An Independent Medical Exam is an exam designed to help the insurance company or the Workers’ Compensation Board evaluate and value your workers’ comp claim.
The IME is an exam conducted by a doctor paid by the insurance company. While the name says independent, it is performed by a doctor on the insurance companies behalf. The IME doctor’s job is to push back on the extent of treatment your doctor may say is required. Because the IME doctors get paid by the workers’ comp companies, their diagnosis will generally lean toward representing the insurance company’s interests, not yours. Many IME doctors spend most of their time conducting IMEs for insurance companies, so they are hesitant to “bite the hand that feeds them.” This makes it even more important to work with a doctor that is very familiar with workers comp claims to ensure you have all the documentation required to have your claim approved for the treatment that you need to recover.
The goal of an IME is to:
- Identify the specific injuries from the work-related accident
- Define the severity level of the work-related injuries
- Identify the treatment required
- Provide the Worker’s Comp Board with a second opinion
- Identify any potential false claims
IMEs are also sometimes used in auto accidents, but there are differences between workers comp and auto accident IMEs. An IME is not part of the formal claims process in an auto accident liability claim but can be requested during civil litigation discovery. These rules indicate that if your injury is “in controversy,” the other party can demand an IME be conducted.
Our focus is on workers’ compensation rules as the IME process is part of the formal legal process in this article. However, our goal is to prepare you for what to expect if you have to submit to a workers’ compensation IME or liability and understand the do’s and don’ts of an IME.
Do’s and Don’ts of an IME
There are several things that you should keep in mind when getting your IME, and reviewing this list before your IME can help ensure it goes smoothly.
- Always tell the truth. While this may seem like simple advice, it is critical. Insurance companies are very good at identifying when patients are lying, and it can have a very negative impact on your claim and care.
- Request a copy of everything provided to the IME doctor by the insurance company and provide it to the New York Workers’ Compensation Board and your doctor.
- Take someone with you when you have the IME take notes regarding the process.
- Provide as much detail as possible regarding your accident and make sure the facts are the same as what you provided your doctor.
- Give complete information about all your injuries, don’t just answer their questions. Again, ensuring you provide complete and accurate information is critical.
- Explain to the IME doctor all your limitations due to your injuries.
Workers’ compensation claims can be complicated, so it is essential to understand your rights and work with a doctor who is very experienced in treating people for workers’ compensation-related injuries. If you need help, you can also work with a New York workers’ compensation attorney to help you.
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