An IME is an independent medical examination, but don't let the name fool you. There is nothing independent about this exam
Why? Because you’re being sent to a doctor who is hired and paid by the insurance company! Their goal is to save the insurance company money by denying you treatment and ending your benefits as soon as possible.
So what should you do when you’re told to attend an IME? And how can you actually use your IME as an opportunity to help your case instead of hurting it?
We’re going to answer these questions right now!
My name is Rex Zachofsky and I became a New York workers compensation lawyer 17 years ago after getting injured on the job. If you’re looking for a lawyer to help you with your claim with New York Workers Compensation Benefits, please give me a call at 212-406-8989 to schedule a free consultation.
So what is an independent medical examination, or IME?
Your employer’s workers comp insurance company has the right to send you to see a doctor of their choosing for a medical examination, and in my experience they exercise that right in just about every case… often times more than once!
On the surface, these exams are done so the insurance company has medical proof to justify your claim and the treatment you receive. But these insurance companies didn’t get rich by being generous. They make money by paying as little as possible on each and every workers comp claims, and the IME is their chance to justify doing just that!
What they’re REALLY trying to do is find reasons to deny or minimize the treatment you receive, and to cut your benefits off as soon as possible.
They may also try to prove that your injury wasn’t work-related or find some other reason why your case shouldn’t be established. That means you might be asked to attend an IME at the start of your case, where they can dispute whether or not you actually got hurt at work.
The insurance company might also call you in after you’ve had time to recover, to dispute just how serious your ongoing condition or permanent disability is.
You could also be sent to an IME after your doctor requests authorization for treatment or surgery, in an attempt to force cheaper treatment on you or to deny it and avoid paying for it altogether.
So if you want to get through your IME without it sabotaging your workers comp case, keep watching for tips on how to do so.
You might be thinking to yourself, “Well if IMEs are so bad, why not just skip them?”
Please, believe me when I tell you that it is critical to attend these appointments. Failing to do so not only reflects poorly on your case for the judge, but can also result in your treatment and benefits getting denied completely by the insurance company.
Rest assured that they won’t ask you to travel 100 miles or attend an IME during work hours-if you’ve gone back to work. And if they DO schedule your appointment at an inconvenient time or location, it’s fine to reschedule, just be careful not to take advantage of this too often or it becomes a problem.
When you are scheduled for an IME, it could be for a different reason every time.
As I mentioned before it could be to determine if your injuries are work related.
It might be to determine whether or not you need surgery or ongoing physical therapy. It might be to determine your level of permanent disability. It could also just be a more general IME, so the insurance company can monitor your ongoing condition and progress.
And before scheduling the appointment, the insurance company will go out and find whatever specialist they need in order to combat a report from your own doctor. So if your orthopedic surgeon is asking for authorization to perform surgery, they will send you to see their orthopedic surgeon. And unsurprisingly, most of the time their opinions do not line up.
It's unfortunate, but insurance companies are looking for a return on the money they spend for IMEs, regardless of what treatment we think is necessary.
Some insurance companies will also use these exams more than others. I’ve seen cases where people have only one or two IMEs, while in other cases people have more than ten. The insurance company can schedule them as regularly as they want, within reason. They can’t make you go to one per week. And they wouldn't do that anyway because each visit costs them money.
Whatever the purpose and no matter how many times you go, they are required to give you at least 7 business days of notice. And in those days leading up to the exam, you might receive a questionnaire to complete and bring with you, asking for basic identifying information like your name and date of birth, as well as details about your accident and medical history.
You want to be careful with how you answer here, these questionnaires can and will be used against you, which I’ll explain in just a moment.
You might also be asked to bring medical records with you to your exam… Don’t. It’s the responsibility of the insurance company to provide their doctor with your medical records.
Before you go for your exam, be sure to speak with your doctor and workers comp lawyer if you have one. They will be able to help you prepare for your IME and give you clear instructions based on the type of exam you’re attending.
This is part of the reason why it’s so important to choose a doctor who is familiar with workers comp claims, something I explain in my other video about choosing the right workers compensation doctor.
The exam itself usually only lasts for about 10 minutes.
In New York State you are permitted to bring someone with you to observe the exam if you want. You’re also allowed to record the exam so long as you notify them in advance.
For the sake of your case, be polite and respectful during the examination and give the doctor basic information about your claim. Tell them how you got hurt. Tell them specifically how the accident happened. Be detailed about all of the injuries you suffered in the accident, even the ones you might not think are significant or that have gotten better.
