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#1 - Why is my patient being sent to an Insurance Medical Exam, also known as an IME?

#1 Why is my patient being sent to an Insurance Medical Exam, also known as an IME?

For Providers, Insurance Medical Exams (IME)

QUESTION: Why is my patient being sent for an Independent Medical Exam (IME)?

ANSWER: The most common reasons your patient will be sent for an IME are: 1) there’s little visible damage to your patient’s car, 2) your patient has similar pre-existing conditions, 3) there is a delay from when the car accident happened to when your patient first seeks medical treatment, and 4) there is a gap in treatment, where your patient stops treating with you and then returns to continue treatment.

Why is my patient being sent for an Independent Medical Exam (IME)?

The most common reason for your patient to be required by the insurance company to attend an Independent Medical Exam (IME) is that there’s little visible damage to your patient’s car from the accident.

This reason comes from the misguided belief that if someone is involved in a minor-looking collision, that must mean no one was injured or injured in a way that requires treatment. That’s simply not true. Just as when people who are involved in a car accident where there is substantial damage to the car and they walk away from the accident unhurt.

The second most common reason the insurance adjuster will require that your patient attend an IME is that your patient has similar pre-existing conditions.

The closer in time those pre-existing conditions occurred to when the auto accident happened, the greater the likelihood that your patient will be sent for an IME. That’s why it’s critically important to their treatment to make sure that you carefully document their condition when you first see them after the accident — compared to before the collision, noting if they’ve had any prior similar issues and treatment.

The third common reason is that the PIP adjuster will require your patient to go to an IME if there is a delay from when the car accident happened to when your patient first seeks medical treatment. And the fourth common reason is that there is a gap in treatment, where for example, your patient was treating with you for six months, then they stopped treating for a month or two, and then they returned for treatment.

These are the most common reasons to be aware of why the insurance company may send your patient to an Independent Medical Exam or what we call Insurance Medical Exams.

About 95% of the time, the report from the IME will state that your patient doesn’t need any additional treatment or that their injuries aren’t related to the car accident.

For the best possible outcome when being required to go to an IME is to understand the purpose of the IME, what the IME exam is and isn’t, and how to be prepared for it.

If your patient is being sent to an IME, we’re happy to assist them with preparation — even if they’re not our client. They can also review the series of 10 articles and accompanying videos we’ve developed to walk patients through the IME process and how to prepare for the exam — which can be accessed any time on our website.

We’re here to be a bridge of support for you and your patients.

We have developed a robust library of information for your patients who have been injured in an accident, which can be found in the INJURED? START HERE portal on our website.

There are 40 topic-focused articles, with accompanying videos, organized into the four categories that include the personal injury claim-related questions we’re asked most often, which include:

Each article provides advice and guidelines to help your patients navigate each phase of the personal injury claims process. Whether we represent your patient or not, we are passionate about them knowing how to protect their rights, get the medical care they need, and avoid the mistakes that can harm their personal injury claim.

Each article provides advice and guidelines to help your patients navigate each phase of the personal injury claims process. Whether we represent your patient or not, we are passionate about them knowing how to protect their rights, get the medical care they need, and avoid the mistakes that can harm their personal injury claim.

Additionally, if it would be helpful to have the information we feature on our website available in your office to pass along to your patients, we’ve developed brochures for each of the four article series -- in both English and Spanish that we’re happy to send to your office. Please complete the form below and we’ll get them out to you promptly.

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