How Independent Medical Examinations (IMEs) Can Affect Your Injury Claim

How Independent Medical Examinations (IMEs) Can Affect Your Injury Claim

When you are recovering from an injury – whether it’s from a car accident, a workplace incident, or a slip-and-fall – healing should be your top priority. Yet, for many injured claimants in New York, there’s an unexpected hurdle on the road to recovery that can shape the entire course of their injury claims: the independent medical examination (IME).

IMEs are less about your recovery and more about protecting the interests of insurance companies. Some IME doctors are biased in favor of the insurance company or defense team paying them. This bias can show up in subtle ways, like glossing over your pain symptoms or attributing your condition to a pre-existing issue.

At Hill & Moin LLP, we believe knowledge is power. The more you understand how IMEs work, the better equipped you will be to protect your rights.

What Is an Independent Medical Examination (IME)?

Independent medical examinations are conducted by an examining physician selected by an employer, defense team, or insurance company.

The examining physician reviews your medical records and diagnostic tests to confirm whether your injuries stem from the incident and the severity of the harm you suffered.

IMEs can decide whether ongoing or proposed treatments are medically necessary and address conflicting medical opinions or discrepancies in your medical records. An independent medical examination may be requested for an insurance claim, personal injury, or workers’ compensation claim.

Unlike visits to your own doctor, an independent medical evaluation performed by an IME physician:

• Is a one-time-only visit: After an independent medical exam is completed, there is no ongoing doctor-patient relationship, no future medical treatment, and no commitment to your recovery. There’s no follow-up care, no ongoing medical evaluation, and no continuity.
• Does not involve long-term observation: IME reports are based on a single appointment that may last only 15-30 minutes. That’s hardly enough time to assess the full picture of an injury that affects your daily life. Imagine trying to explain weeks or months of pain in a single visit.
• Is not confidential: During an IME, everything you say or do could hurt your workers’ compensation claim, personal injury case, or insurance settlement. There’s no doctor-patient confidentiality. What you say can be used against you in court.
• May be biased against you: A favorable IME medical report can strengthen your personal injury claim. For workers’ compensation cases, IME findings determine when claimants can safely go back to work. However, bias is an ever-present risk because insurance carriers often pay for IME exams. IME doctors may unconsciously – or deliberately – tilt medical opinions in favor of the party footing the bill.
• Has no treatment plan: The goal of the IME process isn’t healing, prescribing medications, or therapy referrals. The only goal is medical assessment. Unfortunately, a single snapshot exam can’t capture fluctuating pain levels, intermittent symptoms, or the full spectrum of your treatment needs.
• Can be recorded: Under New York law, it is possible for the examiner to record the exam. This recording can be used later to challenge credibility.

In most cases, you are expected to attend a physical examination by an independent medical examination physician. Depending on your circumstances, your attorney may be able to negotiate a postponement or alternative evaluation. Non-attendance may significantly impact any legal proceedings related to your injury or disability claim.

How IMEs Affect Injury Claims

In rare cases, a truly impartial IME doctor may validate your treatment needs and endorse further care. On the other hand, the physician may downplay your suffering or link injuries to pre-existing conditions unrelated to your incident. A negative or inaccurate report can result in denied medical benefits, reduced compensation, or even the termination of ongoing care.

If you believe the IME report is biased or omits key details, you have the right to challenge it.

In some cases, IMEs challenge the credibility of your treating physician, undermining months of documented care. Even if your regular doctor has consistently supported your diagnosis and treatment plan, a contradictory IME can sway the judge or claims adjuster in a different direction.

This is especially concerning in the following types of personal injury cases, where the interpretation of injury severity is key.

Medical malpractice injuries

In cases involving defective medical products or pharmaceuticals, IMEs often focus on whether the device directly caused your injury. An insurance-hired doctor might attempt to downplay connections between your symptoms and the medical product or procedure, suggesting the real issue lies elsewhere.

Motorcycle injury claims

In motorcycle injury cases, IMEs often scrutinize your protective gear and speed rather than the crash itself. Using a non-favorable IME, an insurer might argue that your helmet or jacket protected you enough to make the injury minor – minimizing what may be very real, long-lasting pain.

Slip-and-falls

IME doctors assessing slip and fall claims frequently attribute hip, knee, or spinal pain to “age-related degeneration” or pre-existing joint conditions. This tactic unfairly shifts blame from property owners to the medical history of injured claimants. If an IME doctor wrongfully attributes your pain to pre-existing conditions, your chances of securing compensation for surgery, therapy, or home modifications could be reduced.

Large truck and commercial vehicle collisions

Truck accident victims face especially tough IMEs. These doctors might classify severe injuries as “soft tissue” damage – often dismissed as temporary or minor – despite the reality of long-term suffering. The goal is to create a narrative that downplays the seriousness of your condition.

What Do Doctors Look for During IMEs?

Understanding what an IME doctor looks for can help you prepare mentally and physically for what lies ahead.

Your medical records

Before you arrive, the IME doctor reviews your medical records. These medical records may include your treating doctor’s reports, diagnostic tests, and any prior treatments relevant to your medical history.

However, insurance companies can cherry-pick information to present a narrative that supports their interests. These records may leave out important context that supports your personal injury claim. Additionally, prior injuries, even if unrelated, might be highlighted to suggest that a pre-existing condition is the root of your current issues.

Your overall appearance

From the moment you arrive, you are being observed. The doctor may watch how you walk, sit, and stand – looking for signs that your behavior contradicts your claims.

Even grooming, facial expressions, or how you enter the exam room can be noted. Inconsistencies – like favoring one side of the body – may be used to question your reported pain levels.

