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Why am I being sent to an IME?

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An insurance medical exam is used by the insurance company to stop paying your medical bills and wage loss. The doctor is not there to treat you or to help you get better. The IME doctor will likely report that you do not need any additional treatment, just what the insurance company wants in order to cut off your benefits.


Here is a list of possible reasons why the insurance company is sending you to an IME:

THERE WAS NOT MUCH VISIBLE DAMAGE DONE TO THE CAR YOU WERE IN.

 

Insurance perspective: If the car doesn’t appear to be badly damaged, any injuries you have must be minimal.

 

Reality:  People can be severely injured in traffic accidents even if there is little or no damage to the vehicles.  For example, if your head or body is turned at the time of impact, you’re in a more vulnerable position.  Also, some people are more fragile than others.  Some people walk away from a violent crash in which cars are destroyed, while other people can be injured when there is no car damage at all.


YOU HAVE PRIOR SIMILAR INJURIES OR TREATMENT

 

Insurance perspective:  If you had a similar problem in the past, your current injury must be caused from that.

 

Reality:  Just because you may have had an injury before the collision does not mean you are incapable of being injured again. Oftentimes people injure certain body parts more than once over the course of a lifetime. A sprained neck in the past doesn’t mean it’s impossible to have another sprained neck later.


THERE WAS A GAP IN YOUR TREATMENT.

 

Insurance perspective:  If you were truly injured, you would be treating for it regularly. If there are any gaps in your treatment it means that you stopped because your injury resolved and the need for more treatment later must be the result of something else. 

 

Reality:  Doctor’s availability, transportation, work obligations, or the lack of insurance can result in a gap in treatment. Sometimes injuries seem to have healed, but the symptoms return after the patients start to resume their normal lifestyles.   


THERE WAS A DELAY IN TREATMENT.

 

Insurance perspective:  If you experience a delay in symptoms, those injuries must have been caused by something other than the motor vehicle accident.

 

Reality:  After an accident there is typically shock and adrenaline that can overshadow injuries. It can take time for some injuries to be felt. More severe injuries can mask less severe injuries.  Some injuries progress over an extended period of time.   Just because an injury isn’t instantly reported doesn’t mean the later symptoms are unrelated.


THERE WAS A SUBSEQUENT INJURY. 

 

Insurance perspective:  If you need more treatment, it is because something new happened.

 

Reality:  Your injury can be made worse by something that happens later. A past injury can also make you vulnerable to a future injury.  If your motor vehicle injury has contributed to a later injury, the PIP insurer may still be responsible for the additional care you need.


YOU SHOULD HAVE ALREADY RECOVERED.

 

Insurance perspective:  Injuries heal within defined periods of time.  You should be done treating.  

 

Reality:  There is no way to determine when an injury will fully heal. All people are different and injuries range in severity and recovery time. Some people may fully recover from their injuries while other people may never fully recover.