appear at their doctor’s office for a so-called IME or Independent Medical Examination. But it’s not “Independent”!

We call these insurance medical examinations a DME or Defense Medical Examination. But what they really are is an insurance defense medical examination because it’s the insurance company that pays for them.

The defense insurance company pays an agency that pays their doctors to examine you and their doctors only do insurance defense exams.

How Many Exams by the Insurance Doctor Do I Have to Go To?

There are usually two or three doctors in different fields who will conduct the exams. The most common doctors medical used to conduct defense exams are orthopedic surgeons, neurologists, and psychiatrists. One exam will be scheduled for each medical specialty the defense insurance company wants to pay for.

If you have been treated by an orthopedic surgeon and a neurologist, you will likely be examined by both an orthopedic surgeon and a neurologist for the defendant’s insurance company.

The defense is not normally permitted to have you examined twice by the same medical specialty. An exception could be if you had surgery after your Defense Medical Examination. This is a widely held rule, and even in Canada, the defense is normally limited to only one physical exam by the same medical specialist.

Will Anyone Go With Me to the Insurance Exam?

We don’t let you go alone to your physical exams!  You will be accompanied by someone who is trained to:

  • Prepare you for the physical;
  • Prevent the defense doctor from doing anything that should not be done;
  • Prevent the defense doctor from asking questions that should not be asked; and
  • Record everything that the defense doctor does.

Many lawyers let their clients go to the insurance company exams alone.  You don’t want to go to these exams alone!

What Happens at the Insurance Exam?

Upon arrival at your physical exam, the doctor’s staff will photocopy your driver’s license so they can prove who was examined and you will be asked to fill out a form with your personal information and your injuries.

A typical independent medical examination consists of the doctor asking you questions for 2-3 minutes and then examining you for 2-3 minutes for a total of 5 to 15 minutes.  Most plaintiffs are shocked to find out how short the exam is and wonder how the defense doctor can write an honest report after a 5-minute exam.  The answer is that the doctor is not paid to write an honest report.

Is an Insurance Independent Medical Examination Fair?

An Independent Medical Exam in a personal injury lawsuit is requested by the defense attorney and paid for by the defense insurance company. Defense doctors are paid a lot of money by the insurance company to write a report that they can use to defend their case by hurting your case.

The defense insurance doctor can easily write a medical report that the insurance company defense attorney can use against you in the following three ways:

  • Admitting you have an injury but minimizing your injury;
  • Denying the existence of your injury;
  • Claiming that your injury existed prior to your accident; and other ways.

Read this article about defense doctors who lied about injuries and see why you want someone trained to watch the defense doctor at your defense exam. This is another of many articles about doctors who lie for insurance companies.

Are Independent Insurance Exams Supposed to Be Fair?

No. An Independent Medical Examination is not supposed to be fair. They are not conducted for you and you did not pay for the examination. A doctor who performs an Independent Medical Examination is not your doctor and cannot be sued for medical malpractice.

Independent Medical Examinations are specifically designed and allowed to be conducted by a doctor hired by the defense attorney so the defendant can be in a fair position to argue against the claims of someone injured in an accident.

The written report of the independent medical examination is supposed to be biased.

But insurance doctors are well known for “extreme bias”, and even outright lies. Just ask your own doctor. I have friends who are doctors who could use more money but they think it’s immoral to do insurance exams because they don’t want to be pressured into writing false reports.

Why Would an Insurance Exam Doctor Lie in a Written Report?

Why would an insurance exam doctor agree to write a report either with lies or hiding the truth? How much do you think an insurance exam doctor can earn from doing these exams? They can earn as much as $1M to $2M per year!!!

Take a look at this transcript of a hearing held because an insurance exam doctor was caught lying at a trial. The doctor testified the exam was 20-25 minutes when it was really 3 minutes. The transcript shows the doctor earned $2 million dollars per year doing insurance exams! Also, watch the videos listed at the bottom of this page about doctors writing reports for State Farm.

Videos About a Type of Independent Medical Exam – When Insurance Companies Lie

The videos listed below are about a type of independent medical exam called a peer review or paper review used to deny treatment. In a lawsuit, the insurance company’s attorney for the defense is entitled to medical exams to prove your injuries don’t exist or are not related to your accident.

These videos are about peer or paper reviews without an exam but in a lawsuit, you will have a physical exam and a report.

Dateline: The Paper Chase Pt 1 of 4 State Farm used a doctor’s “paper review” (a/k/a peer review) to rule that injuries were not related to the accident and deny payment
Dateline: The Paper Chase Pt 2 of 4 How to stop paying for medical treatment
Dateline: The Paper Chase Pt 3 of 4 79 out of 79 reports favored State Farm-Listen to a State Farm Superintendent saying it’s intentional!
Dateline: The Paper Chase Pt 4 of 4 Just how much can they save?  A judge called the IME company “a completely bogus operation” and State Farm knew the reviews were not objective.

Why You Don’t Want to Go Alone to Your Independent Medical Exam

Obviously, just as your deposition is of vital importance to your case, your physical exams are also crucial. Most attorneys allow their clients to go to the defense physical exam alone! A few attorneys will have a paralegal accompany their client to the physical. But paralegals are not trained about what to do at defense medical exams.

Reasons you need someone experienced with defense medical exams with you at your Independent Medical Examination:

  • To make sure that you do not fill out the wrong information on the doctor’s office form which can be used against you to damage your case;
  • To make sure that the doctor does not ask you questions about how your accident happened;
  • To make sure that the doctor does not take x-rays, blood tests, or any other invasive test; and
  • To observe the physical and write a report of everything that was said, done, or not done.

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Attorney Franckel is a well-known personal injury lawyer, Founding Partner of 1-800-HURT-911® New York, and a former Member Board of Directors of the New York State Trial Lawyers Association. He has an Avvo Top 10  Rating, Avvo Client’s Choice Award with all 5-star reviews, Avvo Top Contributor Award, Multi-Million Dollar Trial Lawyers Award, and other awards. See Mr. Franckel’s bio for areas of expertise.

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Philip L. Franckel, Esq. is one of the HURT911® Dream Team™ Founding Partners at 1-800-HURT-911® New York; He has a 10 Avvo rating; Avvo Client’s Choice with all 5-star reviews; Avvo Top Contributor; and a former Member of the Board of Directors of the New York State Trial Lawyers Association.

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Robert Plevy, Esq. is one of the HURT911® Dream Team™ Founding Partners at 1-800-HURT-911® New York. Rob began his legal career in 1993 as an Assistant Corporation Counsel defending The City of New York against personal injury lawsuits.

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