If you have been injured in an accident in California, and you:
1. file a lawsuit against the at-fault party or party(s),
2. or arbitration against your own insurance company for uninsured motorist benefits,
As you will read below, IME’s are NOT “independent” in any sense of the word, and they are regularly used by insurance companies to improperly deny benefits to deserving people in their respective accident claims. The problem is at first blush it seems "fair" for an at-fault party to use an IME to understand the injured party's injuries; however, it is my opinion that they have been eroded to "pigeon hole" each injury claim as undeserving, and incentives are given to the IME doctor to be on a mission to look for anything, and I mean anything, that can make an injury case worth less no matter what (it is not about being independent or fair anymore, and maybe it never was).
IME’s are simply another example of insurance companies at war with their own customers, and persons who file a lawsuit against their insured (person who was at fault for the California accident). Insurance companies are at their happiest when they are collecting our annual premiums and despise us whenever we file a claim for those benefits we have been paying for for so many years. In fact, when a claim is filed, the first thing that is done by the insurance company is to look for ways to deny the claim! It is about profits, and not paying out on claims.
The Purpose of an IME
The official stated purpose for an IME is for the insurance company to have a so-called “independent”, supposedly unbiased doctor, offer a sincere medical opinion on the severity of your bodily injury, whether your injury was caused by the accident, and what will be the appropriate medical treatment of your injuries in the future. Sounds good in theory but the theory starts to break down from the moment the IME doctor is hired; as Sherlock Holmes would say, the "game is afoot."
WHO BENEFITS FROM AN IME? THE INJURED PARTY, OR THE IME DOCTOR??
An IME is conducted by a duly licensed medical doctor hired by the insurance company who practices (usually) in the same community as the injured party, who is paid by the insurance company, and who reports to the insurance company directly. As you might have guessed, the insurance companies who hire these doctors are looking for medical doctors who will tell them what they want to hear and any doctor who regularly tells the insurance company something they do not want to hear is quickly scratched off the IME list. The problem with this is that medical doctors have learned that performing IME exams can be VERY lucrative (how about earning more than $500,000 a year from IME’s alone, you really do not need to have a medical practice seeing patients like other doctors do, huh?). To this end, medical doctors are eager to remain on the good side of the insurance companies that pay them for IME exams.
THE INDEPENDENT ANALYSIS IN AN "IME" TODAY IS FLAWED!
See, when medical doctors are recruited or hired (hired guns) by the insurance companies, they learn in no uncertain terms what the insurance companies are looking for in their final IME report–minimize everything!
1. The medical reports from an IME doc say the person was NOT injured in the accident….
2. If they say they were injured, then they routinely say the injury is NOT due to the accident but is due to a pre-existing medical condition….
3. If they say it was not due to a pre-existing medical condition, then they say the injury really not so bad….
4. If they do say the injury was bad, then they say the injured person has fully recovered and needs no further medical treatment. Does the above sound like they pigeon-hole these exams? Yes, they do.
Insight into an Attorney Attending their Injured Client's IME
When the plaintiff attorney attends the injured party (plaintiff) to the IME, the very presence of the attorney gives the plaintiff "moral support." Also, it emphasizes to future jurors the involuntary and adversarial nature of the medical exam. The attorney may also observe specific conduct that may later be used to attack the credibility of the witness, for example, the defense doctor may have:
1. devoted an entire hour on the plaintiff's medical history, but only six minutes on the physical exam;
2. dictated the report while referring to the defense medical record summary instead of the actual medical records;
3. had the plaintiff completely disrobe even though the symptoms of injury were entirely upper body;
4. spent more time examining non-injured portions of the plaintiff's body that the injured parts of the body;
5. read a book while other members of a panel asked questions to the plaintiff;
6. conducted the exam in a manner which aggravated the symptoms; or he or she acted rudely or nonprofessionally;
7. declined to look or review the actual X-rays and imaging studies brought to the IME;
8. was significantly late to the IME or even fell asleep!
Additional information about the defense medical doctor should be collected by obtaining his or her curriculum vitae, networking with other injury attorneys to locate deposition transcripts (Consumer Attorneys of San Diego), sample reports, or even performing a jury verdict search. Additional information can be obtained via subpoena too.
Can my San Diego Personal Injury Lawyer Attend The IME With Me?
Yes, and yes!
You have to attend the Independent Medical Exam (IME) under California law one time when it is called by the defense attorney in your case (after your case is filed in California Superior Court). Believe, it is not "independent" in any sense of the word, but you are required to attend.
Second part of the answer is "yes," your San Diego injury lawyer can attend your IME. There are some definite advantages for the lawyer to attend too.
Great Suggestions on What to Do & Expect at Your California IME
1. You should bring a watch with a second hand, a pen, a note pad, tape recorder, extra batteries, tape, cell phone; and if the attorney attends, bring the phone number of the defense attorney;
2. Do not bring any part of the client's files;
3. Do not let the plaintiff bring anything;
4. Review any paperwork filled out by plaintiff - better yet, fill it out yourself on behalf of the client;
5. Do not permit the plaintiff to fill out any exit paperwork, and be sure to take a copy for your file;
6. Do not volunteer information on any paper forms that is beyond the scope of what is needed for the IME;
7. Time each portion of the proceeding;
8. Set the tape recorder in the middle between the defense medical doctor and the plaintiff;
9. Take notes even though the tape is recording;
10. Do not answer any questions;
11. Stop the defense medical doctor if any improper inquiry takes place;
12. Phone defense attorney if the defense medical doctor abuses anything in the IME process -do this in the middle of the proceeding if necessary;
13. Sit as close as possible to plaintiff;
14. If plaintiff needs to disrobe, leave the room then return when the blue smock is on the plaintiff;
15. Do not interfere with the defense doctor's examination;
16. Try to memorize the various tests given (take notes);
17. Watch and make note of the defense doctor's body language;
18. If you notice that your plaintiff is in pain, intervene and instruct your plaintiff that physically painful medical procedures are not permitted in a California IME;
19. Do not allow X-rays or any diagnostic tests unless previously agreed to;
20. After the IME, list to the plaintiff's observations; the lawyer will be rewarded with a wealth of information like what "medical tests" the treating doctors id that the defense doctor did not do.
I refer to these biased exams as Insurance Defense Exams, not Independent Medical Exams because that is what they are. I have even seen IME doctors conveniently forget to include prior diagnosis codes or diagnostics in their IME reports. I hope this blog page give you insight into the challenges a injured person faces in California. If you have any questions, you can call me directly at (619) 813-7955.