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“Independent” Medical Examinations—What You Need To Know

As an attorney whose entire practice is dedicated to helping victims of car crashes, slip and falls and work accidents (i.e., plaintiffs and claimants), I am constantly presented with requests from insurance companies to send my clients out for “independent” medical examinations. By law, most of the time, a plaintiff or claimant is required to attend. Before we get into the circumstances and parameters of these exams, I want to explain why I have “independent” in quotes.

examWhen an insurance company requires you to submit to one of these examinations, it has the ability to choose which doctor you see. Believe me, when I say that the medical provider the insurance company selects is chosen for a reason. I usually see the same doctors performing these examinations over and over again, many of whom make hundreds of thousands of dollars from insurance companies, annually, solely from these examinations and deposition fees associated with litigation or prospective litigation.

Having said that, how can you best prepare for and handle a defense medical examination? First of all, you have the right to have a relative or legal representative present for the exam. This person can serve as an independent witness in the event that there is a factual dispute over what occurred during the examination. Second, keep track of the time of three segments of the examination: the total amount of time the doctor is present with you in the examination room; the amount of time the physician spends taking a verbal history from you and asking questions related to your condition; and how long the doctor spends physically examining you. When I am litigating a claim, I always point out to a judge or jury that a treating physician spends exponentially more time with the plaintiff/claimant than the insurance company’s hired gun and therefore is in a much better position to render a credible medical opinion about their condition.

Next, it is important to know that the doctor’s office where the insurance carrier sends you cannot compel you to complete any paperwork, including medical questionnaires, pain diagrams or the like. Pennsylvania law does not confer upon the insurance company or its agents the power to make a claimant or plaintiff provide information in this manner, in the context of workers’ compensation claims, motor vehicle accident claims or any other type of personal injury claim. By providing a defense medical examiner with written information concerning the mechanism of your injury, your treatment and/or your present condition, you open yourself up to being cross examined with this documentation.

Last, you have to be very careful when answering questions posed by the insurance company’s doctor, so that the report the examiner generates accurately reflects the information you provide. While the specifics of this piece of advice are difficult to convey in this limited article, I would be more than happy to discuss these tips with you in person. Please remember that our firm offers a free analysis and evaluation of your claim and is located in Hempfield, right off of Good Drive.

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