Seattle Personal Injury Attorney Chris Thayer
Seattle Personal Injury Attorney Chris Thayer
Handling Personal Injury Claims in the Seattle Area and Throughout Washington Since 1995

My name is Chris Thayer and I am a personal injury attorney practicing in downtown Seattle. I handle personal injury, medical malpractice and wrongful death claims throughout the greater Seattle area, including Issaquah, Mercer Island and Kirkland.

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What to expect from an IME

Posted Wednesday, December 14, 2011 by Chris Thayer

An “IME” (independant medical examination) is an examination by a supposedly independant doctor or chiropractor, generally performed at the request of an insurance company. These arise primarily in two contexts: at the request of your Personal Injury Protection (PIP) insurer, or at the request of the third party liability carrier.

Your PIP policy typically provides that it will pay for all medical expenses that are “reasonable, necessary and related [to the accident]” or words to that effect. This means that, regardless of fault in the accident, your PIP policy will cover your medical expenses. However, if the insurance company starts to have concerns about whether or not the treatment you are receiving is “reasonable, necessary or related”, it may request an IME by a doctor or chiropractor of its choosing. You have certain rights with respect to a PIP IME, and if you have not already retained an attorney to protect your interests, if you receive a request for a PIP IME, you should consider consulting an attorney. Very generally, you are typically going to be required to undergo the IME as there is most likely a “cooperation” clause in your insurance policy, but you should be aware of your rights before you attend the examination.

An IME by a third party liability carrier typically only arises after a lawsuit has been filed. If the third party carrier requests such an examination pre-lawsuit, you should absolutely consult an attorney. You have the right to refuse this examination pre-lawsuit and most cases you should refuse.

Keep in mind that insurance companies typically refer IME request to the same select group of doctors and chiropractors. Some of these doctors and chiropractors no longer maintain a clinical practice and their entire business is devoted to working with insurance companies. The insurance companies are looking for ways to reduce the amount they have to pay on claims. It is not surprising then that many of these IME doctors and chiropractors retained by the insurance industry are very conservative and routinely issue reports that are contrary to the claimant’s own treating healthcare provider’s assessments and recommendations.

Understand the role of the IME doctor or chiropractor before you attend your examination. Also, you should reach agreement that the examination will be videotaped, or at least audiorecorded to protect yourself and ensure that the examining doctor or chiropractor honestly reports their findings. You should familiarize yourself with “Waddell Signs” which are a series of tests that the examiner will likely conduct, with the purported purpose of determining whether or not a person is exaggerating or manufacturing certain symptoms.

Dealing with an IME request by an insurance company can be challenging and complicated. You do have rights and there are measures that can be takent to try to ensure you are treated as fairly as possible. If you have received a request for an IME from an insurance company, you should consider consulting with an experienced personal injury attorney promptly, to ensure your rights are protected.