What to Expect When Getting a Independant Medical Review
If you are receiving long-term disability (LTD) benefits, the insurance company will periodically review your claim to determine if you keep to run across the applicative definition of inability. Often, this will involve obtaining your medical records and forms from your doctors to be reviewed by a nurse or doctor who works for the insurance company. Still, sometimes, the insurance visitor asks you to attend an contained medical exam, or IME, in order to determine what your functional impairments are and thus whether yous go along to meet the definition of disability. Nonetheless, although these exams are labeled "independent" and performed by someone outside of the insurance company, in that location are several things yous should be aware if your long-term disability insurer wants to send you for an IME.
Is an Independent Medical Test (IME) Actually Independent?
Although IMEs are labeled "independent," in most cases the doctor performing the test is not truly independent because the insurance company is paying for the exam. If the doctor performs a big number of IMEs, and thus derives a substantial portion of his income from insurance companies, he may be incentivized to go on insurance companies happy and help them avoid paying long-term disability benefits. Unfortunately, this can result in biased exams and reports that practice not accurately reflect your medical condition and impairments.
Yous tin can request the medical provider's curriculum vitae (CV) prior to the IME engagement. The provider's CV may indicate that the provider completes these exams regularly for insurance companies. This could be indicative that the provider is more likely to find you not disabled so that he tin acquire additional piece of work from the insurance company. Although regularly conducting IMEs is not a definitive indicator that the provider will be biased, it is important to keep in listen. Y'all should consider contacting an attorney if the insurance visitor wants you to attend an IME and you are concerned well-nigh the exam provider's neutrality.
Is an IME Appropriate for My Disabling Condition?
At that place are some instances in which an IME may not be appropriate for your disabling condition. Typically, IMEs are brief – the physician volition interview y'all nearly your medical history and perform a brusque physical test. For many claimants, that erstwhile, brief exam is non sufficient to fully and accurately determine their functional impairments. Still, this is especially truthful if your disability is due to conditions that cause chronic hurting or fatigue, such as fibromyalgia or chronic fatigue syndrome. Often with these conditions, y'all are able to perform some activity merely non on a reliable and consistent basis for several hours per day or multiple days per week. Thus, the brevity of an IME will not accurately reflect your functional impairments or ability to work. Unfortunately, most insurance companies practise not consider whether an IME will accurately reflect your disability when they inquire you lot to nourish one.
What Can I Exercise to Endeavour and Make Sure My IME Is Off-white?
Before you attend the scheduled IME, you should gather your medical records on your own and bring them to the appointment to ensure that all of the relevant information is being presented to the md. You lot should non rely on the insurance visitor to ship the appropriate medical records. Failing to provide the doctor with medical records yourself can outcome in the doctor having a skewed evaluation of your by medical history.
To further ensure that the engagement is as unbiased equally possible, you can request to bring a witness to the examination who can after attest to the contents and results of the appointment. Additionally, you should request a copy of the doc'south study following the exam. This will allow you to identify whatsoever discrepancies between what occurred during the exam and the report the md submitted to the insurance visitor.
Tin I Turn down to Participate in an Independent Medical Exam?
Generally, if the insurance company asks you to attend an IME, yous must do so. Most long-term disability policies take provisions which require that you cooperate with the insurance company in their assessment of your merits. As a result, failing to participate in the IME could cause your claim to exist terminated or denied. You can sometimes fence that an IME should not exist necessary and that yous have provided plenty medical documentation for the insurance visitor to make a decision, but if the insurance company continues to insist that y'all attend the IME, refusing to do so could jeopardize your claim. You should consider contacting an attorney if you lot are being scheduled for an IME and recollect yous accept already supplied enough information.
At Chisholm Chisholm & Kilpatrick LTD, our team of experienced attorneys and professionals has assisted clients throughout the long-term disability claim procedure. Nosotros understand that existence scheduled for an IME is stressful and can potentially jeopardize your claim. If your long-term disability insurer has scheduled yous for an IME and you are concerned near the impact information technology will take on your LTD claim, contact u.s. now at (401) 237-6412 for a FREE consultation to run across if we can assist you.
Source: https://cck-law.com/blog/independent-medical-exams-ime-long-term-disability-claims/