The question I’d like to address today for you is what exactly is an independent medical exam or what they call an IME?
What is an IME?
What is an Independent Medical Exam? It’s an independent medical exam you must take by law under the Defense Base Act that our clients have to comply with. The insurance company sends you to an independent doctor, not your own, one of their choosing to assess you and your injury or illness for which you’re receiving benefits and compensation.
If they don’t comply, their benefits can be cut off or subject to cut off because the insurance company has the right to send you to one of their own doctors of their own choosing to get what they would maybe consider a second opinion as to whether or not your treatment is — necessary reasonably necessary — and whether or not it’s actually directly related to an injury that you suffered overseas at work.
2 Reasons You Do the IME
Those are the two big issues that the insurance companies send you to these doctors for:
1.) That you comply with their request for the Independent Medical Exam
2.) That your treatment is needed and related to overseas work
Now please make no mistake that this person is not going to treat you. This person conducting the IME is not your friend. This person is trying to figure out–based on my experience–any possible way that they can get to minimize the claim or to refute anything they can that your doctor is trying to treat you with. Whether that be medications that they consider maybe improper. Whether they don’t think a surgery is warranted when your doctor says that it is warranted.
It might be outright they might say, “hey you don’t have PTSD,” when you’re already getting treated and your client and you’ve already been diagnosed with PTSD with your doctor. It happens all the time.
Everybody is Watching
Insurers’ Have Eyes on You
Just be aware when you’re entering into an IME that everybody is watching you. They’re going to be watching you from when you open up your car door. They’re going to see how you got to the medical appointment. They’re going to watch you go up and down the steps if you have to. They’re going to watch you every step of the way. when you’re in the waiting room, whether you’re wincing in pain, or whether you’re really faking it. The insurers’ eyes are going to be on you.
Try to Refute Your Claim
That’s what they do and there’s going to be a report that comes out and that report will be the evidence that the insurance company is going to try to use to refute what we are using to show that you’re entitled to reasonable and necessary medical care and that you can’t go back and do a job because you’re restricted to do those physically whereas the other side may say oh yeah he’s fine.
He can go do this and that when you’re then susceptible to additional injury if you take a job like that and you also are in jeopardy of jeopardizing your team of people that you’re with overseas in a combat zone.
See Lawyer Before IME
So these things are pretty serious. You should definitely consult with an attorney before you go to an independent medical exam even if that’s not me. It’s just something smart to do because the insurance companies have minions and minions of people that are watching and doing things and studying and helping each other figure out how to manipulate the system and you need someone on your side that knows the system enough to be able to manipulate it back to your side to the right side.
Again Brian Wiklendt. Thank you for your time. If you have any questions.