Independent Medical Exams (IMEs) for Disability Claims: What to Expect

When a claim is filed against a short- or long-term disability policy, the insurance company may request that the claimant attend an independent medical exam (IME). IMEs are basically a visit to a doctor selected by the insurer, during which the nature and severity of your disability or health impairment will be evaluated.

Because IMEs can be important to keeping the claims process moving – and because their outcomes can be critical to the success of a claim, below we have provided some helpful information about:

• How to prepare for an IME
• What can generally be expected during these exams
• What to do if the IME doctor issues a bad, unfavorable or inaccurate report after the exam.

While the following information is general in nature, please don’t hesitate to contact Denver Disability Lawyer Shawn E. McDermott when you are ready to receive more answers about your rights to and/or claims for short- or long-term disability benefits.

How to Prepare for an IME

• Be prepared to discuss your symptoms and limitations in as much detail as possible.
• Be aware that the doctor conducting the IME is likely not unbiased. In fact, it’s not uncommon for these physicians, who are paid by the insurance companies, to make determinations that promote the insurance company’s interests (sometimes even at the expense of the claimant/patient). So, be careful about what you say, and don’t mistakenly believe that the doctor in on your side.
• Plan to have a trusted family member or friend attend the exam with you. This person can provide you with support, help answer questions asked by the examining physician and generally be a witness to what occurs during the IME.
• Before attending any IME, double check if this is actually required per the terms of your policy. If it is required, then failing to attend can result in a denial of your claim. If it is not required, then it could be in your best interests to not submit to one of these exams.
• Be prepared to bring any medical records or test results that the insurance company instructs you to bring to the IME.
• Plan to arrive to your IME about 15 minutes early in case you need to fill out any paperwork.
• Consult an attorney before your appointment. An experienced lawyer – like Denver Disability Lawyer Shawn E. McDermott – can review your situation and provide you with additional advice regarding how to protect yourself during the IME.

What Happens during an IME

During an IME, the treating physician will usually conduct a physical exam, ask a series of questions and/or review the medical records or test results you have brought with you. The doctor may also request that you undergo certain testing or procedures. If these requests seem to be unrelated to the condition, carefully consider whether you want to undergo them (or whether you wish to refuse them).

Some of the various elements that IME doctors will be assessing during these exams include (and are by no means limited to):

• The claimant’s general appearance and behaviors
• Whether it appears or could be possible that the claimant is lying about or exaggerating the disability
• Objective evidence of the disability or impairment.

What to Do If an IME Doctor Issues an Unfavorable Report after Exam

If an IME doctor issues a bad report – like one alleging that you are not disabled or you are lying about your condition, here are some steps that can be taken to counter those findings and preserve your claim:

• Request a copy of the report.
• Look for and point out any mistakes, inaccuracies, inconsistencies or cursory assessments.
• Counter the wrong elements with reports from other doctors and/or other evidence you have.
• Contact an attorney ASAP for additional help and support.

Contact Denver Disability Lawyer at McDermott Law, LLC

If your short- or long-term disability claim has been denied, contact Denver Disability Lawyer Shawn E. McDermott. Dedicated and experienced, Shawn McDermott has a record of success when it comes to helping people stand up to insurers and secure the full amount of benefits to which they are entitled.

Call our firm at 303-964-1800 or email us using the contact form on this page to set up a complimentary consult with Attorney Shawn E. McDermott Law, LLC and find out more about how he can help you.

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