What is an Independent Medical Examination in a Personal Injury Claim?

What is an Independent Medical Examination in a Personal Injury Claim?

Apr 21, 2021

Whether it’s a car accident, pedestrian accident, motorcycle accident, truck accident, scooter accident, or any other type of motor vehicle collision or incident resulting in a physical injury, filing a personal injury claim often requires what’s known as an ‘independent medical examination.’ In most personal injury cases where the victim sustains a physical injury, the at-fault party (also known as the defendant) will request – typically via an insurance company representative – that the claimant undergo a medical examination by an “independent” physician. The goal of an independent medical exam (IME) is to seemingly allow a neutral party to examine an injured victim of a car or motorcycle accident and determine the extent of those injuries (which will likely affect the ultimate amount of any financial damages award via a settlement of verdict).

Essentially, the at-fault party will often use an IME in a personal injury claim as a means for countering an injured victim’s argument relative to the severity of any injuries sustained in an accident. The defendant (and his or her insurance company) has a clear objective to reduce any settlement or verdict to the lowest possible amount. It is in their best interest to minimize any financial obligation and ultimate payout awarded from a lawsuit stemming from any number of scenarios – a slip and fall, dog bite, premises liability claim, wrongful death claim, etc. However, given the clear motive behind supposed “independent” medical exams, how can injured victims be certain that the evaluation they undergo is, in fact, impartial?

Let’s take a look at what an independent medical exam entails, what considerations need to be had when victims of car accidents and other incidents are ordered to complete an IME, and how injured claimants can protect themselves from potentially nefarious medical professionals representing insurance companies and their clients.

What is an Independent Medical Examination (IME)?

Following any type of accident resulting in an injury, the initial medical treatment that the injured party receives is typically performed by a doctor of that person’s own choosing. In many cases, provided the accident did not require immediate transport to an emergency room, an injured party will choose his or her own primary care physician for any necessary care. However, any time a personal injury claim is filed due to an accident, the defendant (or the defendant’s insurance company) will inevitably request a second opinion. In the majority of personal injury cases, the at-fault party or insurance representative will insist upon an IME.

An IME is typically performed by a licensed doctor of medicine (MD) or doctor of osteopathic medicine (OD). These physicians usually have specific medical knowledge or training related to the type of injury a claimant has sustained. They also tend to have years of experience performing IMEs.

While the examination is referred to as “independent,” any experienced and competent personal injury attorney will tell you that IMEs are, almost universally, anything but independent. In fact, in most cases the insurance company will actually have an already established relationship with the doctor performing the IME. These IME physicians are essentially employees (at the very least representatives) of the insurance companies. Accordingly, they tend to have the best interests of the insurers in mind whenever conducting an IME.

As a result, IMEs are notoriously biased against injured victims. When you stop and think about it, this is a fairly logical outcome, as IME physicians are compensated by the insurance companies for conducting these medical exams. Said compensation would likely not continue in the event that an IME doctor regularly provided conclusions that resulted in the insurance companies having to pay more money for personal injury claims.

There are typically some standard guidelines that must be followed when conducting an IME. These include:

• The defendant or insurance company is required to provide the injured victim with reasonable notice regarding the time, location, type, and scope of an examination.
• The defendant or insurance company is required to cover the cost of an IME.
• Only one IME is usually permitted (unless cause for additional exams can be shown).
• The doctor (independent medical examiner) is required to make him or herself available for any necessary cross-examination by the plaintiff’s personal injury lawyer. This includes depositions as well as trials.

Is an Independent Medical Examination Actually Impartial?

Though an IME is supposed to be “independent,” many injured victims (as well as their legal representatives) would argue that it is anything but. In truth, ‘independent’ is actually an inaccurate description given that the doctor who performs the injured party’s exam is far from neutral. As the physician conducting the IME is actually chosen by the insurer to represent them, it’s virtually impossible for him or her to be neutral when determining the findings of an exam. Remember, the IME doctor is chosen by the defendant rather than the victim, but is tasked to serve impartially and weigh said findings on behalf of both parties.

Given that fact, the chosen doctor should, in effect, be viewed as a representative for the insurer’s legal team rather than an independent party. It therefore stands to reason that the examining doctor will almost certainly be inherently biased and more sympathetic to the position of the insurer.

In fairness to the insurer (or defendant), the rationale behind an IME is seemingly to offer a different medical opinion or perspective from that of the victim’s treating doctor. A victim with serious injuries requiring extensive treatment is placed under the care and supervision of his or her attending physician, and the insurer could argue that they are inevitably biased in favor of that patient given their relationship and the large amount of one-on-one time that can be required. However, this in no way means that an impartial and inherently biased medical examination on behalf of the defendant or insurance company is the best answer.

Nevertheless, an IME is the current standard for second opinions in personal injury cases. Therefore, it’s important for injured victims of car accidents and other scenarios to understand the goals behind an IME.

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What are the Goals of the Defendant’s Insurance Company When Requesting an IME?

