Independent Medical Examinations
Most people who have been injured and are receiving insurance benefits are closely monitored by the insurance company paying the benefits. If a lawsuit is filed, or if the company wants to test the injured person's staying power, the adjuster is likely to ask for an Independent Medical Examination. Needless to say, "independent" is a misnomer, as it implies that the physician conducting the examination is without bias. In fact, with rare exceptions, insurers don't select "independent" doctors and doctors who are paid by insurers to conduct these examinations know "where their bread is buttered". These exams are a legitimized opportunity for the insurer to investigate the disabled person's medical condition thoroughly and then to put a spin on the findings that is most favorable to the insurer.
Unfortunately, consumers have few remedies in the context of Independent Medical Exams (IMEs), and they can be a significant invasion of privacy and a significant source of difficulty. Under most policies and typical law, the disabled person must attend the IME or his benefits may be terminated. An attorney can attend the IME with the disabled person, however, depending on the situation this may be an expensive, invasive, or at least awkward-and-ineffective remedy. Many physicians who might have maintained an open mind are extremely discomfited by the presence of an attorney and this fact may guarantee a negative report.
We have had some success with the local courts in terms of limiting the extent of IMEs or the distance that the disabled person must travel. Even though the insurer must normally pay all of the expenses associated with such an exam, it can be unreasonable to force a disabled person to drive past several hundred physicians in order to be examined by the "reliable" doctor routinely chosen by this insurer.
Cases involving neuropsychological injuries can be especially troubling, since many defense IME psychiatrists or neuropsychologists want to administer a battery of tests that lasts for a day or longer and may attempt to insist that no attorney be present. They may also insist on performing the test in close proximity to a treater's prior testing--a factor that can result in misleading and false evidence of improvement.
Disabled or injured persons who receive notice of an IME should contact a personal injury lawyer for free advice immediately. Almost all injury lawyers will provide a free consultation on an issue of this nature, and it would be worth the time spent. It may be that the date should be moved, that the location can be moved, or that the examination can be limited--even without formal intervention. It may be advisable for an attorney to attend the IME, or it may be necessary to evaluate what records and films should be gathered and by whom. It is also possible that the attorney can reassure the patient about the reputation of the "independent" examiner.
An attorney may recommend that you make your own record about the time and content of the exam in order to demonstrate that it was relatively superficial. He or she may also recommend that the patient be accompanied by a third person. The patient should also be warned about the possibility that in taking his "history", the IME physician may attempt to conduct an inappropriate examination of the patient in an attempt to bolster his employer's defense to providing benefits.
ANOTHER KEY ISSUE FOR PATIENTS TO KEEP IN MIND IS THE FACT THAT UNDER MICHIGAN LAW, THE IME DOCTOR OWES NO DUTY TO THE PATIENT. In several past cases, IME patients who were mis-diagnosed or undertreated as a result of IME examinations have attempted to sue the IME doctor for malfeasance or malpractice. Michigan "reform" courts have held that no physician-patient relationship exists between the IME doctor and patient and that the doctor therefore owes NO duty to the patient. If he is wrong in his analysis, or leaves something out of his examination, the patient has no recourse against him.