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               Independent Medical Exams, Making The Best of Them
 
 
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This is not like seeing your doctor, for this doctor is not treating you. He or she is evaluating you independent of a doctor-patient relationship.
These have a mixed reputation, but several steps can protect you, and help you get some benefit. IMEs are usually done at the request of an insurance company, and then scheduled by a company which they in turn contract with that specializes in such exams. It's important to understand this, because you are not dealing directly with the physician, and possibly not even directly with the insurance company. On the one hand, the insurance company has a strong desire to save costs and looks upon the exams to help with this process in a way that may make your challenges greater.

On the other hand, depending on the physician you have, IMEs can provide important insight and guidance which you may not have had up to that time. The IME physician is not supposed to discuss your specific case, and probably needs to complete reviewing the case records and materials later before having an opinion. But they can speak about the problem in general terms, and put specific advice in the report.

It's important to understand that IME's can often affect your medical care, including approval for tests and treatments as well as your disability pay. Therefore they can affect the course of your treatment, affect delays in treatment, and delay or change your reimbursement.

The physician doing the exam may be in the same specialty as your problem, or a related one. It is not uncommon to have several different specialties involved, each with an IME for the problem in their area. For example spine problems may have a chiropractic IME, a neurosurgical IME, and an orthopedic IME if there are considerations from each of those in your treatment.

Try to make the exam setting as favorable as possible. If the exam is distant, ask to have it closer. Driving a long distance is usually hard on you, and may make your exam more difficult. Ask around about your IME physician, and if the information worries you try to have a different IME doctor selected.

Usually you will get the results about IME exams a week or two afterward, as a copy of the report. However, this varies with the type of case (for example workman's compensation versus no fault MVA) and the state rules. If you do not get a copy directly, you may need to contact the insurance company or your case worker, or attorney. Learn those rules.

If an IME exam goes wrong, it can take a lot of time and effort to correct the effect. A further IME may be needed. Or a court hearing may be used, depending on the circumstances. These and other procedures can be delayed while you wait with problems in work or disability classifications, or treatments that you need for weeks, months, and sometimes years.

Example: IME Frustration. Here is a real case, with several common problems.
BA has been our of work with a back injury from a fall. She has had medications, physical therapy, and chiropractic without improvement. Her physician sent her to a specialist, an orthopedic spine physician, who stated she should consider surgery, and rated her as totally disabled.
She was scheduled for an IME in a different city, and drove alone an hour to the exam. This made her back and leg pain worse. She forgot to get her X rays and other studies to bring with her, and also did not have her doctor's note from the visit just a week before. At the exam, the IME doctor could not make a decision about recommended treatments from the recent visit because there was no doctor's note in his chart from an exam so recently. And she did not get it before coming. Also he could not review her radiolgical studies. Another problem was that she forgot about a past injury to her back, contradicting her own doctor's notes. Then in the exam some standard tests and movement made her worse, and the drive back made her worse still. When she got the results of the report, her disability was decreased and she was rated as able to do a light duty job. This also cut her payments. The treatment her doctor advised could not be approved because there was no note recommending it. This caused more delay in helping her.

It is important to take these exams seriously. Go to them, have your records, and know what is in your records. You need to present a clear and accurate portrayal of your problems and your history. Then read the reports and be sure your doctors work with you to solve any problems or inconsistencies that arise.

For more detailed advice, continue to our discussion of strategies and solutions for IMEs

And Lookout for the IME Snares

IME Intro

These below require a regular membership level.

Power Patient Approach To IMEs
Disablity
Seven IME Snares
Quiz Yourself to Optimize the Odds
Finally, Use Our Checklist Before Your IME


Need More IME Help? Call For a Consult.

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