Understanding The ‘Independent Medical Exam’ After Automobile Crash

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By: Shane Farnsworth Special to the Boca and Delray newspapers
An independent medical examination or IME, is not what the name suggests. It is often not independent and largely designed to either limit medical benefits available to you or limit your damages if injured in a motor vehicle crash. Understanding an IME and its implications is essential your personal injury case.
An IME generally arises in two contexts. The first is when your insurance company requires you to submit to an IME. This is done pursuant to the Florida No-Fault or PIP Statute. Your insurance company will choose and pay a doctor to conduct an examination of you.
The doctor chosen and paid for by the insurance company will only see you one time. The IME doctor will not be providing any medical treatment. The IME doctor has no doctor/patient relationship with you. Instead, the IME doctor’s role is to provide your insurance company an opinion as to whether further treatment for your injuries is reasonable, related and necessary. If the IME doctor’s opinion is that further treatment is not warranted your insurance company will terminate your PIP benefits even if they have not been exhausted.
The second context in which an IME generally will occur is when you sue the negligent parties that caused your injuries. As part of the litigation process, the insurance company for the defendant is afforded the opportunity to have you evaluated by a doctor of their choice. As in the PIP context, the doctor is paid to evaluate you on a one-time basis. The IME doctor will not be treating you and there is no doctor/patient relationship.
The IME doctor will review your medical records and history. At the IME the doctor will conduct an examination. Following the exam, the IME doctor will render an opinion. That opinion is generally about whether they agree your injuries exist and if so, the relation of those injuries to your motor vehicle crash. If the IME doctor opines that you were not injured or your injuries are unrelated to the motor vehicle crash, then the defendant’s insurance company will use this opinion to try and minimize any damages you could be awarded by a jury or to settle the case for less than its true value.
Insurance companies are completely within their rights to conduct an IME under the situations discussed above. However, the system creates the appearance of an inherent conflict that can make the suggestion of an “independent” exam questionable. In fact, attorneys for injured parties will often fight for and receive court orders prohibiting insurance companies from referring to these exams as independent to a jury.
Insurance companies routinely hire the same small number of doctors to conduct these exams. Those doctors are often paid large sums of money by the insurance company for their opinions. The IME doctor’s opinion in most instances disagrees with the treating physicians. They also regularly find no injuries or no causal connection between injuries and your motor vehicle crash. Be aware that you can expect the IME doctor to testify against you at trial. The IME doctor will be the insurance company’s expert. Their testimony will seldom help you and in most instances will be contrary to the evidence presented by your treating physicians. In many instances the fate of your case can hinge on the jury’s interpretation of this battle of medical experts. That is why it is imperative for you to understand the IME process and how it affects your personal injury case.
Shane Farnsworth is an attorney at Shane M. Farnsworth, P.A. in Delray Beach. He represents clients in the areas of personal injury, insurance disputes and civil litigation. His office can be reached at 561-272-8337 or online at shanemfarnsworth.com.