An Independent Medical Examination (“IME”) is a statutorily recognized medical evaluation used almost exclusively by insurance companies to question your medical condition, causation, work restrictions, or your medical treatment. However, do not let this term of the insurer fool you, these examinations are not “independent.”
In reality, an IME is used as a tool by the insurance company to limit their liability and your benefit entitlement. These examinations allow the insurer to send you to a doctor of its choosing, because it disagrees with your medical diagnosis, your treating physician, or your current medical treatment. Put simply, IMEs allow the insurance company to send you to its “hired gun,” so it can deny, stall, frustrate, slash benefits, or withhold medical treatment.
The doctors who conduct IMEs in Montana are paid big money by insurance companies. As a result, many of these doctors are financially biased in favor of the insurance company, and they know what is expected of them.
An IME doctor is not there to help or treat you; they are not your friend. There is no physician-patient relationship, so anything you tell these doctors will be conveyed to the insurance company. And anything you say will be used against you. It is not uncommon for the IME doctor to act as a claims investigator, trying to uncover anything he/she can to assist the insurance company. Some insurers will not even tell you that you are scheduled for an IME, instead the insurer will send a letter stating that you are scheduled to see a certain doctor. At that appointment, the IME doctor will provide a disclaimer that there is no physician-patient relationship. The doctor is simply hired by the insurer to provide opinions.
Remember IMEs can have a serious impact on your workers’ compensation claim, and you are generally required to attend these examinations. See, Mont. Code Ann. § 39-71-605 https://leg.mt.gov/bills/mca/title_0390/chapter_0710/part_0060/section_0050/0390-0710-0060-0050.html. Therefore, it is important to consult with a workers’ compensation attorney, if you or a loved one is asked to attend an IME, or if your claim was denied because of an IME.