The ultimate goal of having a doctor conduct an IME on behalf of the insurer is to first establish a differing medical opinion from that of the victim’s doctor (which happens in virtually all cases), providing a legal basis for the insurer to dispute the victim’s claim. In most cases, if the insurer makes a formal request for the victim to undergo an IME, he or she will be required to do so before the case proceeds to trial (or even informal settlement negotiations begin in earnest). It should also be noted that a required IME is frequently standard procedure if you live in a no-fault state and are making a claim under no-fault insurance. California is not a no fault state, while Florida, Michigan, New Jersey, New York, and Pennsylvania have verbal no-fault thresholds. Hawaii, Kansas, Kentucky, Massachusetts, Minnesota, North Dakota, and Utah utilize a monetary no-fault threshold.

If you are the victim of a car, truck, motorcycle, or bus accident (to name a few scenarios) filing a personal injury suit, there are certain norms regarding likely outcomes of an IME that you should be aware of and prepared for in advance. Typically, once an IME is conducted, the resulting findings via the insurer’s chosen doctor tend to reflect the following pattern:

1. The victim’s injuries are less (in many cases deemed much less) severe than they are claiming
2. The victim’s injuries are, in fact, not the result of the accident, and/or
3. The victim is actually not injured at all

Steps and Best Practices for Injured Victims to Take Before and During an IME

Personal injury victims are encouraged to consult with their attorney and treating physician prior to undergoing an IME. Sam Dordulian, former Deputy District Attorney for Los Angeles County and Founding President of Dordulian Law Group, always ensures clients are educated and informed prior to undergoing an IME.

Dordulian typically advises clients to:

1. Understand that an IME is not actually an independent medical exam. Rather, Dordulian is adamant that a more accurate term than IME (independent medical exam) would be DME (defense medical exam). These exams can only serve to benefit the defense’s case, and should therefore be referred to as DMEs rather than IMEs. It’s important for clients to appreciate these facts so they don’t go into an exam believing that the doctor conducting the IME (referred to hereafter as a DME) is truly neutral and interested in doing what’s best for the injured victim. Instead, the client needs to understand that this is a defense doctor whose agenda is to help the defense team in any way they can.
2. According to Dordulian, it is also important to have the client review his or her prior statements contained in medical reports/records (and other related documents). The goal here is to ensure these previous statements are consistent with their current claims and complaints. “Consistency is critical, and anything they [the injured client] says that is inconsistent with prior statements could be very damaging,” says Dordulian.”I remind my clients that their DME exam doesn’t start when they walk into the exam room. It’s important to remember that they are being watched from the time they arrive at the office, to the time they leave post-DME exam. Additionally, sometimes they are watched from the parking lot as they walk into and out of the doctor’s office. While the client should be honest and not standoffish, since this is a defense doctor they need to remain vigilant, keeping their guard up at all times and making sure all their issues and complaints are clearly voiced. Additionally, do not ask the DME doctor for advice, and avoid social conversation (e.g. small talk),” Dordulian says.
3. Dordulian also advises his clients to refrain from consuming pain medication before a medical exam.

“I always remind my clients they shouldn’t consume the pain meds that they have been prescribed while injured on the day of their DME evaluation. Though that might seem problematic given the increased pain, they don’t want the medication’s effects to mask that pain or physical limitations that the DME physician needs to observe first-hand and then assess,” says Dordulian.

In other words, while it may be painful for the duration of the DME, it’s important that the examining physician actually witness first-hand the amount of pain you, as an accident victim, are having to endure on a daily basis. Approach the DME as a test that, although temporarily uncomfortable, is critical to ultimately proving your case.

Some of Dordulian’s additional recommendations for personal injury accident victims facing a DME include:

– Injured parties should never attempt to minimize or downplay their specific injuries in an effort to be polite or personable. Additionally, simply agreeing with the DME doctor’s statements out of respect (or possibly fear) is never advisable. Assuming that, since you are filing a personal injury lawsuit and your injuries sustained during the accident are indeed legitimate and causing you pain and suffering, it’s incumbent upon you to describe what you are experiencing in detail to the defense’s DME doctor.

– Having a witness is very important. A witness can be someone who experienced the accident and can corroborate how it transpired (who viewed first-hand what injuries were sustained following the accident and the impact those injuries had/continue to have on the injured victim). A witness can also be someone who viewed the injured individual’s condition prior and subsequent to receiving medical treatment (i.e. before the accident and resulting injuries). This type of witness is actually preferable, as it can provide a perspective on how an injured victim’s quality of life has deteriorated after the accident. Personal witnesses can prove to be a huge asset in a personal injury case. Such a corroborating witness can be key to your case’s proceedings, should the DME findings be contested in court at a later date.

Ready to file a claim and pursue justice through a financial damages award? Our expert attorneys are available online or by phone now.

To recap, a DME (IME) witness can be any of the following:

1. An individual who was on the scene with you at the time of the accident
2. A friend or relative who was with you immediately afterward when you were hospitalized and receiving medical care
3. A medical professional other than your doctor – such as a nurse or physician’s assistant – who is familiar with your diagnosis, having cared for you in the hospital. Such a corroborating witness (or witnesses) will be critical, should you decide to appeal a DME doctor’s opinion.

