As our video explains, an Independent Medical Exam for LTD benefits is anything but independent. In fact, it is a perfect example of an insurance company at odds with its own deserving customer. If your insurance company wants to schedule you for an Independent Medical Exam during their claim evaluation process, what can you do?
First of all, insurers are within their rights to request IMEs. This can apply whether you’re just applying for long term disability or you’re 5 years into a paying claim. In fact, many disability policies contain language that stipulates if you fail to cooperate or attend the IME, benefits may be denied or suspended.
Likewise, you have a right to a copy of the IME report. You may also have someone accompany you during the exam.
The intent of an Independent Medical Exam for LTD assessment
An IME should be impartial and produce reliable analysis of your medical condition. It should give a fair measure of the restrictions and limitations imposed by your disability. It should expose those claimants who do exaggerate impairments.
But in practice, the insurance company will use the IME to avoid paying benefits in valid claims.
The process involves a physical examination performed by a medical doctor chosen and paid for by your disability insurer. In many cases, the hired doctor is instructed as to what the insurer is looking for. IME doctors who find claimants to be medically healthy and able to work do so to protect their job security.
When the intent is to construct a medical report that supports denying or terminating disability benefits – that insurance company places its financial interests above the interests of the claimant, and is not acting in good faith.
How can you beat this? What can you do to protect yourself during the IME?
Involve a lawyer in the IME process
As your attorneys prior to an Independent Medical Exam, we can make certain the IME doctor has your complete medical records, history and diagnostic test results associated with your condition. This sounds simplistic; yet it is often the case that the insurer does not give the IME doctor your complete information. How can a doctor possibly make a medical judgement of disability without it?
We may also enforce your right to videotape the insurance company’s Independent Medical Exam for LTD claims processing. These and other measures can help ensure the IME is performed fairly and you are not taken advantage of.
Our attorneys will challenge unfair findings in the IME report and spell out any incorrect allegations or factual mistakes, supported by relevant medical evidence.
Be truthful. Don’t embellish.
Sometimes, unyielding insurance companies are a reason why honesty is so important in long term disability cases. Tell the IME doctor about your pain and limitations as they really are. Refrain from exaggerating symptoms.
Certain impairments may cause you to have good days and bad days; symptoms wax and wane. If you tell the insurance company’s IME doctor that you can barely walk the 25 steps to your mailbox and back, and that you must always use a cane, make sure that is the case. What happens when, five days later, video surveillance footage exposes you playing badminton at the family cookout?
That gives the insurance company the toehold it needs to deny. Physicians hired to perform an Independent Medical Exam for LTD assessment know to keep a sharp eye for innocent mistakes or straight up deceit, and will view either one as fraud.
Last but not least, a case with merit never needs to rely on exaggerations of symptoms (known as malingering) or other misrepresentation of pain or functionality.
What if the insurer denies your claim, based on the IME report?
Get a disability lawyer involved and appeal the denial!
A well-prepared appeal can overcome the insurer’s biased IME report and prove that you are unable to work.
Because you are in no condition to work, our law firm takes care of everything for you. We will obtain and assemble all necessary documentation, talk with your doctors, produce statements from witnesses, work with with vocational experts, and use the latest science and technology to study and build the details of your case.
You have a dedicated advocate with Marc Whitehead & Associates. Wherever you live, we can help. Call us at 800-562-9830 today for a free case evaluation.