You have been injured in a car accident in Michigan. The insurance company is already giving you a hard time. They aren’t paying wages, medical bills or any other no-fault benefits on time or at all. Michigan law says you are entitled to these things, and the car insurance adjuster promised they would pay these benefits soon. Then the car insurance company wants you to attend an “independent medical examination” or IME. What is an IME and what does this mean for your case?
Under Michigan Court Rule 2.311, when the mental or physical condition of a person is in controversy, such as after a car accident or slip and fall, the court may order the party “to submit to a physical or mental or blood examination by a physician … or to produce for examination the person in the party’s custody or legal control.”
This means if you have filed a lawsuit for damages following a personal injury, the defendant is entitled to ask the plaintiff to submit to an “independent medical examination.” The doctor who perform the exam then must prepare a report of his or her findings. This includes the results of all tests done and conclusions.
For car accident cases, this requirement is found right in the Michigan No-Fault Law. Under MCL 500.3151, if the physical or mental condition of a person is material to a claim for PIP benefits, the insurance company can request that the person seeking benefits submit to a mental or physical exam by physicians. This provision allows car insurance companies to vigorously defend no-fault PIP cases, using the reports made by the IME doctors as a sword to cut-off or terminate benefits.
Unfortunately, independent medical examinations are not independent, rarely involve much in the way of medical advice and are barely an examination. Yet they are allowed under Michigan law, and routinely abused by car insurance companies, and their adjusters and defense lawyers to pay you less money on a case.
What Does an Independent Medical Examination Mean?
In a Michigan no-fault case following a car accident, if the insurance company is asking you to submit to an independent medical examination, then they are most likely getting ready to stop paying benefits or limit the payments they have been making.
Insurance companies hire and pay the IME doctor to perform the exam. These exams cost the insurance company hundreds and sometimes thousands of dollars. The doctors are essentially hired guns. However, these exams are allowed under MCL 500.3151. Because they are hired guns and want more business in the future, these doctors will author a report that favors the car insurance company. That is why these “independent” medical exams are really not independent at all.
However, under both the Michigan Court Rules and the Michigan No-Fault Law for car accident cases, insurance companies and defendants are entitled to ask plaintiffs to submit to an IME.
What Happens During an IME?
Remember, the doctor performing the IME is hired by the insurance company to perform an examination. There is no doctor-patient relationship. This means the doctor is not there to make you better or give you recommendations to improve your medical condition.
First, the letter will ask you to bring all of your medical records to the exam. Don’t do this. You are only required by law to bring yourself to the exam. You do not have to bring any medical records, imaging studies, x-rays, MRIs or anything to the doctor’s office. The insurance company can get your records themselves.
Most “examinations” are barely exams at all. The doctor will ask the person some questions about how the accident occurred and the symptoms they are experiencing. A physical examination may occur, but it is often quick and cursory.
Some doctors will ask a lot of questions about your health before the injury, or inquire about how the incident occurred. I typically instruct my clients to not get into too much detail about the accident. The doctor is not entitled to know about this and frankly will only use this information against you.
What Doctors are Allowed to Perform These Exams?
For car accident cases in Michigan, the doctors allowed to perform IMEs is controlled by MCL 500.3151(2). Under the law, the physician performing the IME must be licensed in Michigan or another state and must specialize in the same specialty as the physician providing the care with the same board certification. This means if a neurologist is providing medical treatment to an injured car accident victim, then the IME must also be performed by a neurologist.
In addition, under MCL 500.3151(2)(b), in the year immediately preceding the exam, the IME doctor must have spent more than 50% of his or her time either (1) actively treating patients in a clinical setting, or (2) teaching students in an accredited medical school or residency program.
If the IME doctor fails to meet these conditions, the doctor can be stricken from the case.
How Many Independent Medical Examinations Does a Person Have to Attend?
Although IMEs are subject to a general requirement of reasonableness, there is no limit to the number of independent medical examinations an insurance company can ask a person to attend. Although I have fought situations where an insurance company has asked my client to attend multiple exams, usually the judge will allow the exam to go forward so long as the doctors performing the examinations are the same specialty as a treating doctor.
Some insurance companies are notorious for the amount of money they spend and the number of “independent medical examinations” they force injured claimants to attend. State Farm and Allstate are known throughout Michigan as some of the worst offenders. The charges for these exams are outrageous. I have seen doctors charge more than $3,000 for an IME, and this does not include time for depositions or additional medical record review.
Who Pays for the Transportation to the IME?
The insurance company must pay for the transportation costs both to and from the IME location. If you don’t have transportation, the insurance company who sets up the exam must pay for the transportation. If you are driving yourself, ask for reimbursement for gas money for the exam.
Where Do the Examinations Take Place?
Some of the “examinations” take place at the doctor’s office who is performing the exam. However, most take place at a location rented by the company who set up the exam. For example, companies such as MES, Michigan Evaluation Group (MEG), MedSource, Axiom, ManageAbility (MAI) or Exam Works will have their own offices where the exam takes place. The doctor will travel to this location and conduct multiple exams in one day.
This doctor will earn thousands of dollars for this work. Our Michigan car accident lawyers have subpoenaed the financial information of many of these doctors. Some doctors earn $500,000 or more every year doing this work!
Naturally, the IME doctor has a huge financial incentive to write a report explaining the patient wasn’t hurt in the car accident or doesn’t need more treatment. If the doctor writes too many reports that favor the injured person, that doctor will not be used again for future evaluations by the insurance carrier.
Will I Get A Report Following the Independent Medical Examination?
Yes, under Michigan law either you or your lawyer are required to receive a copy of the report authored by the IME doctor following the “examination.” The report will list the medical records the doctor reviewed before conducting the exam, and the results of the brief physical examination that took place.
Usually, the insurance company will provide a list of questions it wants answered by the doctor. The answers to these questions are then provided. Typically, the doctor will have an opinion that says the claimant is either recovered from the accident, or the medical treatment already provided was not related to the injuries from the car accident. Often, the report will also say the injured person has has reached maximum medical improvement (MMI), which means the illness is stabilized and unlikely to improve with or without additional medical treatment.
What Are Some Helpful Tips When Attending an IME?
There are no hard and fast rules on what to do during the exam. However, at the very least make sure you are not combative to the doctor and present yourself in a positive way. Dress well and make sure you make a good appearance. Additional tips include:
- Do not bring any medical records to the exam. Your only requirement is showing up and appearing for the exam.
- Write down when what time the exam starts and when it ends.
- Don’t fill out the “patient registration form” given to you by the representative at the front desk upon check-in. These forms may be used against you later by the insurance company and their lawyers.
- Don’t submit to any objective testing, such as an x-ray or CT scan. Again, you are only there for a physical examination.
- Don’t exaggerate your symptoms or pain during the exam.
- Be aware that the insurance company may be conducting surveillance on you in the parking lot outside of the examination office.
How to Protect Yourself from the Insurance Company Following an Independent Medical Exam?
Getting a letter from the insurance company asking you to attend to an IME is a red flag. It usually means they are terminating benefits or looking for a way to get out of paying money for your injuries.
When this happens, it is important to seek legal help that is experienced in dealing with insurance companies and their IME tactics. The Michigan personal injury lawyers at the Lee Steinberg Law Firm have been defending clients subject to ridiculous IMEs for decades.
We are aggressive in protecting your clients’ rights and obtaining the benefits and money damages they deserve. Give us a call at 1-800-LEE-FREE (1-800-533-3733) for a free consultation. We are here to answer your questions and protect you.