Your responses to physical tests

The doctor might ask you to bend, twist, lift, or perform range-of-motion tests. Pain levels and hesitations are noted, but interpretations can be subjective.

These tests are intended to assess your physical capabilities. However, they can also be used to argue that your injuries are not as severe as reported. For example, hesitation or guarded movements can be cited as psychological factors rather than genuine symptoms. If you appear guarded, it may be chalked up to “exaggeration” instead of pain management.

Signs of deception and inconsistencies

IME doctors look for signs of exaggeration and may ask questions intended to elicit responses that downplay your injuries. For example, a doctor might inquire about your ability to perform daily activities, aiming to gather information that suggests you are less impaired than claimed.

If you report daily struggles but demonstrate mobility during the exam, they may raise doubts. These notes go directly into their final report, which can weigh heavily on your case.

How to Protect Yourself Before, During, and After an IME

The following tips can help you prepare for an independent medical evaluation and safeguard your interests throughout the process.

What to do before the independent medical exam

While IMEs can feel intimidating, preparation and awareness go a long way. Here’s how to make sure you are protected before the exam:

• Review your records: Make sure you are familiar with your medical history. Your words should align with what’s documented.
• Speak with your legal team: A personal injury attorney can walk you through what to expect and help you prepare key talking points.
• Keep a pain journal: Recording your symptoms, daily challenges, and medication use can provide context for your condition.

What to do during the independent medical evaluation

Think of the IME process as an investigative interview rather than a medical consultation. You are under the microscope: every grimace, every hesitated answer, and every movement is scrutinized for signs of deception. By applying the following tips during the exam, you can protect your legal interests.

Don’t speak negatively about others.

Even if you are frustrated with your employer, the insurance company, or other medical professionals, try to stay neutral during the exam. Hostile language during the physical examination can paint you as biased or vindictive, harming your credibility.

Don’t answer more than what is asked

Stick to factual information about your condition and avoid speculating, overexplaining, or going off-topic.

The more concise and accurate you are, the more difficult it is for the IME doctor to twist your words or misinterpret your situation.

Don’t ask for a diagnosis

Remember, the IME doctor isn’t there to treat you or provide medical advice. Requests for medical advice can be interpreted as dissatisfaction with the process.

Don’t exaggerate your symptoms, and be consistent

Approach the IME exam like you would going to a job interview – how you present yourself matters. Give truthful and consistent answers that agree with your treating physician’s records and your symptom diary. If something hurts, say so – but avoid dramatizing your current symptoms. Exaggerating symptoms or fabricating limitations will be used against you.

What if the doctor conducting the exam asks a question you don’t know? If you are not sure about an answer, it’s perfectly okay to say, “I don’t know.” When you are consistent, it makes it more difficult for opposing parties to claim your injuries are not serious.

Watch out for leading questions

Leading questions are phrased in a way that elicits answers that minimize your disability. Statements like “You can lift your arm fully now, right?” are used to create contradictions with your past statements.

Notify your legal team if you think your IME doctor is downplaying your injuries

IME doctors may interpret normal compensation behaviors – limping, for example – as “voluntary guarding” rather than genuine pain responses. Additionally, certain maneuvers may manipulate the injured area and briefly trigger pain. This may cause the examiner to dismiss your complaints as inconsistent.

Remember your legal rights

Before and after an exam, it is a good idea to refresh yourself on your legal rights. Consider discussing the following points with your attorney:

• You have the right to receive written notice about the time and location of the IME

• You have the right to record the exam (audio or video) as long as the examiner is informed
• The examiner must inform you if he or she plans to record the exam
• You have the right to bring a family member, friend, or advocate to observe the exam

What to do after the IME process is complete

To protect your interests, consider taking the following steps after an IME exam:

• Document everything: Keep detailed notes about the IME, including the date, time, location, and duration of the examination. Record the questions asked, tests performed, and any statements or unusual behavior on the part of the IME doctor.
• Notify your attorney: Share your notes promptly so your personal injury attorney can compare these with the IME findings report when it arrives.
• Continue treatment: Don’t let the IME report derail your recovery. Keep seeing your treating doctor for ongoing care.

What Happens If Your Medical Care Is Denied Based on an IME Report?

Sometimes, the fallout from a bad IME isn’t immediate, but it can be devastating.

You might suddenly find that:

• Your insurance company refuses to pay for ongoing treatment
• Your wage replacement benefits are reduced or terminated
• You are pressured to return to work before you are ready

If this happens, don’t panic. You have legal options. A skilled personal injury attorney can help dispute the IME report, bring in second opinions, or request another exam from a more impartial physician. The key is acting quickly.

At Hill & Moin LLP, we have years of experience in navigating the ins and outs of IMEs, especially when they are used as a tool to limit rightful compensation. We know how to challenge biased reports and advocate for the care you deserve.

Don’t Let an IME Jeopardize Your Future: Contact a Skilled Advocate Today

An IME doesn’t have to derail your case. However, careful preparation and strategic legal support are required. Remember, this isn’t just a doctor’s appointment – it’s a turning point in your case. Treat it seriously. Walk in informed, confident, and with your legal team backing you.

If you are facing an IME or worried about how one could impact your claim, don’t face the uncertainty alone. Hill & Moin LLP is here to help you protect your health, your rights, and your future.

Find out what Personal Injury Recovery Solutions® our knowledgeable, results-oriented lawyers can offer to you. Contact us today to schedule your no-obligation free consultation. Your right to fair treatment should never hinge on a one-sided exam.

Don’t wonder about your rights!