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Think twice about having an independent medical exam and be prepared if you have to have one

By John Singleton on December 15, 2020

As much as we hope insurance companies will take care of us if we are ever injured in an accident, it does not always happen. Most insurance companies base their business model on maximizing premiums from customers and minimizing the amount paid to accident victims.

When you file a claim after a car accident, dog bite, or similar injury, an insurance adjuster may try to convince you to take a lowball settlement offer, saying it is the best he can do. If you push back and demand fair compensation for your injuries, the insurance company may make you jump through hoops, which still may not lead to your getting what you are owed. This is especially true when an insurance company asks you to get an independent medical exam.

What is an independent medical exam?

An independent medical exam, or IME for short, is a medical exam that insurance companies may request when reviewing a claim. In a perfect world, these exams would be administered by an unbiased doctor who writes a fair, detailed report about how you are doing. Sadly, these exams are often biased and unfair to victims.

Three things to know about IMEs:

  1. The insurance company does not request these exams to see how your treatment is going. Instead, they are usually trying to collect evidence to discredit your claim.
  2. Although you may have a stack of test results and medical reports to support your claim, the insurance adjuster may say that these reports are insufficient and that they want you to see a doctor they have worked with in the past. This doctor often may have a long history of performing IMEs for insurance companies, meaning the doctor owes a majority of business income to the insurance company. This can make the “independent” examiner anything but unbiased, and his reports will often be written to support the insurance company’s argument. The doctor may even ask you about your case or ask leading questions in the hope that you will admit fault.
  3. With an IME report in hand, the insurance company will argue that further treatment is unnecessary, that you are exaggerating your injuries, or that you are faking your case altogether. Even if the IME doctor agrees that your injuries are real, he may claim that they were not caused by the accident. The doctor can also be called as an “expert witness” in a trial or deposition on behalf of the insurance company.

Isn’t seeing a doctor after an accident important?

Yes. After an accident, always visit a doctor, whether at an emergency room, doc in the box, your general practitioner, or a specialist. Many serious medical conditions can be masked by shock and adrenaline, or they can simply develop over time following an accident. If you do not act quickly to get checked out, you can find yourself in intense pain or suffering from a serious medical condition.

And, if you are worried about paying the medical bills for check-ups and related tests, rest assured that if your accident was caused by another person’s negligence, you are likely eligible for a personal injury claim. With a claim, you can recover all the costs of your injuries, including diagnosis and ongoing treatment. Several ways to cover your medical expenses are also available until you receive your settlement.

However, IMEs can complicate your case, especially if you did not receive other treatment following an accident. Even if the exam is thorough, IMEs are often not meant to help you heal from your injuries. Instead, they can be used to dismiss your medical concerns and minimize the amount of money you will receive later.

Is it a bad idea to get a second opinion about my treatment?

No. If you are concerned about your own diagnosis or treatment plan, you should always consider getting a second opinion. Most of us rely on our general practitioner, but ER doctors and specialists can also provide detailed information about your injuries. However, you always want to choose the right doctor to review your injuries – not one who is in the insurance company’s pocket.

Do I have to agree to an IME?

Virginia insurance companies have the legal right to request an IME in two scenarios:

  1. If your claim is in litigation, the insurance company’s defense lawyers can request an Order of Examination, according to Rule 4.10 of the Supreme Court of Virginia.
  2. If you are filing an underinsured motorist claim with your own insurance company, it can require an IME during settlement negotiations with you.

In either of these scenarios, you may have to go to an IME. However, always speak to an experienced attorney first. At GibsonSingleton Virginia Injury Attorneys, we are well-versed in IMEs and how to handle the situation when an insurance company requires one.

Generally, by the time the insurance company requests that you have an IME, you’ve seen multiple doctors and are well into treatment. This should mean that we have an overwhelming amount of medical evidence to support your claim. So, if push comes to shove, we can use that evidence to dispute the IME report and protect your right to compensation.

If I have to get an IME, what should I do?

That being said, we have tips you can use during a visit to an IME to minimize the negative impact on your case:

  1. Prepare: Given how many IMEs we have dealt with, we at GibsonSingleton can prepare you for questions the examiner may ask. We can review your medical records with you so you can fully understand and explain your injuries, how you were tested, and why you received specific treatments.
  2. Arrive early: It always helps to set a good tone for the appointment, although we all know how long the wait time at a doctor’s office can be. Getting there early will give you ample time to check-in and prepare mentally for the exam, while also demonstrating that you are taking this visit seriously. If you arrive late, the IME doctor could take it as a sign that you are not serious about your injuries and getting better.
  3. Bring someone you trust: While it may not always be possible in a post-COVID world, you may be able to bring a family member or friend with you. Not only can doing that boost your confidence, but your companion can take notes and act as a witness about anything that concerns you or if you later disagree with the IME report.
  4. Be cooperative and honest: At the end of the day, this is a doctor’s appointment, and you should try to be respectful and polite. Answer all the medical questions as thoroughly as possible, including how your treatment is going, what level of pain you are experiencing, and how your injuries have affected your daily life. Remember: you know your injuries better than anyone, and you have medical records to support you.
  5. Avoid volunteering information: The focus of the exam should be on your health and recovery, not on your accident. You do not have to go into details about your accident, and you should avoid oversharing extra information. The doctor should focus on your injuries, not your legal matters.

Who can help me through an IME and ensure I get compensated fairly after an injury?

We understand that an IME can be intimidating, particularly because insurance companies can try to use them against accident victims. But if you work with us at GibsonSingleton Virginia Injury Attorneys, we will put our experience, expertise, and skills to work for you in making your claim as strong as possible. We will review every aspect of your case – from your medical records to the accident report to the physical evidence.

So even if you have to have an IME, as Virginia injury attorneys, we can work with you before the exam and defend your claim afterward if we disagree with their report. Furthermore, the IME is just one aspect of your case, and we can advocate for proper compensation for your injuries in many other ways.

Call us today for more help

Both my partner, Ken Gibson, and I have gone through serious car accidents. As personal injury lawyers, we know the claims process inside and out. So if you choose us to represent you, we will provide compassionate, in-depth legal guidance throughout the entire process. Not only are we experienced attorneys, but we’re also former U.S. Marines. We will prepare a strategy and execute it on your behalf to get the best possible outcomes for you.

To discuss your case and get more advice in a free consultation, call us at GibsonSingleton Virginia Injury Attorneys, (804) 413-6777 or toll-free at (855) 781-6777.

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Prevention, empathy, and diligence are hallmarks of everything we do at GibsonSingleton Virginia Injury Attorneys. Our community can see these ideals lived out in our work to prevent personal injuries from happening.

  • Safety Education
    GibsonSingleton launches a “Texts=Wrecks” campaign to reduce the number of people injured or killed by distracted drivers.
  • Annual Coat Drive
    During the fall, our team works to distribute coats to people in need in our community.
  • Hands-on Service
    John and Ken join the Gloucester Point Rotary Club in cleaning up the community.
  • Supporting Local Schools
    The Gibson family participates in Gloucester’s Botetourt Elementary Shuffle fundraiser.