How to Prepare Yourself for an IME (Insurance Medical Evaluation)

Author Subject: How to Prepare Yourself for an IME (Insurance Medical Evaluation)
Del Posted At 11:36:05 06/11/2000
A friend to injured workers sent along this valuable info. We thank them.

Although it talks about auto accidents, it's very applicable to workers comp in every state. Please print a copy so you've have it to review before your next IME.
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Subject: Insurer medical exams (IMEs)

Below is a good find on the Prairielaw site,
http://www.prairielaw.com/default.asp

Passing the Medical Exam
By Robert A. Johnson


Every year there are more than 1 million injuries due to motor vehicle
accidents in the United States. Many of these injuries are too minor to
report, but some are serious enough to require medical treatment, insurance
claims and ultimately, lawsuits.

If you are injured and make a claim against the driver who caused the
accident, his or her insurance company has the right to have you examined
by a doctor of its choice. This is variously called an "independent,"
"adverse" or "compulsory" medical examination.

Whatever itís called, the doctor who performs the exam will testify about
your injuries for the insurance company who is paying his or her fee. The
doctor is examining you not for the purpose of treatment or to help you
find relief from your injuries, but to obtain information that will either
allow the insurance company to terminate its obligation to pay your medical
bills or to question your injuries should your case go to trial.

Here are some tips about what to expect and how to make the best impression
possible.


Message Board: Auto Accidents


Keep your appointment. Many insurance companies schedule exams through
agencies that supply doctors who are willing to perform these exams for
insurance companies. Your failure to attend the exam may result in your
being responsible for payment of the doctor's fee or the suspension of
payment of your medical bills.

Know what youíre getting into. Although the doctor may be honest, he or she
has been selected to perform the exam because he or she has a conservative
nature and is generally biased against injured claimants. The doctor has
been asked to discover information that will either show you were not
injured or that you are not entitled to further coverage . Some doctors
work regularly for insurance companies and earn a substantial income for
performing exams.

Donít take it personally. It's important to go to the exam with the right
attitude. Understand that the exam is standard procedure and try not to be
defensive.

Honesty is the best policy. The best way to "connect" with the doctor is to
be polite, cooperative, and above all, truthful. If you lie or fake an
injury during the exam, the doctor will recognize your deceit and mention
it prominently in the report. Try to appear open and forthright by
providing helpful and straightforward answers. Also, attempt to make eye
contact whenever possible. Although you need to pay attention to the
doctor's questions so you can answer them carefully, don't appear nervous.
After all, you know the answers to the questions, so try to stay relaxed.


Preparing for the Exam

Get organized. One way to strengthen your case and be more relaxed during
the exam is to gather your thoughts so you can present your medical history
in a logical and concise, but complete manner. Here are some topics youíll
cover:

* Your medical history, including prior injuries;
* How the accident occurred;
* What areas of your body were injured;
* Your primary symptoms;
* When your injuries cause you pain;
* Movements or activities that aggravate your injuries and cause pain or
discomfort;
* Treatment or medication that makes your injuries feel better; and
* Activities that have been affected or limited.

Review the summary with your spouse, friend or co-worker to see if they
notice any items you omitted. Review the summary before your exam, but do
not bring the summary with you.

Note the date, time and place of your exam and the name of the doctor who
will be examining you. Get any directions you need well ahead of time.

Arrive early. Youíll be more relaxed and have time to fill out any forms.

Plan extra time into your schedule. If the doctor is delayed, you won't
feel rushed or upset. You will also want to have extra time after the exam
to write a summary and call your attorney.


Meeting the Doctor

The doctor will ask questions to formulate opinions about your injuries. Be
careful that you understand each question before you answer it. For
example, if the doctor asks, "How do you feel now?" you should find out if
he wants to know how you feel that minute or at this point after the
accident. You may feel pretty well at that particular moment, but may have
had pain associated with your injury earlier in the day, so it's important
to be specific and accurate in your answers.

Take time to answer all questions carefully. If a question is unclear or
confusing, don't be afraid to ask the doctor to explain or rephrase the
question before you answer. If you make a mistake, correct it immediately.

