The Corruption of the IME Physician
Dec. 29, 2022
In California, employees who are involved in a workplace accident may be eligible to seek benefits through a workers' compensation claim. When an injured or disabled employee files a claim, the workers' compensation insurance provider is entitled to perform an independent medical examination (IME) to verify the employee's injuries or disability and approve their disability insurance claims.
However, since IME doctors are often selected and paid by the workers' compensation insurance carrier, there are various incidents of corruption and non-transparency. A seasoned California disability attorney can speak with you about the bad faith tactics used by IME doctors and insurance carriers and help determine how to fight their corrupt acts.
At The Law Office of Bennett M. Cohen, P.C., we're poised and ready to support and represent injured employees in their workers' compensation and disability insurance claims. As your legal counsel, we can inform you about what to expect and how to prepare for an IME. In addition, we will fight for your best interests and outline an effective strategy to protect you from the corruption of IME doctors. Our firm proudly serves clients in San Francisco and throughout the state of California.
What Is an Independent Medical Evaluation (IME)?
An independent medical evaluation can be described as an assessment of an injured person done by an independent physician to get an unbiased opinion of the person's injury. In California, the insurance company will choose the IME doctor. The IME physician will:
Review your medical history and your current health condition
Determine the seriousness of your medical condition or disability.
Determine the treatment you need.
Determine your ability to keep working.
However, the IME report and recommendations of the IME doctor can have a significant impact on the outcome of your workers' compensation or disability claims. In cases involving disputes, the insurance company will use the IME report to deny or undervalue your claims. An experienced attorney can help you understand some of the corrupt acts of IME physicians to always watch out for.
Corruption of IME Physicians
As mentioned earlier, the insurance company usually chooses and pays for the IME doctor. Actually, this makes them not so independent. While IME physicians are required to always give their honest and unbiased opinion of the person's injury or disability, some corrupt IME doctors work in favor of the insurance provider. Here are some common examples of the corrupt acts and bad-faith tactics of IME physicians:
Lying on the IME report
Failure to conduct a medical exam or thorough medical exam.
Looking for things that aren't wrong instead of what is wrong.
Insinuating that a patient is a fraud or the claims are fraudulent.
Failure to conduct a proper diagnosis on the patient.
Failure to review the patient’s complete medical history, health record, or information.
Claiming that a patient’s injury isn’t actually serious with just physical observation.
If you believe that your workers' compensation or disability claims have been affected by the corrupt actions of an IME doctor, you need to reach out to a trusted attorney immediately. Your legal counsel can help fight the corruption, advocate for your best interests, and help you seek the workers' compensation or disability benefits you may be entitled to.
Tips for Fighting the Corruption
According to the most recent statistics, on average, about 63% of disability insurance claims are denied every year. Here are some insightful tips to fight the corruption of IME physicians:
Always give consistent answers to questions asked by the IME physician.
Give an accurate description of your pains, medical condition, and limitations to the IME doctor.
Arrive for the independent medical examination as early as you can.
Collect and document copies of any form you complete during the examination.
Be consistent in all your actions. Do not run from your car and then limp during the medical exam.
Avoid exaggerating your injuries or acting differently before and during the exam.
Take mental notes and record your impressions about the IME procedure and the IME doctor after the exam.
Hire a skilled disability lawyer to help fight for your legal rights or file an appeal if your insurance claims are denied.
A trusted California disability insurance claims attorney can help you prepare for the IME exam, guide you through the entire process, and handle all communications and negotiations with the insurance provider.
Legal Guidance You Can Trust
An independent medical evaluation can have a significant impact on the outcome of your worker's compensation or disability insurance claims. However, the IME reports are often biased, and the IME physicians tend to work in favor of the insurance company paying them. Therefore, hiring an experienced disability attorney is crucial to protect your rights and for clear legal direction.
At The Law Office of Bennett M. Cohen, P.C., we enjoy providing outstanding legal services and advocating for the best interests of injured or disabled employees. As your legal team, we can help file your disability claims, prepare you for the IME exam, and increase your chances of a favorable outcome. Our attorney will work intelligently to protect your best interests and help you pursue the maximum available disability benefits.
Contact us at The Law Office of Bennett M. Cohen, P.C., to arrange a simple case evaluation with a trusted disability attorney. We have the experienced legal counsel and skilled advocacy you need in your claims. Our firm proudly serves clients in San Francisco and throughout the state of California.