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Are Injury Victims Required to Submit to an Independent Medical Exam?

doctor helping patient flex legThis is a complex question, which is why it should be discussed with a licensed attorney. The answer may depend on the type of accident you were involved in and the terms of the insurance policy you are seeking compensation from.

The licensed attorneys at Schmidt Kramer are available to answer your questions after getting injured in an accident, including questions about independent medical exams.

You should not take the insurance company at their word about independent medical exams or anything else related to your claim. Talking things over with an experienced attorney can give you peace of mind, as our attorneys are focused on your best interests and not the insurance company’s.

What is an Independent Medical Exam?

An independent medical examination (IME) is an exam requested by the insurance company. While the insurance company may say the goal of the exam is to confirm the severity of your injuries, the doctors who are hired to perform these exams often reach conclusions that favor the insurance company.

For example, doctors who perform IMEs often find the victim’s injuries are not as severe as the victim is claiming. They may question your treating doctor’s conclusion that you have yet to reach maximum medical improvement.

Insurance companies know the more severe the injury, the more they are likely going to have to pay to settle the claim. It is in their best interest to get a medical opinion that downplays the severity of your injuries.

While the goal of an examination by your treating doctor is to find out the severity of your injuries and determine treatment options, an IME doctor is not concerned about treating your injuries. He or she is not going to offer you medical advice.

Independent Medical Exams for Car Crash Victims

Pennsylvania is a no-fault state, which means car crash victims first file claims with their insurance companies. They can seek compensation for medical expenses and some other damages through their personal injury protection (PIP) insurance, which is required coverage.

Before a Pennsylvania Supreme Court ruling in November 2019, car insurance companies may have been allowed to require crash victims to undergo an independent medical examination.

However, in the November 2019 ruling, the state supreme court held that provisions in auto insurance policies that require crash victims who are seeking first-party medical benefits to undergo an IME are void because they are against public policy. The court said these types of provisions violate the Pennsylvania Motor Vehicle Financial Responsibility Law.

The ruling was for a case involving two cases that were consolidated. The victims in these cases were seeking PIP benefits but were denied because they did not appear at an IME that was demanded by the insurance company.

The supreme court ruling said an IME may be done if both parties in the claim agree to it. However, it is important to note the opinion may only apply when an IME is requested and the victim refuses. An insurance company may try to take a claimant to court to obtain an order compelling the victim to go through an IME.

Independent Medical Exams for Work Injury Victims

State workers’ compensation laws allow employers and their workers’ compensation insurers to send claimants to an IME. Unfortunately, the results of an IME may allow an employer or its insurer to change, suspend or even terminate workers’ compensation benefits.

Fortunately, you can meet with a licensed attorney who can work to protect your workers’ compensation claim and prepare you for an IME.

IMEs for Personal Injury Claims

You should always discuss an IME with a lawyer before agreeing to attend one and especially before attending one.

In a personal injury case, such as a slip and fall case, it is unclear if an insurance company may be allowed to require you to attend an IME. However, you cannot trust what the insurance company tells you.

In fact, if an insurance company is requesting an IME, it may mean your claim has a high value and the insurance company is trying to get out of paying for all your damages. The insurance company may know you have a strong case.

Preparing for an IME

If you are required to go through an IME, or you and your attorney agree to go through one, it is important to be prepared.

It is often a good idea to have your Harrisburg personal injury attorney present during the exam and have it recorded. That way you have proof of what happened at the exam if you need to dispute one of the conclusions reached by the doctor.

Your attorney may give you some tips on trying to make sure the examination is fair. For example, your attorney will likely tell you to avoid downplaying your injuries. You are under no obligation to agree with statements made by IME doctor. Make sure to be detailed in describing your injuries, symptoms and pain level.

The IME doctor may ask about old injuries, which is why it is important to be prepared. Your lawyer can explain what to say about these injuries without saying something that could hurt your claim for your current injuries.

While it is important to be detailed when discussing your injuries, you should not offer information that is unnecessary. You could unknowingly disclose information that may be used against you.

It is also important to treat an IME seriously, which means arriving on time and having a neat appearance. Everything about you will be scrutinized so you want to do your best to show how seriously you are taking the exam and your claim as a whole.

Call to Learn More About Your Legal Options

Insurance companies prefer to deal directly with injury victims because they feel they can take advantage of people who are injured and unsure of their rights and options.

You do not have to be a pawn for the insurance company. By hiring an experienced attorney, you can help level the playing field, all at no upfront cost.

Schmidt Kramer is here to assist you in seeking full compensation for your damages. We have helped victims of many different types of accidents secure the compensation they needed.

Millions Recovered. No Upfront Fees. Call (717) 510-1782.