– Retain copies of each and every document you sign throughout the course of your medical treatment and legal proceedings (always request these documents – whether from the hospital, the doctor, or opposing counsel – immediately after you ink your signature on the dotted line). This includes obtaining all available medical records from various doctors, hospitals, clinics, etc. It is also advisable to take down your own personal notes with each medical treatment received – chronicling in detail your experiences such as pain, degeneration of your condition, the extent of your injuries, etc.

Your experienced and skilled DLG personal injury attorney will be able to take the lead in completing these steps. This is one of many reasons why it is advisable that injured victims retain competent and qualified legal representation after experiencing an injury (whether minor or severe) through an accident.

Can You Challenge Your DME’s Findings?

If you ultimately wish to challenge the findings of your DME, as you are confident that they contradict the truth related to your injuries and condition, you do have options.

If you brought a corroborating witness to your DME, you should not only communicate what you believe to be unfair about the report to the insurer, but also stipulate that you have a witness to verify your viewpoint (both as it relates to the DME and the events viewed by the witness cited above). Additionally, you may want to consider forwarding your medical records to the defendant’s insurer, highlighting specific findings from your doctor that refute the DME’s conclusion (again, your Dordulian Law Group personal injury lawyer can handle this step). In such an instance, it is important that you emphasize how your medical records and doctor’s diagnosis are representative of a more thorough, comprehensive, and accurate screening, rather than merely a short, one-off DME. Some victims have even gone so far as to request a letter from their doctor, written directly to the insurer as a supporting declaration intended to refute and discredit the DME report.

Finally, it could behoove you to research the relationship between the insurer arguing against your claim and the DME doctor – specifically how frequently they have worked together in the past, and what percentage of cases (if any) ultimately resulted in opinions stemming from the DME that were in favor of the victim. More than likely, you will find that the physician consistently ruled in favor of the defendant/insurer rather than the injured victim.

How Choosing DLG Provides You Protection From “Independent” Medical Examinations:

When you experience a car accident or other unfortunate incident that results in an injury, the recovery process can be arduous and stressful. Having to take on insurance companies and their teams of lawyers can be overwhelming, and while the primary focus should be on your physical rehabilitation, it’s easy to become distracted with paperwork, doctor’s appointments, and mounting bills.

When you choose Dordulian Law Group to handle your personal injury civil lawsuit, you don’t just have a top-rated and experienced team of litigators on your side. At DLG, we offer a unique set of advantages to injured victims that can’t be found elsewhere.

To help build the strongest case possible and ensure you recover a maximum financial damages award for your injuries and various losses, we deploy a number of advantageous tactics:

– Our in-house Chief Investigator, Detective Moses Castillo, uncovers critical evidence to corroborate every case we handle. Castillo is a retired LAPD detective who spent nearly 30 years on the job investigating and closing a variety of cases, including pedestrian collisions and car accidents in the department’s elite Central Traffic Division. With DLG, you have the added advantage of a former detective investigating your case and uncovering critical evidence that can help increase your final settlement or verdict.

– Additionally, two attorneys in our premier Car Accident Division previously worked as defense counsel for major insurance companies. That means they know every dirty trick, shady tactic, and underhanded method insurance companies will use to reduce payouts for accident victims. Now, Arpineh Yeremian and Paulina Jaafar are on our team, fighting for injured victims with the experience and understanding of the insurance industry. With DLG, you have the added advantage of former insurance insiders serving as your dedicated advocates.

– Finally, lead litigator, Sam Dordulian, brings a rare wealth of knowledge and experience to personal injury cases. Unlike most personal injury lawyers, Dordulian has successfully handled over 100 trials – spanning everything from car accidents to sex crimes to murders. Dordulian and his team prepare every case with the possibility of going to trial. That means DLG clients have the added advantage of never having to worry that their case will be settled prematurely, ultimately receiving a minimal damages award. With our experience in trial law, DLG clients are ensured that their case will lead to maximum possible financial compensation for damages like medical bills, lost wages, lost earning capacity, psychological or emotional trauma, and much more.

When you’re injured in an accident, choosing the best firm to represent you is the most important decision that can be made. Injured victims who choose Dordulian Law Group know that they will be represented with the professionalism, dedication, and compassion that they deserve.

Our experienced attorneys can help you pursue a financial award for your personal injury case. Contact us online or by phone for a free consultation today.

DLG’s No Win/No Fee Guarantee

With Dordulian Law Group, you never have to worry about upfront costs, out-of-pocket expenses, or hidden fees. DLG operates on a contingency fee basis, meaning we never charge a penny until we’ve successfully recovered a maximum financial damages award on your behalf.

To date, we’ve successfully obtained over $100,000,000 in settlements and verdicts for injured clients just like you. We’re ready to fight for you and handle your claim 24 hours a day, seven days a week. To learn more about the many advantages available by choosing DLG, contact us today at 818-322-4056.