In our last post we outlined general information regarding “independent” medical examinations (“IME’s”) conducted by doctors or other specialists for insurance companies. In this article we provide tips to ensure you are properly prepared for your IME. The same tips apply whether you are assessed for a claim relating to a motor vehicle accident, slip or trip and fall injury or for a claim for long term disability benefits.
Reports prepared by insurance company physicians typically indicate whether the person being examined was on time. Therefore, it is recommended you plan to be at least 15 minutes early for the assessment. Keep in mind what traffic can be like in Ottawa on the Queensway and in the surrounding communities of Eastern Ontario at different times of day.
The insurance company physician is already being paid by the insurance company. You do not want to upset the physician and make him or her even more against you by making him believe you do not respect his time or by throwing off her schedule for the day.
In most cases the insurance physician has your medical records. These include not only the records of your medical and other appointments after the accident, but also your appointments before the accident. The insurance company physician will be looking for any inconsistencies in what you say about your pre-accident health. If you had symptoms before the accident, be prepared to outline the difference in how you were feeling before the accident compared to how you are feeling now.
If you do not tell the truth about anything regarding your medical history, there is a good chance the insurance doctor will find out by a review of your medical records. If you are not honest you may also say something inconsistent with what you have said in the past or with what you may say in the future.
The doctor will likely comment in his or her report whether he found you to be honest and credible. The best way to ensure a favourable opinion is to be honest and not hide anything. That is not to say that you should volunteer information that has not been asked. To the contrary; answer only the questions that have been asked without providing extra information. However, if asked about something, tell the truth.
Many tests provided by doctors, psychologists and other health care professionals contain hidden measures which may provide information about whether you are exaggerating your injuries. Sometimes these tests involve asking the same question in different ways or asking you to perform different tests that should result in the same outcome. When you have different test results for things that should be the same, the doctor will write that you had an “inconsistent effort”. Therefore, try your best. If you are too tired, ask for a break.
Most doctors will report not only on the extent of your injury or impairment, but also what they thought of your appearance and attitude. For example, the physician may write something such as “The claimant presented casually but appropriately dressed. She was pleasant and cooperative throughout the assessment.” Such a statement at the outset of the report is likely to make the reader think that you are someone who is honest and will present well in court. The opposite is also true, if the report says something like “The claimant presented in an unkempt manner. He was rude, uncooperative and expressed displeasure at having to complete so many assessments.” The insurance adjuster will likely feel less sympathetic toward your case and believe that a jury will not empathize with you. Remember to always behave politely and with courtesy to the doctor no matter what you think about the insurance company.
You should also be aware of how you walk and move before and after the assessment. The doctor and his or her staff may observe you while you are in the waiting room or even outside of the building as you walk into or out of the assessment. If you walk without difficulty as you enter the building or walk into the assessment room but then start limping as soon as the doctor begins his assessment, this will likely be noted in the report.
If the insurance doctor (or later the insurance company or jury) believes you are exaggerating, they will not look favourably on your claim and may even believe you are faking. If you say your back pain is always a 10 out of 10, and 10 is the worst pain imaginable, the doctor may view this with suspicion. You do not have to have the worst pain imaginable in order to receive compensation for your real and true injuries.
What the insurance doctor really wants to know is if your impairments are true and honest. If you tell the doctor your ultimate goal is to return to health, that you love your job and want get back to your old life or as close to it as possible, then you are likely to be perceived as a fair and honest person, which will help your cause.
It make take one to three months for the insurance company doctor to provide a copy of her report after the assessment. When you finally receive it you may find it has some information you do not agree with. This can include anything from the length of the assessment to what the doctor says you told her.
After your assessment is complete and while your memory is still fresh, take note of the following information:
While you can never be sure how objective the insurance doctor will be, the only thing you can control is what you do. By following the steps outlined above, you will be in the best position to have a report that supports your case or is not overly harmful or inaccurate.