independent medical examination

IMEs and Long-Term Disability Claims

If you have sustained an injury or illness that is preventing you from working for an extended period of time, you will likely want to access any available long-term disability benefits. In the vast majority of cases, the long-term disability claims process will require participation in an independent medical examination (IME). If you review your policy details you will usually see details about this requirement. You may also see that the insurance company retains the right to terminate your benefits should you fail to attend the IME.

IMEs and Long-Term Disability Claims

An IME is, essentially, a medical assessment arranged by your long-term disability insurance company. While you may want to have your primary care doctor conduct your IME, this is usually not permitted. Instead, your long-term disability insurance carrier will appoint its own doctor to conduct the exam. The examination will relate to either claimed physical or psychological issues that are the conditions leading you to need to access your disability benefits.

An IME usually takes place at the start of the claims process but it could, in theory, take place at any time during the claims process. The examination is usually used in order to determine entitlement to access benefits. The examining physician is not there to provide you with treatment nor will treatment take place. In fact, it will likely be both the first and last time you see the IME doctor. The IME doctor is to report to the insurance company on the symptoms of your injury or illness as well as the associated restrictions and limitations. Furthermore, the IME doctor may be asked by the insurance company to give an opinion as to your level of disability as well as treatment recommendations.

At the IME, the doctor may need to ask you about your medical history. Oftentimes, the IME doctor will not have time to review all of your medical records received. The details as to what will happen at the IME will vary depending on your claimed injury or illness. An IME for a physical disability will be different from one for a mental disability. Should your disability be physical, the doctor will likely want to examine things such as your ability to perform specific functions like sitting, standing, walking, and kneeling. Furthermore, the doctor will likely want to examine your body to see if you struggle with a range of motion issues or pain.

The prospect of attending an IME may be intimidating, especially considering it will likely be with an unknown doctor. IME attendance, however, can be a critical part of accessing your long-term disability benefits. Be sure to be on time for your IME appointment. Consider taking notes during the exam or bringing a trusted relative or friend who can take notes for you. Note things such as the length of time the exam lasted as well as questions asked by the doctor and tests performed. Get a copy of your IME report once it has been generated. Review all of this documentation with an attorney to verify that all information is correct.

Riverside Disability Attorney

At Disability Advocates Group, we can help you prepare for your IME and review your IME results. We are here to help you successfully navigate the claims process and will assist you every step of the way. Contact us today.