What is an IME and why it matters.

Independent Medical Examination FAQs

Persons responsible for paying for physical injuries usually want to ensure the injuries claimed are real and accurate before disclosing large sums of money for the injuries. Therefore, the Defendant—or person responsible for paying for physical injuries—may request the Plaintiff—the injured party—to undergo an Independent Medical Examination (“IME”).

Purpose of an IME:

• Avoid the notion that the Plaintiff’s physician is bias while assessing the extent of the Plaintiff’s injuries
• Ensure the Plaintiff did in fact sustain injuries
• Affirm the injuries are as serious as the Plaintiff claims them to be
• Ensure the Plaintiff’s injuries are not attributable to a different cause

IME

If the injured party does not wish to attend an IME, he or she may be compelled to do so under certain circumstances:

• State Law: many states have passed laws allowing insurance companies to compel and IME when a claim seems questionable.
• Case Law: most states also have court rules which provide that judge may order an IME under certain circumstances.
  • Typically and IME is ordered when the Plaintiff’s physical or mental injuries are in dispute.
• Some Exceptions:
  • if submitting to an IME would cause the Plaintiff an undue burden then he or she may not be compelled to submit to an IME (i.e.: traveling long distances from home to attend the IME)
  • If the Plaintiff claims he has physical injuries but only sues for damages to his or her car then an IME cannot be ordered.
  • If the Plaintiff sues after an injury is completely healed then an examination cannot be ordered

What happens if an IME is ordered?

If an IME is ordered, the Plaintiff may be required to submit to multiple examinations.

Who pays for an IME?

The party seeking to compel an examination is most likely required to pay for the examination.

Who chooses the IME Physician?

• The Defendant: it is most likely the party seeking to compel an examination will choose the examining physician.
• The Court: If the parties do not agree over which physician to use the court may decide the physician.

IME physicians:

New York Times: “exam reports are routinely tilted to benefit insurers [defendants] by minimizing or dismissing injuries”

• Who:
  • Some IME physicians are semi-retired doctors impaired by their age and sometimes have no special training.
    • – “Basically if you haven’t murdered anyone and you have a medical license, you get certified….It’s clearly a nice way to semi-retire” – Alan Zimmerman [Queens IME Orthopedic physician, 75]
  • Some IME physicians see an IME just as a game that they need to win.
    • – “If you did a truly pure report, you’d be out on your ears and the insurers wouldn’t pay for it. You have to give them what they want….that’s the game baby.” –New York Times
  • Some IME physicians never even look at the examinee or barely examine them.
    • – “You go in and sit there for a few minutes—and out comes a six-page detailed exam that he never did….there are some noble things you can do in medicine without treating. This ain’t one of them” –Dr. Stephen M. Levin [Co-Director of the occupational and Environmental Medicine unit at Mount Sinai Medical Center]
  • Some IME physicians even admit to being unethical
    • – “Dr. Robert Pick, an orthopedic surgeon who last operated in 1987, stunned a courtroom when he acknowledged making money off the case…Pick had also given sketchy testimony about the results of two examination…the doctor said he never reviewed the reports bearing his signature….” – Daily News New York

Effects of an IME Report:

• The examiners’ opinions can empower an insurer to slash benefits, withhold medical treatment or stall a case.
  • – “I was in so much pain and felt so hopeless for so long…. [d]octors see you’re in pain and say you’re not. How do they call themselves doctors?” –Carol Houlder [substance abuse counselor-waited a year for her ankle surgery]