Independent Medical Exams Are Not Really Independent

Tucker Law Group
January 18, 2017

Listen as John V. Tucker describes why independent medical examiners aren’t really independent.

If you are dealing with a long term disability case, chances are that you have heard of independent medical exams, or IMEs. You may have even been asked to undergo such an exam. Are these doctors really independent?

In most cases, the doctors performing these exams are not really independent. Insurance companies often say they use a vendor so that they have no influence over the vendor’s choice of doctors, but this is not true. The insurance companies use the same vendors, which have the same doctors. Chances are that the doctor has dealt with that insurance company multiple times before. Some of these doctors and vendors make thousands of dollars from the insurance companies. If your insurance company asks you to see their doctor, you should be wary.

Let’s look at a previous case that I handled. My client, Susan, had a serious pain problem. The problem were so severe that she had a pain pump installed in her body so that her medication would reach her system faster, resulting in less pain. Her insurance company sent her to a doctor who had previously filed a report that said she couldn’t work, but this doctor then changed his report to state that she could work. The insurance adjuster had reached out to the doctor to have the report changed to favor the insurance company. How did we find this out? With further investigation in her report, we found a statement that led us to question what happened, which in turn led us to information about the adjuster trying to get the report changed. Watch the video to learn more.

If you have questions about Independent Medical Examinations, I want you to call me at (866) 233-5044. I welcome your call.

Video Transcript
Are the disability insurance companies independent medical examiner's really independent? I'm John Tucker. I'm a disability attorney and I represent people like you all across the United States in disability insurance and long-term disability cases. I've handled cases against all of the major disability insurance companies: Aetna, Cigna, Unum, Prudential, MetLife Standard and others. Are these doctors that they're going to send you to really independent? Very often, no.

These insurance companies try to mask who they're hiring by using outside vendors. They say, “Well we use an outside service so we have no part in picking the doctor.” The problem is that they use the same vendors who pick the same doctors over and over. And some of those doctors as well as the vendors make not only tens of thousands, but hundreds of thousands of dollars off these disability insurance companies. In our office we call that knowing where your bread is buttered.

In the case of these insurance companies, if they're going to send you out to one of their doctors, that should raise red flags for you. Let me tell you a story about one of my clients. Her name was Susan and Susan had a very serious pain problem resulting from an injury. Susan’s injury was so bad that one of her doctors had actually installed what's called an intrathecal pain pump. This is a medical device that actually is installed in the body and pumps pain medication directly into the body to get the medicine there faster to do a better job.

Her insurance company sent her to a so-called independent medical exam. She didn't have a choice because her policy said she had to go. When she went, unbeknownst to her, the doctor actually wrote an initial report that said she couldn't work. In the background, behind the scenes, the insurance adjuster reached out to the vendor they used to ask the doctor to change the report. Later, when the report got changed, he miraculously decided she can work.

How did we find out about that? As part of our investigation, we got their entire claim file. And we found one little snippet in one sentence in their internal notes that let us to question what had happened. We’ve done thousands of these cases, so we had a sense that something had gone very strange in her case. After we did more investigating, we found out about the adjuster trying to get the opinion changed and how that so-called independent doctor changed his opinion.

If your insurance company is trying to send you out to a mandatory medical examination, call me at the number on your screen to talk about your rights. I've handled thousands of cases for people just like you all over the United States. I'm John Tucker. Thanks for watching.