What is an Independent Medical Examination (IME)?
If you are in the Long-Term Disability (LTD) process, your insurer may ask you to attend an Independent Medical Examination (IME). IMEs are medical exams during which a healthcare provider will evaluate you and provide their opinion on your disabling condition. Your LTD provider may send you to an IME in order to evaluate your disability status. They will likely send you to a doctor other than your own to conduct the exam. IMEs are a common part of the disability claims process. However, insurance companies will often send you to an IME to try and get evidence to deny your claim. Make sure you understand your rights before you attend an IME so that you can protect yourself and your benefits.
Do I have to go to an Independent Medical Examination (IME)?
Unfortunately, in most cases, the answer is yes. It may be written into your policy that you have to attend IMEs. This means that declining to attend an IME may result in your benefits being denied, simply because of your refusal to attend the exam. However, if your claim has already been denied and you are on appeal, you might have the right to refuse attendance. If you want to verify whether you have to attend an IME, you can contact our Firm and provide us with a copy of your Policy for analysis. If you do end up needing to attend an IME, let’s discuss what you can do to protect yourself as much as possible:
Bring Your Own Medical Records and Any Assistive Devices
Bring medical records from your own treating providers. Ideally the insurance company will provide the medical examiner with these records, but do not assume that this will happen. In order to make certain that the examiner sees your medical records and the opinions of your treating providers, compile relevant records to your appointment. This includes any imaging or assistive devices.
Bring a witness
Bring someone with you, such as a spouse, family member, or medical professional, so that they can attest to what happened at the exam. Otherwise, if your claim is denied, it is your word against the doctor’s word. Sometimes, the insurance company or doctor performing the IME will not let a witness attend, so we advise that you get written permission before the IME. If you need assistance with this, contact our Firm.
Time the duration of the appointment
We frequently hear from clients who attended an IME where they met with the doctor for all of 10 minutes, and then were denied based on that doctor’s report. The duration of the examination can be a useful piece of information if your claim ends up being denied. Use a watch or your smartphone to track the amount of time spent with the medical examiner at your IME.
Audiotape or Videotape the exam
Recording an IME can be helpful so that you have concrete proof of any inconsistencies, misinterpretations, or errors that take place during the examination. It may be a good idea to get written permission to do this in advance of the IME. It is our Firm’s position that you do have a right to audiotape. If you decide to record without permission, here is a resource that may explain some of your rights. Please bear in mind we cannot attest to the accuracy or legality of this information. However, we do have the understanding that recording a conversation with the consent of only one party is legal in Arizona (unless you are an attorney like us!).
Request a copy of the examiner’s report after the exam and request any paperwork in advance
To ensure that you’re not in the dark when it comes to the results of the examination, request a copy of the IME report. Ask for all paperwork you will be expected to complete before the exam.
Be aware of surveillance
Insurance companies sometimes use IMEs as an opportunity to surveil you. They may surveil you on the day of the IME as well as the days surrounding the IME. Be aware of how you get in and out of the car and how you approach the IME facility. As long as you are truthful about your abilities and medical conditions, you should have nothing to worry about.
We Can Help
If your long-term disability claim was denied after an unfavorable or unfair IME, or if you are being scheduled for an IME and need guidance, contact the experienced attorneys at Sandstone Law Group. We can help you understand your benefits, prepare for an IME, appeal your claim denial, and secure the benefits that you deserve.