Proving your injuries often requires having doctors examine you and turn in medical records and reports about your injury. We need to prove everything about your injury, from its cause to how much it will affect your life going forward. However, the defense is permitted to use their own doctors to examine you, too.
The defendant or their insurance company can request an “independent medical exam” (IME) with a doctor of their choice to examine you. This gives them an equal opportunity to gather medical evidence and details about your condition and disabilities so they can present that evidence in your case, and not just use the medical records they receive secondhand.
Contact the Texas personal injury lawyers at The Queenan Law Firm at (817) 476-1797 for your free case review.
What is the Process for an Independent Medical Exam in Texas?
Independent medical exams (IMEs) are usually carried out like this:
- The victim files an injury claim through insurance or as a lawsuit
- The victim presents medical records and doctors’ reports
- The defense/the insurance company requests an IME
- The victim accepts and attends an exam with a doctor that the defense chooses
- The IME doctor writes a report
- Both reports are presented to the court (or insurance company) as evidence in the claim.
Are IMEs Mandatory?
Insurance companies might not request an IME in the first place if they have all of the evidence they need. For example, if your medical records and doctor’s reports aren’t particularly controversial and present evidence that would be hard to refute, it might not be necessary for the defense’s case strategy to get their own IME.
Insurance Can Refuse Payment
That being said, if they do request an IME, you usually do have to attend. If the insurance company wants an IME as part of the insurance claim, they will deny the claim if you refuse.
May Be Court-Ordered
If they request that the court issue an order for you to attend an IME, you can get in trouble for refusing that court order.
What Kinds of Things Do They Look for in an Independent Medical Exam?
IME doctors are usually looking for the following info:
- Proof that you are, in fact, injured in the way you say you are
- Evidence of how severe the injury is
- Whether the injury is disabling
- What activities of daily living you can and can’t perform because of the injury/disability
- What work tasks you can and cannot perform because of the injury/disability
- The cause of the injury
- Any mistakes or errors your doctors made in methodology, diagnosis, or prognosis.
What Happens with the Info Obtained in an IME?
The IME doctor’s goal is usually to provide the defendant/insurance company with evidence to counteract the evidence you present. The insurance company is the one choosing the IME doctor and paying them for their opinion, so they want an expert opinion and report that will help their case.
If the doctor’s report comes back agreeing with your side’s doctors, then that might be enough to stop the insurance company from continuing the case. If they have no medical evidence to lean on, and their doctors agree with your doctors, they might be willing to settle.
What Qualifications Are Needed for an IME Doctor?
Insurance companies cannot just force you to attend an exam from anyone they want and call that an IME. They must use qualified healthcare professionals, though they might not always be “physicians” (i.e., MDs or DOs).
However, they usually will pick IME doctors with similar qualifications to your own doctors so they can more easily argue that their doctors are right and yours are wrong. That is difficult to do if their doctors have less experience or qualifications.
FAQs About Independent Medical Exams in Texas Personal Injury Cases
Are Independent Medical Exams Actually “Independent”?
Not really. IMEs are usually requested by the defendant or their insurance carrier to counteract the evidence you present from your doctors’ exams and reports. They are paying for the exam and choosing the doctor, so it is presumed that their reports will say what would best help their side, or else they won’t be helpful to them in court.
Courts can potentially request truly neutral IMEs with doctors the judge chooses, but this is rare.
Can You Say No to an Independent Medical Exam?
Technically, you can refuse to attend an independent medical exam, but it may block you from getting damages for your injuries.
If you are merely negotiating the claim with the insurance company, they can deny your claim if you refuse to undergo an exam with their doctors. If the case gets to court, the court can order you to undergo the exam, and refusing can mean dismissal and other potential penalties for denying a court order.
Who Can Request an IME?
Independent medical exams are usually requested by the defendant. This means the person you are suing or the insurance company representing them would request the IME.
When Can IMEs Be Requested?
Insurance companies often request IMEs while they decide the claim, i.e., between when you file and when they decide the claim. If your case goes to court, an IME may also be requested as part of the evidence collection/discovery stage of the case.
Can the Victim Request an Independent Medical Exam?
You can see whatever doctors you choose and present their reports and records as evidence in your case. When we talk about an “independent medical exam,” we are talking about an exam that the insurance company or defendant requests you to undergo with a doctor of their choice, not an exam your side chooses.
What is an Independent Medical Exam in a Workers’ Comp Case?
Independent medical exams work similarly in a Workers’ Compensation claim: the employer/insurance carrier demands that you see a doctor they chose to examine the injured worker. The goals are the same: to combat the worker’s medical evidence with their own evidence.
These exams are also used in the kinds of personal injury lawsuits our attorneys handle.
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