If you don't tell the doctor about all your injuries then they will not write it down. And if they don’t write it down then there’s no medical record of it, giving the insurance company the excuse they need to eventually restrict or deny benefits.
Remember: if they don’t write it down, it's as good as you not telling them at all, so make sure they write it down!
If the doctor doing the examination asks you to move any of your injured body parts, please be sure to tell them what does and does not cause pain, and don’t do anything that’s going to make your injury worse! Also, be sure to let them know any medications you’ve been taking could make your movement easier.
Once the exam is over, you have a right to a copy of the medical report within 10 days.
I’ll often get calls from clients complaining that they went through an IME and the doctor only spent 5 of 7 minutes with them and he didn't even pay attention to them when they were speaking, and he didn't perform any of the testing that he said he performed…
What I tell my clients is: please wait until your report comes in. When you get the report from the doctor, make a photocopy of it. Then take the copy of the report and go through it line by line, making a note of anything that you have a problem with.
If the doctor says he did straight leg raise testing where he made you lift your leg up up off the table, and you did not do that, make a note. If the doctor says that you climbed on and off the examination table with no problem and you remember needing help or asking for a step stool, make a note. If the doctor says that you told him that you never got hurt before and you never had an accident or prior injury and you told them about an old accident, please make a note of that.
Why? Because these notes give us a chance to get out in front of any problems that might pop up. This is all valuable information that your lawyer can and will use when they cross-examine this lying doctor. They’re like ammunition. Without having notes like these, your lawyer will be going to the deposition of this doctor blind. With these notes, you can go on the offensive.
Which leads me to my tips for IMEs…
As much as the doctor performing the IME is on the side of the insurance company, we can use them to help you and to make your case stronger.
How? By showing that: A) you're being cooperative by attending the examination, and B) the examination fails to properly document your injury or reflect your overall disability and need for treatment and benefits.
You might have two-to-four IMEs over the course of your case, each only 10 minutes long. We use that fact to show that the doctor could not have actually reached a valid or accurate conclusion as to the type of injury that you suffered, the extent of your disability, and your need for treatment. We make these arguments in court all the time, and they help support your case.
Aside from taking notes after you receive the IME medical report, you should also note the time you arrived for your appointment and the time that you left. If you have a 1:30 PM appointment for instance, and the the doctor's report shows that you weren’t seen until 3:00PM, I like to make note that you got there at 1:00 and were left sitting around for 2 hours.
It makes the doctor look bad, and I like to highlight it when it's time to take their testimony.
Another way you can protect your case during an IME is by being careful about the information you share on the questionnaire. Do not give them all of the information they ask for, especially any questions about your ability to look for work or perform work.
I tell all my clients to go ahead and put down their basic information, but to consult with me before writing anything else. It’s okay to leave certain questions blank if you’re not comfortable answering them—better that than accidentally writing something damaging about your case.
If you're unsure about which questions you should answer, please consult with your attorney.
The questionnaire is also an excellent place to list your prior accidents and injuries to protect your benefits and to avoid being accused of fraud. Most fraud claims I see start with the insurance company claiming that you failed to disclose an old worker's compensation claim, an old car accident, an old football injury, an old disability, whatever.
This is why I stressed the importance of making sure the IME doctor writes things down, because it doesn’t matter if you failed to tell the doctor or the doctor forgot to report it—the insurance company will accuse you of fraud all the same.
If you had a prior accident, injury, disability, worker's compensation claim, car accident, trip and fall, anything—especially if it involves the same body part or sites of injury or disability—you must disclose it to their doctor, and the questionnaire is a great place to put it in writing. Even if they don’t ask for it, write it down anyway, because you don’t want to be accused of committing fraud. Fraud is bad.
When you're finished, please ask for a copy. You have a right to it!
You can have all the supporting evidence in the world to back up your claim, but it’s only going to be as strong as you make it during your hearing.
That’s why having a workers compensation lawyer is such a game changer, because they not only know all the tricks to build a strong case, but they also know how to represent you in court so the judge sides with you instead of the insurance company and their IME doctors.
So if you or a loved one have been injured on the job here in New York and would like to set up a free consultation, please give me a call at 212-406-8989 today, and together we can get the treatment you need and the benefits you deserve.
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🔹 Watch my video about choosing the right doctor: The Wrong Doctor can RUIN Your Workers Comp Case