Avoid unnecessary elaboration. Remember that the doctor is hired by the
insurance company to help its case. So, while you should always answer a
question politely, honestly, and completely, don't ramble on or elaborate
unnecessarily.

Try to remember what goes on during the exam in as much detail as possible,
but don't take notes in front of the doctor or bring a tape recorder into
the exam ó that could make it appear that you are more interested in
getting money for your injuries than in improving your health.

Be honest and precise. During the exam, you'll be asked to describe your
pain and discomfort. Since pain is subjective, it may be best to describe
your pain by referring to what areas of your body hurt when you do certain
movements or activities. Be as truthful and accurate as possible. No one
likes complainers who exaggerate their injuries. On the other hand, don't
understate your pain and the problems it causes you.

Behave consistently.The doctor will be observing you during the exam and
looking for inconsistencies. For example: You tell the doctor that you
can't turn your head to the right. Later, the doctor goes to your far right
and asks a question. You turn your head all the way to the right to look at
the doctor. Your physical action of turning your head is inconsistent with
your prior response.


The Physical Exam

After taking a medical history, the doctor will make a physical exam. The
exact procedures vary based on your injuries and the doctor.

Here are a couple things to avoid. Do not:

* Do not volunteer any information not requested.
* Do not discuss who is at fault in your case.
* Do not discuss settlement of your case.
* Do not allow the doctor to take X-rays or conduct other diagnostic tests.
* Do not take any written or psychological tests such as a MMPI.
* Do not go to any other doctors or facilities without your attorney's
approval.

Is extremely important to note the exact amount of time the doctor spends
actually examining you because the doctor will prepare a detailed report
regarding your injuries despite having only spent a short time actually
examining you.

During the course of your exam, without the doctor knowing it, keep track
of the time the doctor spends with you and what is being done during each
time period. For example:

2:00 p.m. Arrive at the doctor's office.
2:15 p.m. Appointment time
2:30 p.m. Go to examining room
2:40 p.m. Doctor arrives in examining room.
3:00 p.m. Interview ends, told to undress, doctor leaves
3:10 p.m. Doctor returns and begins exam
3:15 p.m. Examination over
3:20 p.m. Leave clinic


After the Exam

Once the exam is over and you have left the doctor's office, prepare a
written summary containing the following information in as much detail as
possible:

* What the doctor said to you;
* What you answered;
* What, if anything, was dictated into a tape recorder by the doctor during
the exam;
* What tests or procedures the doctor performed;
* How much time the doctor spent with you;
* What was done during each time period; and
* Any inappropriate or unusual questions or comments made by the doctor.

The doctor will prepare a report for the insurance company describing his
examination of you, along with his findings and opinions. It is extremely
rare for the doctor to determine that you were injured in the accident or
recommend any further treatment.

If you feel you have made a good impression, ask the doctor what treatment
he or she would recommend for your injuries. Your questions may prompt the
doctor to treat you as a patient, rather than an insurance claim.

Robert A. Johnson is a partner at Mansfield Tanick & Cohen, a Minneapolis
firm that provides legal services to individuals, families, businesses and
organizations nationwide. His practice areas include personal injury cases
and motor vehicle accidents.


Copyright © 2000, Prairielaw.com
Del Re: The Above Article Has Been Reformatted (Currently 0 replies)
Posted At 12:29:07 06/11/2000

So it prints better, the above article has been made into a separate .htm file and placed in the IWA File Room here.
judy john Re: How to Prepare Yourself for an IME (Insurance Medical Evaluation) (Currently 0 replies)
Posted At 16:36:38 06/29/2000

Del,
thanks for the informative IME suggestions. I already printed it out and will begin the paperwork. I just submitted my brief to workers comp
board. Dr. sent his final opinion to insurance co. also will be included in brief. I have to wait 20 days to find out if I go higher still in the system. I refuse to lie down and let them run over me. I know they will continue to try.I want to apologize to all the people I did not beleive
when they told me how rough getting blood out of a turnip was.I commend those who continue to fight righteously for compensation.
judy john

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