An IME or Independent Medical Examination is a tool used in medical malpractice cases to objectively determine the physical or mental state of an injured claimant. It is carried out by a physician with whom the patient has no existing medical relationship, as this fosters the objectivity of the physician's conclusions. IMEs may be ordered if the patient's injuries are in dispute or the insurance company needs to confirm the nature of the patient's injury. Like a deposition or a request for medical records, medical examinations are seen as objective tools of ‘discovery' in a lawsuit, used to explore and verify the plaintiff's claim. Because of the large sums of money at stake in personal injury and medical malpractice case, objective verification of the inciting injuries is necessary. The purpose of the IME is not to render any type of care or treatment to the patient, simply to ascertain their condition for use by the insurance company and any other party involved in the malpractice suit. Generally, the party requesting the IME is required to pay for the examination and relevant doctor's fees.
Anyone who files a personal injury or medical malpractice claim should be prepared to submit to an IME, as they are fairly standard in medical malpractice litigation and generally demanded by the defense. Those who bring forth an honest claim have nothing to fear from an IME.
Are IMEs Truly "Independent"?
Although classified as “independent,” IMEs are often decried for lacking the very objectivity that is central to their purpose. The insurance company has the right to select the doctor conducting the IME, and this is rarely a one-time transaction between physician and insurance company. Doctors who conduct IMEs may be employed by the insurance company or routinely recruited to examine injured claimants. It is in the best interest of the insurance company that a claim is dropped or dismissed. For this reason, a report may minimize the extent of the patient's injuries or suggest the patient is exaggerating some aspect of the injury.
During an IME, the doctor will observe the patient's general appearance, look for signs of deception, objective and subjective manifestations of injury such as reports, charts, and indications of pain and discomfort. They may inquire about other possible contributing factors such as the patient's drug use, smoking, drinking and eating habits, and anyway in which they may have exacerbated or contributed to their own injury.
Patients are advised to speak with their lawyers prior to undergoing an IME. A plaintiff lawyer may advise the patient to emphasize certain aspects of the injury or disability so that they are not underestimated or downplayed in the eventual report.
Independent Medical Examinations may not be required under certain circumstances.
- The insurance company policy did not contain any specific language regarding IMEs, most states do not require IMEs if the policy did not specifically address them
- An examination would subject the patient to undue hardships and strains or is scheduled at a location unduly far from the patient's residence
- The patient has filed suit after they are already completed healed from the injury
Best Practices For Plaintiffs Undergoing An IME
- Bring a family member, friend or preferably your attorney to the IME: the presence of a third party may help eliminate potential disputes over what transpired during the IME, its duration and any other specifics that may be probed in court or during arbitration hearings
- Plaintiffs/Patients should be aware that their every move and word is up for scrutiny during such examinations, and the physician is not there to treat them but essentially to evaluate their condition and become a witness for the defense. Have your lawyer coach on what ought to be discussed and presented during the examination
- Do not volunteer information that was not requested and do not presume the waiting room is a safe space to discuss the case
How Independent Medical Examinations Impact Med Mal Cases
An IME doctor may be considered an expert in the case. Their medical opinion and the report rendered in the exam may be presented in court and used to sway the jury's perception of the case. If the doctor concludes that the injuries were not as portrayed by the prosecution, were exaggerated by the patient, or not a result of the physician's alleged malpractice, this testimony could affect the outcome of the case.
An IME will not necessarily refute the patient's claims, but it is a possibility which both claimant and plaintiff attorney must be aware of. It may be effective to challenge the content of the IME doctor's evaluation. In the event that the doctor's opinion was based on faulty or incorrect information, a refutation may be the best course of action.