An Independent Medical Examination is not Independent.  The doctor that performs Independent Medical Examinations typically works for a company that has been hired by your automobile insurance company.  The Independent Medical Exam is not intended for treatment.  The purpose of the exam is to determine whether your automobile insurance company has to pay for your future medical treatment. If the doctor performing the Independent Medical Examination determines that you no longer need a certain type of medical care, your insurance company will stop paying for that medical care.  For example, if the Independent Medical Examination doctor determines that you no longer need chiropractic care, your automobile insurance company will stop paying for chiropractic care.

WHAT DO I DO IF MY AUTOMOBILE INSURER WANTS ME TO ATTEND AN INDEPENDENT MEDICAL EXAMINATION?

Do not ignore your insurance company’s request for an Independent Medical Examination.  You have to attend the Independent Medical Examination.  If you do not attend the Independent Medical Examination, you will be in breach of your insurance contract and your insurance company will refuse to pay for any future medical treatment.  Once you receive the request for the Independent Medical Examination, notify your attorney and your treating physician.  Your attorney may or may not want to be present for the Independent Medical Examination.  Schedule an appointment with your treating physician for the same day as your Independent Medical Examination.  Bring a notebook to your appointment.  In your notebook, note the time that you arrive, the time you spend in the waiting room, and the time that Independent Medical Examination doctor actually spends examining you.

You should be courteous to the Independent Medical Examination doctor and the doctor’s staff. Fill out all paperwork honestly.  During the examination, the Independent Medical Examination doctor will ask you questions.  Answer the Independent Medical Examination doctor’s questions honestly, but do not volunteer information.    Do not confuse the role of the Independent Medical Examination Doctor with your treating physician.  The Independent Medical Examination Doctor is not there to assist you.  The Independent Medical Examination doctor assists the automobile insurer.

WHAT HAPPENS AFTER THE INDEPENDENT MEDICAL EXAMINATION?

After your Independent Medical Examination, the doctor will generate an Independent Medical Examination report and submit the report to your automobile insurer.  The Independent Medical Examination report will either state that the doctor believes that you require additional treatment, or it will state that further treatment is not necessary.  Usually, the Independent Medical Examination report concludes that further treatment is not needed.  If the Independent Medical Examination concludes that further treatment is not necessary, your automobile insurance company will send you a letter advising you that your insurance company will no longer pay for certain types of treatment.

WHAT DO I DO IF MY AUTOMBILE INSURER REFUSES TO PAY FOR FUTURE MEDICAL BENEFITS BASED ON AN INDEPENDENT MEDICAL EXAMINATION REPORT?

Do not stop your medical treatment.  Advise your attorney and treating physician that your insurer will not pay for certain medical treatment based upon an Independent Medical Examination Report.  Ask your treating physician to send a letter to the automobile insurer disputing the results of the Independent Medical Examination.  This letter must discuss the future treatment that your treating physician believes is medically necessary to treat your injuries.  Continue to treat with your treating physician.  The first time that your automobile insurer denies a bill based upon the results of the Independent Medical Examination, either you or your treating physician should contact an attorney to pursue payment of your doctor’s bill.  Bogin, Munns & Munns, P.A. has attorneys that specialize in resolving personal injury disputes with insurance companies.

CONCLUSION

You have to go to your Independent Medical Examination.  You do not have to accept the results of the Independent Medical Examination.  Your treating physician has been examining and treating you over a period of time.  Your treating physician, not a doctor that examined you once, is in the best position to determine medical necessity. If your insurer denies your medical bills based upon an Independent Medical Examination, challenge the denial.  Do not impede your recovery by stopping your medical treatment.

– Aaryn Fuller, Esq., is an experienced personal injury attorney with Bogin, Munns, & Munns, P.A., a full service law firm with offices in Orlando, Clermont, Kissimmee, Deltona, Daytona Beach, Ocala, Melbourne, Gainesville, and Leesburg, Florida.  Ms. Fuller works out of the Orlando office of the firm and welcomes questions and comments regarding the above and can be reached at afuller@boginmunns.com

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