Registered Nurse
25 Years Experience
Former Insurance Company Attorney

Workers' Comp. 101: The Independent Medical Evaluation - "IME"

By: Cynthia M. Hennessey Attorney

One of the many confusing terms used in Workers’ Compensation, "IME" stands for Independent Medical Evaluation or Independent Medical Examination. In theory, the examination is supposed to be used to help clarify your medical condition and whether your injury was caused by your work activity. It is used to provide a diagnosis, the treatment recommended, whether you require work restrictions, whether you can work at all and how much disability you have as a result of the injury.

In practice, however, the IME is most often a tool used by the Workers’ Compensation Insurance Company to limit their liability. In other words, the Insurance Company has a "Master List" of doctors that they hire to perform the IME. They have used these doctors hundreds and hundreds of times. The doctors know what is expected of them and it is not to write reports that are sympathetic to your Work Comp case.

The Insurance Companies pay for reports that are favorable to them. The doctors are well aware of the fact that if they fail to provide the Insurance Company a favorable report, they will not be sent future business. It is that simple. And make no mistake about it, the IME is very expensive. The doctors receive typically $1500-$5,000 to say they examined you and to write the report for the Insurance Company. If they are then asked to testify against you, they receive often triple this amount. When you multiply it out by hundreds of Workers’ Comp cases per year, it is easy to see why the doctors enjoy this lucrative piece of business. Most of these doctors make more from performing IME’s than they do in the rest of their practice. They will not disappoint the hand that feeds them.

With this in mind, it is very important that you remember first and foremost that the IME doctor is "not your friend". He is not concerned about your well- being. It is not uncommon for the IME doctor to act as a "claims investigator", trying to dig up any information he can to further taint your claim and thereby help the Insurance Company. Thus, I always advise my clients to say as little as possible to the IME doctor, do not volunteer any information. He doesn’t need to know about your hobbies, your personal life, and your vacation plans etc.

As a side note, I advise my clients to watch everything they do the day of the IME. Because the Insurance Company knows you will be arriving at a certain place, at a certain time, they LOVE to send their private investigators to the doctor’s parking lot to put surveillance on you, or in other words to film you. What they want to find is that you told the doctor something that was contradictory to what their investigator discovered. For example, if you tell the doctor you can’t stand or bend without severe back pain, or you can’t lift anything heavier than a gallon of milk, don’t let the Private Investigator film you dancing in a bar or loading your trunk with cases of beer 20 minutes after the IME.

Back to the IME. It is important to beware of certain tricks the IME doctor will use to trip you up. One such test is referred to as "Waddell’s tests". This means the doctor will perform certain "tests" on you, and will ask whether it hurts, when he knows it is impossible for it to hurt given the type of injury you had. For example, when a worker has a herniated disc in the low back, he will experience numbness, tingling and pain into the buttocks, the legs or the feet depending on which level the disc is herniated. The doctor will ask you if you feel symptoms in an area that lies outside of the distribution where the nerves from the spine lead down. If you respond that you have symptoms in the "wrong" place, he will conclude in his report that you "failed" the Waddell’s tests. In other words, the IME doctor will "trick you" into saying it hurts. He then will conclude in his report that you were either exaggerating your problems or even "malingering". So my advice, never exaggerate your symptoms. You will not be able to "fool" the doctor.

Despite the fact that the IME doctor works for the Insurance Company, you have no choice. You must go, and you must be courteous and polite. Do not under any circumstances call him names, make derogatory remarks, accuse him of being biased, or act uncooperatively. These are deadly things to your case and will hurt you. The doctor will certainly write in his report anything that paints you in a negative light. This will be read by the Judge and Judge’s look on that very unfavorably. So, as much as you might like to express your thoughts to the IME doctor, be courteous and polite no matter what.

After the IME, the Insurance Company will receive the report from the doctor. You do have a right to it. Do not be afraid to request it. Remember, it will be biased. It might contain errors. What can you do if it is inaccurate or biased? Can you "explain" it to the Judge in your case? As much as you might think you can convince a Work Comp Judge that the Work Comp IME doctor was biased or wrong, you simply cannot do it on your own, without your own doctor’s report. This involves hiring a lawyer. Your personal family doctor cannot write the report for you. It requires legal terms that are specific to Worker’s Comp.

A lawyer who specializes in Workers Compensation should send you to a doctor who will thoroughly examine you, review your records and take the time to listen to you. We choose doctors who are not "in the pocket" of the Insurance Company. They will review the "Work Comp IME" report and set the record straight. We choose doctors who will not try to trick you, who will write multi-page reports, accurately setting forth your entire medical history, treatment, diagnosis, and symptoms. These reports are our ammunition against the Workers Comp IME. We then have the doctor testify for you explaining to the Judge why the Work Comp IME is inaccurate and biased. With this in mind, it is extremely important to hire an Attorney who specializes in Workers Compensation. Not only do we know the right doctors to send you to, but we see the same Work Comp IME doctors over and over, we know their backgrounds, we know their weaknesses, we know how to discredit them. A good Work Comp Lawyer can "undo" the damage done by the IME.

With all of this in mind, good luck with your IME.

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