Independent Medical Examination (IME) For No-Fault Claims

If you suffer from a car accident injury, you may be seeking compensation from your Michigan auto insurance or damages from the at-fault driver. Unfortunately, the insurance company will go to great lengths to avoid payouts.

One approach used is an independent medical exam (IME). An IME may sound harmless, but it is a tactic to undercut an injury claim to avoid paying it. These defensive medical exams are not neutral or even fair. The doctor’s opinion usually reflects what the insurance company wants them to say.

Learn what an independent medical evaluation entails, what you can do to prepare yourself for one, and how a knowledgeable and experienced Michigan personal injury attorney can provide legal advice and help you fight for the compensation you deserve.

What is an Independent Medical Exam (IME)?

An independent medical exam is an appointment with a doctor chosen by the insurance company. If you have no-fault insurance coverage in Michigan, your insurance carrier may delay paying your medical, wage loss, and other no-fault benefits until you have been seen by the doctor they choose. This is permitted by section 3151 of the No-Fault Law.

At Matz Injury Law, we prefer to call these physical examinations defensive medical exams, or DMEs (Defensive Medical Exams), to emphasize that they are often biased in favor of the insurance company.

What is the Purpose of an Independent Medical Examination?

The purpose of an IME is to provide an insurance company with evidence to support their claim your injury isn’t serious or is unrelated to the accident. Defensive medical exams can be separated into two categories: PIP defensive medical exams and third-party IMEs.

A PIP defensive medical exam is ordered by your auto insurance carrier and usually occurs before you file a lawsuit. A third-party defensive medical exam can be scheduled at the request of the at-fault driver you are suing.

The purported purpose of the DME (Defensive Medical Exam) is to:

• Have an impartial, independent doctor verify the extent of your injuries
• Determine whether the accident caused the injuries
• Decide whether you require ongoing treatment
• Determine whether you can return to work

In truth, these exams are far from impartial. These exams allow insurance companies to argue against your claim, reducing or eliminating the amount they must pay. The defensive medical exam doctor cannot treat you, prescribe medication, or write you a work notice. Never request any of these services from the IME doctor. If you do, the insurance company may accuse you of “drug-seeking behavior” or otherwise use your requests against you.

What Does IME Mean in Insurance Claims?

In insurance claims, IME means the following:

• The insurance company hires a physician to evaluate and assess your injuries.
• The IME doctor does not treat the patient or have a standard doctor-patient relationship.
• IME physicians are not interested in helping your case and usually only spend minimal time with you to provide an opinion supporting the insurance company.
• These doctors help insurance companies receive a favorable outcome to help them avoid paying compensation.

How Do You Prepare for an IME Appointment?

To prepare for an IME appointment:

• Show up on time for your appointment.
• Dress appropriately since the IME doctor will report on your appearance.
• Do not fill out or sign any paperwork without consulting with your personal injury lawyer.
• Plan to meet with your physician, who can dispute anything the IME physician claims about your injuries.

_{Schedule a free consultation with Matz Injury Law to prepare for your IME and protect your claim.}

What to Do During Your IME Appointment

It can be intimidating to go into an IME appointment. Take a deep breath, cooperate, and get through it.

• Cooperate with the doctor.
• Do not refuse any tests they ask of you.
• Avoid talking about the events of the accident. The IME physician should already have the accident report from the insurance company, and anything you say in your appointment can be twisted and used against you.
• Do not lie about your prior health and medical history.
• Do not volunteer any extra information. Only answer direct questions as succinctly as possible.

Since the doctor will only spend minimal time with you, the less you say, the better. Your attorney can help dispute the results of the IME if your insurance company refuses to pay your PIP benefits or the defendant’s insurance company denies money for medical care.

Michigan IME Laws

Michigan has specific laws about defensive medical exams that claimants must follow.

