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Why is My Insurer Requiring Me to Have an Independent Medical Examination?

Why is My Insurer Requiring Me to Have an Independent Medical Examination?

Many long-term disability contracts require that you undergo an independent medical examination (IME) as a condition of qualifying for or continuing to receive benefits. The idea behind an IME is to have a neutral third party evaluate and report on an individual’s medical conditions and limitations to the insurance company. The opinion of a medical expert can go a long way toward proving your disability and, therefore, your entitlement to benefits.

The biggest problem with IMEs, however, is that they are rarely independent or neutral. The insurance companies pay doctors to perform IMEs. Some medical practices do nothing but IMEs for various insurance companies. Since this can be a lucrative form of income for doctors, it is financially in their best interests to side with the insurance company rather than the claimant whom they are examining. As a result, the neutrality of the medical opinions stemming from IMEs can be quite suspect.

Therefore, individuals undergoing IMEs mandated by their insurance plans should be cautious when attending these examinations. No matter how friendly or responsive the doctor may seem, he or she is likely not on your side. You may wish to bring a trusted friend or relative to accompany you during the IME so that you have a witness as to any irregularities that might occur. You also should be cautious not to make light of your symptoms or medical conditions. While you should not exaggerate your symptoms, you should be completely honest about what symptoms you are suffering and how they impact you daily. If something is painful, you should describe the level and frequency of the pain and how it affects your overall activities.

Obtaining long-term disability coverage can be essential to protecting your future. When you initiate a claim under this coverage, however, you need to be aware of your rights and responsibilities, which may necessitate the assistance of legal counsel. At Bonnici Law Group, we offer you client-centered representation at all stages of the long-term disability benefit claims process. When you need the kind of help that only an experienced long-term disability benefits attorney can offer you, contact Bonnici Law Group at 619-259-5199 or help@bonnicilawgroup.com.

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