Brain Injury Independent Medical Exam after a Brain Injury – Beware of
The term used in lawsuits is “IME” for brain injury Independent Medical Exam. Those words get plaintiff attorneys as irate as the word “mild” in reference to brain injury, gets me. Defense lawyers don’t want independent exam, nor second opinions. What they want is their hired gun to find some excuse to deny brain injured person benefits.
Be forewarned when you are sent for your brain injury independent medical exam “IME”. You are going onto the darkside, the enemy camp. Insurance companies make a profit by not paying claims to brain injured individuals. While insurance should just be about the gamble, paying up when they lose, insurance claims are not paid by the bean counters. They are paid by business men and women, whose advancement within the company or industry is not going to be built on a fair profit. To move up they must find a way for the claim department to pay less than the bean counters estimated.
The way to pay less than the bean counters predicted is to minimize claims and deny benefits. While there should be a legal limit as to how far the “adjusters” can go there is the Court to as a practical problem to rain in the adjusters. The incentive of adjusters, and thus defense attorneys, is to push cases as close to the limit as possible. The less that is paid, the more success for the individual adjuster and the company.
The check on the system is legal action. The insurance company must hire an attorney, pay for DME’s, costs.
So that is the basic structure of the system.
Into this mix process steps the insurance medical exam. These expert witnesses are paid far beyond their routine rates, to see the plaintiff for a few minutes and find some reason for the adjuster to pay less than he should. Remember this: This is one of the most profitable types of work for physicians to do, especially as a result of managed care. There are experts who will slant their opinions towards the insurance company. If you were an adjuster, who would you hire, the independent doctor or the hired gun?
The brain injury independent medical exam (IME) is not the “good hands doctor”, who is there not to offer you a helping, but a to provide the defense attorney with a sleight of, hand.