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Why Do I Need an Independent Medical Exam?

Why Do I Need an Independent Medical Exam?

In many cases, an insurance company that provides long-term disability or LTD benefits will require that you undergo an independent medical examination (IME) before approving your claim for benefits, or perhaps before continuing to pay you benefits. Requirements about IMEs differ from one insurance policy to the next, so you may be able to decline the request in some cases, but most policies do require you to undergo the IME.
Unfortunately, these IMEs tend to be anything but independent. The insurance company pays for the doctor who performs the IME. As a result, if the doctor finds that claimants are disabled and entitled to benefits on multiple occasions, the insurance company is unlikely to continue to use that doctor for IMEs. In other words, the doctor has a financial incentive from the insurance company to find that claimants are not disabled and not eligible for LTD benefits. This work can be lucrative; some doctors and medical practice make most or all their income from performing IMEs.

Nonetheless, you likely must attend an IME. When going to your IME, you should keep the following in mind:

• Even if the doctor is friendly and encouraging, he or she is not on your side.
• Minimizing or making light of your medical conditions will not help your case.
• If the doctor asks you to do something that you cannot do, you should not try to do it.
• If the doctor makes disrespectful or dismissive statements about your condition, you should be sure to document what he or she says.

Bringing a trusted family member or friend with you can help you get through an IME more successfully. You likely will not be able to remember every detail of the IME, but your companion can help by taking notes and supplementing your memory. Oftentimes, an attorney or staff member of a representing firm will attend an IME with a client to make sure that the appointment is handled fairly and adequately.

It can benefit you greatly to get legal advice about the most effective means of building and maintaining the most successful ERISA long-term disability claim possible. Bonnici Law Group provides skilled, aggressive legal representation regularly for individuals seeking long-term disability benefits under insurance policies governed by ERISA. Our priority is to represent your interests and protect your rights to the benefits that you deserve. Call us at 858-261-5454 and schedule an appointment to meet with us about your case today.

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