Independent Medical Examinations refer to medical evaluations performed by a healthcare professional who has no prior affiliation whatsoever with the patient. They are conducted for various reasons, most commonly in personal injury cases, workers’ compensation claims, and disability disputes.
In North Carolina, IMEs are often used to objectively evaluate a person’s medical condition, determine the extent of their injuries, and provide insight into their ability to work. The purpose of IMEs is to objectively evaluate a person’s condition to help resolve legal disputes or claims.
These examinations are commonly requested by insurance companies, employers, and government agencies to clearly understand a person’s physical abilities and limitations, which in turn can directly impact eligibility for disability benefits or workers’ compensation claims. As such, the outcomes of an IME can be critical in determining an individual’s legal rights and potential entitlements.
How Can an Attorney Help?
If you are scheduled for an IME, it is critical to prepare for it with the assistance of a Raleigh worker’s compensation attorney. This examination is typically conducted by a doctor chosen by the insurance company, meaning their goal is to minimize your injury claims. Fortunately, with the help of an experienced lawyer, you can protect yourself and your rights.
Your attorney will guide you through the process, ensuring you understand what is required and what to expect during the examination. They can help you compile necessary paperwork, such as medical records, that clearly document your injuries and the extent of their impact. Additionally, if the exam results are biased or unfair, your attorney can question the report’s validity and advocate to fight for a fair settlement.
Facing an insurance company that is relentless in its pursuit to avoid paying claims can be overwhelming. Still, with the help of a skilled attorney, you can feel confident that your best interests will be protected.
What is an Independent Medical Examination?
Using an IME can be a double-edged sword for plaintiffs seeking just compensation for their injuries. On the one hand, this process is often necessary when dealing with insurance companies who may not be willing to accept the initial diagnosis of a treating doctor.
However, using an IME can also be questionable due to the report’s potential for bias and manipulation. This is exacerbated by the fact that the defendant often can choose the medical professional to perform the evaluation, leaving the plaintiff disadvantaged. Despite these concerning aspects, certain rules and guidelines must be followed during this process.
Notice of the time, location, manner, and scope of the examination must be given in advance, and only one IME is generally permitted unless there is good cause for further evaluations. Additionally, the defendant or insurance company is typically required to cover the cost of the IME.
What is in a Report?
The IME report should start with an introduction that provides basic descriptive information such as the injury dates, date of IME, etc. This introduction is an essential reference point, as parties involved in the personal injury lawsuit refer to it frequently.
- Doctor’s conclusions: The report should have a summary of the doctor’s conclusions prominently displayed at the top of the page. This summary provides a snapshot of the entire report, making it easier for parties to understand the doctor’s case assessment.
- Claim history: The report should provide a detailed history of the claim, including a review of all medical records relevant to the injury. This information helps the doctor understand the injured party’s medical history and identify underlying conditions that could affect their recovery.
- Initial conversation: Notation of the initial conversation between the injured party and the independent medical examiner should be included. This information provides insight into the injured party’s description of the injuries, pain, and other symptoms.
- Detailed findings: The report should contain detailed findings of the IME, including a diagnosis or prognosis. The IME should cover various physical examinations, including reflexes, strength, and neurological testing. The report should also provide a detailed analysis of any imaging studies that the doctor may have reviewed during the examination.
- Conclusion: The report should conclude with the doctor’s final assessment of the injury, outlining their prognosis for recovery and providing guidance on appropriate treatment and rehabilitation. This conclusion is crucial as it impacts the injured party’s compensation and other legal ramifications related to the case.
Who Needs to Obtain an Independent Medical Examination?
If you’re involved in a legal case, or worker’s injury and a medical exam is requested, it’s critical to understand your rights and obligations. The court typically orders an IME to provide unbiased information about your medical condition or injuries. If you refuse to attend the appointment, you risk the judge dismissing your case or imposing other sanctions, such as awarding attorney fees to the other party.
Don’t Let Medical Reports Drag You Down
It is important to note that while IMEs are intended to be impartial, the examining physician is often chosen by the requesting party and may approach the examination with a bias toward the party paying for it. As such, all parties involved should approach IMEs with a healthy dose of skepticism.
Also read: 7 Ways To Leverage Machine Learning For Automated Health Insights
