What is the Real Meaning of an Independent Medical Examination?
You were injured in some type of accident. It could have been a car crash, a slip and fall, or an incident that occurred at work. You already are being treated by a number of medical providers. To your surprise, you are directed to appear for an independent medical exam. What exactly does that mean?
The term “independent medical exam” seems to suggest that there will be no bias in the medical evaluation. However, considering the origination of the request might suggest otherwise. Independent medical examinations are also referred to as IMEs. Insurance companies or attorneys for the parties responsible for your injuries often ask for independent medical evaluations. Objectivity is sometimes cited as an issue.
What is an IME?
There is a big difference between a treating medical provider and one retained by the defense. The doctor who you see regularly orders diagnostic testing. This may include everything from a simple x-ray to MRIs and lab work. The information is used to diagnose your condition and develop a treatment plan. Understandably, you might develop a relationship with the treating doctor.
Most of the time, one physician is in charge of your overall care. Consequentially, you may be referred to physical therapy. You may decide on chiropractic treatment. In some cases, there may be a need for surgical intervention. All of these individuals or groups fall under the classification of treating medical providers.
An IME is conducted by a medical provider who has not treated you in any way. For the most part, the evaluations are performed by doctors in a particular specialty area. For example, if you broke your leg, you would be referred for an independent medical evaluation with an orthopedic physician. For a head injury, you might be asked to meet with a neurologist.
Purpose of the Independent Medical Evaluation
There are a couple of reasons for an independent medical evaluation. In one case, your own automobile insurance coverage may require an IME to determine if you really need proposed treatment. NJSA 39:6A-4 indicates that Personal Injury Protection (“PIP”) insurance is available for those injured in car crashes. However, that does not mean that bills are not held to some discretionary considerations. The PIP carrier could require an IME before agreeing to certain treatment.
Independent medical evaluations are conducted by workers’ compensation doctors as well. Again, there may be a question about treatment plans. An IME is also used in all types of accident cases to determine the extent of the injury.
Obviously, it would be unethical for any physician to claim you don’t need treatment if you do. Likewise, doctors are expected to be truthful concerning their assessment of the permanency of your injuries. Notwithstanding, a defense medical expert may be more conservative than a treating physician.
If you are referred for an IME, your attorney will provide you with information concerning the appointment. The doctor will have copies of treatment records. You should be honest about your condition and any preexisting conditions. Also, keep in mind that you are under observation even when you least expect it.