Everything You Need to Know About an Independent Medical Assessment for Disability Benefits
What is an Independent Medical Exam?
An Independent Medical Examination also called an IME, is meant to provide an unbiased and professional medical examination as evidence when you are making a long term disability benefits claim. An IME is conducted by a medical specialist who has never previously offered medical care to you.
Why do I need an IME?
Most disability insurance policies allow an insurance company to request that a claimant attend an IME with a doctor that the insurance company has chosen. Insurance companies use these medical assessments as part of their adjudication in disability claims because it helps them to decide what to do about the disability claim. Independent medical exams can be required for both short term and long term disability benefits claims.
Is an Independent Medical Exam mandatory in the disability claim process?
Although you always have the option to decline an IME, a disability lawyer will tell you that it’s important to consider the potential consequences. If your disability claim is pending approval or if you are already receiving disability benefits, refusing to participate in an IME could give the insurance company the power to deny your disability claim or cut off your disability benefits, even if you are unable to work. In most circumstances, a claimant must attend an examination.
What kinds of medical professionals perform an IME?
Medical professionals who may be asked to complete the assessment include: family physicians, specialists, chiropractors, physiotherapists, psychiatrists, and psychologists. Insurance companies will often use the same doctors for independent medical exams in hopes of having a level of control over the medical findings. Although they will choose a qualified medical professional, it may be stressful when you are applying for disability benefits because not all doctors will agree on diagnoses.
Does the insurance company always choose the doctor?
Applying for a disability claim can be a long and complicated process. The long term disability claim process can be especially complicated when your insurance company tries to deny your disability claim. Even if your doctor supports your disability claim for long term disability, your insurance policy may have provisions. These provisions can allow the insurance company to have you assessed by a doctor of their choosing in order to establish if you are truly entitled to disability benefits.
While the medical practitioner chosen by the insurance company must be qualified to do a medical assessment and the medical assessment itself must be reasonable, it can often be an area of great concern for those seeking disability benefits because not all doctors agree on diagnoses.
Can I ask my doctor for a referral instead?
Sometimes a family doctor can feel intimidated going against the conclusions of a specialist who has examined you on behalf of the insurance company. Fortunately, you can ask your family doctor to refer you to another specialist. This specialist can be in the same field as the insurance company's expert, or in the most appropriate specialty for your condition. The combination of a supportive family doctor and a specialist who agrees with your family doctor's findings is persuasive. This combination can help and you may have a good chance of securing your LTD benefits.
Can I record the IME session?
If you would like to have an accurate record of the doctor’s questions and your answers, you may record the session with the doctor’s consent. A recording may also determine whether the doctor’s examination techniques are competent and whether their report corresponds with the insurance company’s decision about your claim.
Can someone join me in my IME?
Although you can request this, many assessors will not allow it and if you insist, they will simply not proceed with the assessment - our disability lawyers have seen this before. Unfortunately, this could result in suspension, termination, or denial of your disability claims based on your non-cooperation. You could contact the College of Physicians and Surgeons to inquire about your rights in these circumstances.
Can I request a copy of the IME?
You do have the right to request a copy of the IME report. If you are dealing with a situation when the insurance company response was “claim denied” based on an Independent Medical Exam, you will want to know why. If you have concerns about whether it is legitimate, please contact the long term disability lawyers at Share Lawyers and ask for a free consultation.
How can I prepare for an IME? Advice from a disability lawyer
Arrive early, know the address, where to park, and be aware of traffic.
Bring in a written list of your medications, physicians, symptoms, dates, activities, restrictions.
If possible, bring in a list of pertinent medical records and diagnostic imaging reports (x-rays, ultrasounds, scans, etc.).
Be honest.
Be polite and courteous.
Dress appropriately.
Bring a family member or friend for support (they are likely not permitted into the examination with you).
Bring a notebook and pen. Take notes after the assessment to record your impressions.
Do not discuss your legal case with the assessor.
If you are unsure about your rights in a situation where you are asked to undergo an independent medical examination, we encourage you to reach out to the long term disability lawyers at Share Lawyers today. Our disability law firm is here to help you navigate your options with the help of a disability lawyer.
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A note from our long term disability lawyers
Taking a medical leave from work is not an easy decision to make. Concerns about providing for yourself and your family and keeping your job may cause you to want to push through your pain, but this won’t make your problems go away. Stopping work is often the smartest decision for your long term health and well-being, and your disability benefits are there to provide you with financial support until you can return to work.
If you have made the tough decision to stop working and apply for your short term disability or long term disability claims, you may feel overwhelmed by the process and have questions that your employer and your insurance company are not able or willing to answer. Share is There to see you through and answer your questions.
A disability lawyer knows what you have been going through
Our disability law firm understands that things have not been easy for you over the last little while. Your health has been suffering, you are unable to work, and now your insurance company, who was supposed to be there in your time of need, has decided they will not pay your disability benefits or respect your disability claim.
Disability benefits exist to provide you with the financial support you need so that you can focus on your health and rebuilding your life. It is unfortunate that your insurance company has not lived up to its promise. If your disability claim has been denied, we will fight to get you the benefits you are entitled to. Our disability lawyers have helped thousands of Canadians get their LTD claim over the past 35 years, and we can help you too.
Our experienced disability lawyers can fight back on your behalf
Share Lawyers believes that every client who is dealing with a disability claim deserves superior personal service. To achieve that goal, we have developed our team of experienced, compassionate, and caring long term disability lawyers, law clerks, and administrative staff to meet all of your needs. Our team of experienced long term disability, life insurance, employment, and critical illness insurance lawyers have made successful disability claims against many insurance companies, third-party administrators and employers.
If you are unable to work, your disability benefits should be there to provide you with the financial support you need. While your insurance company may be focused on finding ways to avoid paying your claim, our focus is on what is in your best interest. When Share Lawyers gets involved, you have an entire team of lawyers that are there to support you and to fight for what is yours.
Our disability claim lawyers and disability law firm fight for your disability insurance claim by relying on our many years of experience to apply the best strategic planning and approach in each case, using the latest technology available. Experience matters, and with Share Lawyers, you are in the best hands with 35 years of success on your side.
In this video, we explain the role of a long term disability lawyer and how we can support you when you have been denied your long term disability benefits.
