An Independent Medical Examination or IME is a tool of the automobile insurance industry to make sure that a claimant has actually suffered injuries and requires additional medical treatment.
The PIP Benefits statute M.G.L. c. 90 § 34M allows those injured in motor vehicle collisions to recover up to $8,000.00 of no fault benefits, meaning that regardless who was at fault immediate medical expenses will be covered by the automobile insurance.
A primary objective of the no-fault automobile insurance is “provide an inexpensive and uncomplicated procedure for obtaining compensation for injuries sustained in automobile accidents.” Dominguez, 429 Mass. at 115.
However, an insurer is allowed by that same statute to require a claimant to go to an Independent Medical Examination, or IME.
An IME does not have to be a licensed medical doctor, only a physician. In the court's view requiring there to be a licensed medical doctor preforming the exam would be an "unreasonable result that the Legislature did not intend." Ortiz v. Examworks, Inc., 470 Mass. 784, 792, (2015). Rather any appropriate licensed or registered health care practitioner, including physical therapists would be appropriate. Id.
Some important tips for an independent medical exam.
Do not ignore your notice. If you receive an IME notice pay attention to it. The IME notice may not mention the automobile collision, or the insurance company at all. Many IMEs are done through third party providers, so if you see a request in the mail for a medical examination it may be related to a collision you had been in.
Review your notice. The IME notice should provide you the time, date, and place of the IME. If the IME is several hours away, call to reschedule somewhere closer. If the IME is at a time you cannot attend, call to reschedule another day. If the IME notice is confusing consult a lawyer. Most lawyers, including the lawyers at LMR will provide you with a free consultation.
Talk to your Attorney. If you have an attorney speak with them before your visit. They will be able to tell you what to expect in more detail. Also, they may have particular experience with the place you may be going.
Go to the IME. IMEs can be annoying. They may require you to take off work, obtain childcare or reschedule your life. However, missing an IME can cut off your benefits and negatively impact your personal injury case. If you incur expenses going to the IME track them and provide them to your attorney.
Be Truthful. This one should be obvious, you should be honest in your dealings, even if you would all prefer to fib about your weight or height honesty is imperative so that the IME can make an assessment. If you are caught lying, dire consequences could ensue. You should listen to the question the IME asks and answer just that; remember this is not your doctor, but a physician hired by the insurance company.
Be Courteous. Be early, wash, brush your teeth, dress well and pay attention. If you are going to be late, call ahead. If you cannot make it, try and reschedule. Making a good impression affects people, even physicians.
Note your interactions with the IME. We have heard from former clients that some IMEs do not take much time, and did not do much testing. If you create a record of when you arrived at the IME, what you were told, what tests were performed and how long you were there you can use that information. Taking someone with you can help with this documentation. Do not photograph or record anyone without their express permission!
If you are injured and an IME has been scheduled, or if you are a medical provider whose bills were denied because of an IME decision please contact us.
The information provided on this website does not, and is not intended to, constitute legal advice; instead, all information, content, and materials available on this site are for general informational purposes only. Information on this website may not constitute the most up-to-date legal or other information.