Car Accident No-Fault Benefits

Any time you file a claim against your no-fault insurance policy for personal injury protection (PIP) benefits, your insurer can request that you submit to a IME. Under Michigan state law, the examiner must:

• Be a licensed physician
• Specialize in the same area as the physician providing your care if you are receiving specialized care
• Have devoted a majority of their time over the prior year to practicing active clinical medicine (and to the relevant specialty area, if any)
• Teach as an instructor in an accredited medical school, residency, or research program

Car Accident Liability Claims

The defendant’s insurance provider can request a DME (Defensive Medical Exam) if you are suing an at-fault driver for additional damages, including economic and non-economic damages like pain and suffering. The examining physician must meet the same legal requirements as a no-fault defensive medical exam.

What Happens After an IME Exam?

Once you conclude your IME, the doctor prepares and submits a report. The physician’s findings, conclusions, and recommendations will weigh into the insurance company’s decision to reduce compensation or cease the accident victim’s no-fault benefits.

Fortunately, your attorney can challenge the IME’s report if the following conditions apply:

• The exam was done without considering your complete medical history.
• The report includes opinions outside the realm of the IME physician’s area of expertise.
• The doctor filed their report past the deadline, making their input inadmissible evidence.
• The IME doctor’s findings directly conflict with the recommendations of the initial doctor who examined you.

What Do I Need to Do After an IME Exam?

You do not have to do anything after an IME. If anything needs to be done, your personal injury attorney can determine your next steps, such as disputing the report.

What If I Disagree With Results After an IME Exam?

You can challenge your medical exam results if they are incorrect or unfair. If the doctor’s conclusions are based on misinformation, you can write to the doctor and the insurance to update the medical document to reflect the correct information. In some cases, this may involve getting a second opinion. Your Michigan car accident lawyer is equipped to rebut the IME/DME.

Evidence to support your position and combat the inaccuracies of the IME/DME include your own treating physician’s:

• Medical evaluation and medical records
• Diagnostic tests (e.g., x-rays, CT scans, or MRIs)
• Planned course of treatment for your medical condition
• Non-IME medical information and documentation relating to your injury or permanent disability

When this happens, your attorney at Matz Injury Law office will send a letter to your treating doctor. This letter requests a rebuttal indicating:

• How you were injured
• How the injury was related to the crash
• How the treatment has been reasonable and necessary

Sometimes, clients have multiple injuries to various body parts, so it is vital to make sure that the doctors who disagree have the same specialty area as the defensive medical exam doctor. Juries give far more weight to the opinions of treating doctors who spend time with patients rather than IME/DME doctors who sometimes see the patient for as little as four minutes.

Related Resources

• What Are My Rights After a Michigan Car Accident?: After suffering a Michigan car accident, you have the right to pursue compensation to cover your injuries, medical treatment, lost wages, property damage, and any other losses you have because of the auto accident. Since Michigan is a no-fault state, you do not need to prove fault when pursuing compensation for your injuries.
• Know Your Rights as a Passenger in a Car Accident: The aftermath of being in someone else’s car when it crashes can be overwhelming and scary, especially if your injuries lead to mounting medical costs and lost time from work. You might be wondering if or how you can obtain compensation in Michigan. Understanding Michigan’s “order of priority” rules can help you ascertain how to get the money you need.

Strong Advocacy for Car Accident Victims with IME Challenges

At Matz Injury Law, our personal injury attorneys are well-versed in Michigan’s no-fault law and tort law. We have years of experience representing people fighting auto insurance companies’ tendencies to minimize or deny injuries.

Our law firm has handled cases involving uninsured motorists and underinsured drivers, wrongful death, and all manner of issues related to car accident cases. We will fight for you every step of the way. We have driven hundreds of thousands of miles across Michigan to fight for car accident victims and have earned our clients over $300 million in compensation.

To schedule a free consultation for yourself or a family member, contact Matz Injury Law today by calling our phone number at 1-866-22Not33 or using our online contact form. Let us start your road to recovery together.