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An Independent Medical Examination, or IME, is a medical evaluation that you may be asked to attend as part of your accident claim. The IME is paid for and scheduled by your Auto Insurance to analyze your treatment and potentially terminate your No-Fault Medical Benefits. Your Auto Insurance will select and pay physicians to conduct the IME and to write a report of the IME findings, with the intent of using this report to terminate your No-Fault Medical Benefits.
While the IME is intended to be an independent or unbiased exam, it is often referred to as the “adverse exam,” as this exam is not intended for your treatment or additional care but purely for your insurance company to analyze your treatments and have grounds to terminate your No-Fault Medical Benefits. Here is everything you need to know about independent medical examinations.
Minnesota is a No-Fault state, meaning, in Minnesota, you are entitled to No-Fault Benefits commonly referred to as PIP Benefits (Personal Injury Protection), which, at a minimum and depending on your insurance coverage, include $20,000 in Medical Expenses and $20,000 in Non-Medical Expenses, such as Wage Loss and Replacement Services.
The $20,000 in Medical Expenses is often cut off after the IME, meaning your Auto Insurance will no longer pay for Medical Expenses you incurred as a result of this accident, and instead, your Health Insurance will be billed for these treatments. It is important to provide your Attorney with the front and back of your health insurance card so they may maintain contact and monitor the costs your Health Insurance incurred for treatments related to the accident. The costs your Health Insurance incurs for these treatments are referred to as a Subrogation Lien.
Who requests the IME depends on who is paying for the treatments and ongoing care.
Your Auto Insurance is typically the one requesting the IME during the beginning or treating phases of the case, as they are the ones paying for treatments through your No-Fault or PIP Insurance. They are also the ones paying the physician for their time and for the written report after the IME.
While it’s most people’s first thought that the At-Fault Party’s insurance (Or Bodily Injury Insurance) would be requesting an IME, they are not the ones currently paying for treatments or paying for your benefits, and have no reason, at this time, to request an IME. However, they can still request an IME and might do so later in the case.
For the first $20,000 in Medical Expenses, your No-Fault or PIP Insurance is paying, and they often want to ensure they pay as little as possible, but to cut off benefits, they must have reasonable grounds for termination. That leads your Auto Insurance to request an IME with the intent of receiving a report listing your treatments as excessive and allowing them to terminate your benefits.
While IMEs can be confusing and frustrating, please know that these types of requests are very common, and your legal team at BK Law Group is behind you and will support you as we navigate these next steps together.
The IME consists of various sections. There is a question-and-answer section in which you answer questions about your injuries and treatment, and the physician may also ask about how the accident occurred during this section. After the question-and-answer portion, the IME physician will then do a physical examination, including assessing areas you noted have pain or have had pain in the past. Once the physical examination is concluded, the physician will write a report on everything you have just discussed and present it to your Auto Insurance.
The purpose of an IME is for your Auto Insurance to review and analyze your treatments and to review another physician’s opinions regarding your injuries and treatments. It is then their intent to cut off your benefits by citing the IME report, as it often comes back favorable to the insurance company and unfavorable to you, the claimant.
It’s important to remember that your Auto Insurance pays the physician to conduct the IME and for the written report. This is not your regular treating physician, nor is this a physician who would advise you on further treatment. This physician is solely conducting the IME to assess your current treatments and write a report to your Auto Insurance stating if they feel you received unreasonable treatments for the injuries you sustained.
You do have the right to have a copy of the IME report. Obtaining a copy of the IME report allows you to see exactly what the physician sent to your Auto Insurance. The IME report would consist of the physician’s findings, including the conversations you had with the physician and any questions you answered. Once you get the IME report, you should review it carefully and then contact your Attorney to discuss what you felt was accurate and inaccurate about the report.
The physician should base the exam on the information provided, including any medical records related to the accident, injury history, examination findings, and collision-related documents, such as police reports. After reviewing the IME report, if you feel the IME was inaccurate or biased, please contact your attorney at BK Law Group, and we will discuss potential next steps.
Since your Auto Insurance requested the IME, they must reimburse you for any wages lost and compensate you for the miles traveled. If you need to take time off from work to attend the IME, your Auto Insurance should pay for this time to be covered as a part of your $20,000 No-Fault nonmedical Benefits, including Wage Loss and Replacement Services.
You are also entitled to Mileage Reimbursement paid from your Auto Insurance for reasonable travel expenses, including to and from the IME. Please reach out to your Attorney or Paralegal at BK Law Group, and we will set you up with the proper forms to get these benefits.
You will often have the opportunity to notify your insurance company or your attorney of the dates and times that work best for you to attend the IME. Your best dates then have to be coordinated with the physician’s schedule before the IME is scheduled. Once the IME is scheduled, you or your attorney will receive formal notice of the upcoming IME. Including the date, time, location, and the name of the physician conducting the IME.
In Minnesota, the IME must be conducted within the city, town, or statutory city of residence of the injured person. If there are no qualified physicians to conduct the examination within the city, town, or statutory city of residence, then the exam will be conducted at another place of the closest proximity to the injured person’s residence. You or your attorney should know or ask about the potential IME location and agree that it is acceptable before scheduling the IME.
Yes, you must attend the IME appointment or risk losing your No-Fault Medical Benefits. It is important to be honest about the dates and times that work best for the IME, as your insurance is more likely to be cooperative when scheduling the first IME and is more likely to label you as uncooperative or difficult if they have to reschedule the IME several times.
If you don’t attend or miss the IME without citing any reason or emergency, you can be charged up to, but not limited to, $1,700 to compensate the doctor for their time.
Illnesses and Emergencies happen to everyone; if you are unable to attend your IME due to illness or an emergency, please let your Attorney or Paralegal know, as soon as possible, and they will immediately contact your IME coordinator and your Auto Insurance to inform them of the missed IME and to schedule a new IME.
There are no real ways to avoid the IME, and attempting to do so can make your situation worse by indicating to your Auto Insurance that you are uncooperative and thus providing them with cause to terminate your No-Fault Medical Benefits.
Often, Auto Insurance will request an IME between 3 and 6 months from your treatment start date. This date can also vary depending on when you submitted your claim or when the collision happened. If you submit a claim months after the collision, it is likely your Auto Insurance will want you to attend an IME to assess the nature and extent of your injuries. Other reasons for requesting IMEs later in the case include evaluating your medical treatment and assessing if the IME physician believes your treatment was excessive or consistent with the type of injury sustained.
Your legal team often does this; however, if you have additional documentation or aftercare summaries from your treatments related to the accident, please bring them for the doctor’s review.
This will be used to verify your identity and is common practice for IMEs.
Document or detail your current injuries or symptoms, so you have clear, direct answers when the IME physician asks you about them as well.
IMEs can be intimidating; you are meeting with a new doctor who the insurance company pays to write a report detailing all of your treatments and their opinions on those treatments. To go into the IME best prepared, BK Law Group has put together some advice to make the IME as seamless as possible.
Overall, if your Auto Insurance or your attorney notifies you of a requested IME appointment, don’t worry. These are common appointments, and your attorney at BK Law Group is well-versed in handling all aspects of the IME. Your attorney will help you navigate the next steps and approach the IME with tips to ensure a seamless appointment.
If you need a skilled lawyer for help with a personal injury claim, BK Law Group is here for you. Please contact us by phone at (952) 314-5101 or by email at in****@*********up.com. We are happy to help.
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