The goal of IMEs is to render an unbiased opinion of the party’s injuries. Defense counsel, an insurance carrier, or an employer will typically request an IME. They’re requested to resolve disputes on the injury’s cause, to clarify the extent and scope of the injuries, or to determine medical treatment in personal injury cases, worker’s compensation, and disability claims.
Unlike ordinary medical examinations, the physician or medical professional conducting the IME is classified as a consultant. They aren’t the patient’s personal care physician. As such, the patient does not have the privilege of doctor-patient confidentiality. Furthermore, the physician’s only duty is to act as an unbiased third-party examiner.
Some physicians dedicate a majority of their practice to conducting IMEs and doing consultancy work. However, many physicians might not encounter IMEs very frequently. As a physician stepping into their first independent examiner role, there are some factors that must be considered. Below are some tips for physicians to conduct a thorough and quality independent medical examination.
Consult with the Attorney to Understand the Issues
It’s important to remember that a physician hired to conduct an independent medical examination is not a patient’s primary care doctor. Aside from the nonexistence of any doctor-patient confidentiality protections, the limited relationship between the physician and patient should be restricted to the injuries pertinent to the litigation. The defense attorney who hires the physician will often provide a copy of the plaintiff’s medical records. Additionally, they’ll provide an outline of the injuries and any disputed medical issues or questions. In a workers’ compensation case, for example, counsel must first determine whether the injury was work-related.
The physician’s job is to assess the plaintiff’s condition and give an opinion on the medical issues in dispute. They are not responsible for evaluating the entirety of the patient’s overall health or issues completely unrelated to the case. In order to streamline the exam and avoid tangential medical issues, all physicians should first speak with the hiring attorney to clarify the case issues.
Keep Findings Within the Confines of the Complaint
The hiring attorney will pose tailored questions to the physician. They will, of course, relate to the alleged claims of the injury. Just like the exam itself, a physician should make sure that their written findings focus on the issues at hand. When providing their written report, physicians should address the questions the attorney asked, without deviating from the disputed issues.
That being said, the examination should be thorough enough to warrant a medical finding. Oftentimes this may require questions about the patient’s history and other background information.
Keep Thorough Records
Counsel may end up referring to the IME and an expert’s medical opinion numerous times throughout the litigation. As such, it is incumbent upon the physician to retain comprehensive records of the exam. All results of the physical examination should be documented so that a cogent basis of the physician’s medical opinion is readily available. In addition, physicians should be mindful when ordering testing or diagnostic procedures. They are typically beyond the scope of the IME and, if necessary, would need approval from the hiring party.
Avoid Discussing Your Findings
One of the most significant differences between an IME and a regular exam is that no doctor-patient relationship exists. That means that anything a patient tells the physician is not privileged. Counsel may even use this information against the patient. Plus, a physician’s opinions are limited to the IME report’s contents. Furthermore, only authorized parties will receive the report. Physicians should specifically avoid discussing their findings with the patient or patient’s family members. Remember, there is no professional relationship between them.
Keep Your License Active
There’s a good chance counsel will call a physician conducting an IME to a deposition or to testify at trial. When providing a medical opinion under penalty of perjury, and in front of the jury or factfinders, a physician’s credibility and credentials are on display. This is when opposing counsel will automatically trounce to find a potential issue. Ideally, all physicians that conduct IMEs should be board certified with active licenses. Some physicians choose not to practice medicine, but rather, exclusively work as consultants and expert witnesses for legal matters. Although there is nothing unethical about this practice, it does leave the expert susceptible to allegations of being a “hired gun” for the parties. The jury will always view an actively practicing physician with all the necessary and appropriate credentials for their specialty as credible and trustworthy.
Overall, independent medical examinations have very specific distinctions from the general practice of medicine. All of which physicians need to keep in mind when conducting an IME.
