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3 Common Mistakes to Avoid in Independent Medical Exams for Disability Claims

May 6, 2016

3 Common Mistakes to Avoid in Independent Medical Exams for Disability Claims

3 Common Mistakes to Avoid in Independent Medical Exams for Disability Claims

After filing a short- or long-term disability claim, you may be required by your insurance provider to attend a so-called independent medical exam (IME) (the more appropriate term is Insurance Medical Exam).  IMEs are physical exams conducted by licensed doctors who have specifically been selected by the insurance provider.

The purpose of these exams is usually to provide insurance companies with documentation about a claimant’s condition and associated limitations. These exams, however, can also be used by insurers as risk management tools that can provide evidence for future claim denials (or for the termination of benefits).

To clarify how claimants can protect their rights during IMEs, we reveal some of the most common and costly mistakes to avoid making in these exams. If, however, you currently need specific advice regarding how to file a disability claim or appeal a denied claim, don’t hesitate to contact a Denver disability lawyer at McDermott Law, LLC.

How to Protect Your Rights during IMEs: Avoid these Mistakes

Mistake #1: Attending the IME without First Checking if it is a Policy Requirement

Although most disability insurance policies contain provisions that require policyholders to attend IMEs upon request, some may not.  Additionally, some policies may have terms stipulating that only a physician (as opposed to a nurse or some other type of medical professional) can perform the IME.

Understanding the specific terms of your policy – and whether or not it actually requires you to submit to insurance medical exam – is important to knowing whether you really have to undergo an exam, or how often, as part of your claim.  If your policy doesn’t have this requirement, challenging a request for an IME (rather than simply submitting to the exam) may better serve your interests.

Bottom line: Review and familiarize yourself with the terms of your policy.

Mistake #2: Assuming that the Information Disclosed to the IME doctor is “privileged” or protected

When insurers request IMEs, these doctor visits are NOT like a standard appointment with a physician, during which patients can expect some confidentiality.  The doctor is not your treater or your friend.  Anything a claimant says or does during the IME can be documented by the doctor and be used later by the insurance company to justify a denial or termination of the claim.

Bottom line: Don’t make the mistake of believing the IME doctor is on your side or will be looking out to protect you and your claim.  Just the opposite is likely the case.  Be careful about what you say and do during IMEs.

Mistake #3: Attending the IME Alone

Given that IMEs can sometimes serve as evidence-gathering sessions for insurance companies, going to these appointments by yourself – without the support of a family member or the representation of an attorney – can also be a big mistake.

The reason is that, if you attend an IME alone, it’s far more likely that you may forget to ask certain questions, may not provide all of the information necessary or may share information in a way that could harm your claim.  Another reason is to have a witness available to testify to statements or conduct of the examiner if he or she is abusive or receives information that is later twisted or misrepresented.

Bottom line: Bring someone you trust to the IME.  Ideally, it’s best to consult an attorney before your disability IME.

If you are battling with an insurer over a disability claim, contact Long Term Disability Lawyer Shawn E. McDermott for effective representation, aggressive legal advocacy and help in obtaining the benefits you likely deserve.

To learn more about how McDermott Law, LLC can serve and assist you, set up a complimentary consult with our office today by calling us at (303) 964-1800 or by emailing us using the contact form on this screen.

From our offices in Denver, we provide the highest quality legal services to disabled people throughout the state of Colorado, the surrounding states and nationwide.

Categories: Disability, Insurance, Long-Term Disability Benefits, Long-Term Disability Claims

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