DR. MICHAEL FRANCHETTI: I am trying to find out the extent of any injuries that the patient may have sustained when I do an independent medical evaluation. I am asked either by the patient’s attorney or by insurance companies to express the whole gamut of the opinions whether the accident caused the injury and question the extent of permanency of any injuries that the patient may have suffered. Does this patient still have these findings and complaints, do they need any more treatment or management.
DR. MICHAEL FRANCHETTI: If the history does not fit the examination that should raise a red flag. If the patient was complaining of numbness radiating down the arm or leg, we would expect some findings consistent with a pinched nerve whether it would be loss of strength or abnormal reflexes. If you palpate very lightly the skin over the area and the patient is wincing in pain that would be inconsistent with injury to the underlying muscles.Any pain when I do this.If you lightly press on the top of the skull, then they complained that their back hurts and they have severe pain in the neck that is often inconsistent. If you measure somebody’s range of motion of their back and you see that they are complaining of pain and not bending very far and then you distract them and then talk to them while they are getting dressed and you see them bend down from the floor to pickup their shoes with that distraction that is another red flag.
What's an "IME" mean to me?
An independent medical examination, or "IME" is an evaluation performed by a doctor who is not involved in the patient's care for the purpose of evaluating personal injury claims in worker's compensation case and other types of lawsuits.
Most IMEs are conducted to evaluate claims of orthopedic injuries like "whiplash," back and shoulder injuries. In these cases, there are three scenarios in which an IME is typically conducted:
- In an accident case, the defendant and/or his liability insurance carrier may request an IME of the plaintiff to determine the legitimacy of claimed injuries, as well as the nature, extent and cause of such injuries
- In a workers compensation case, the insurance carrier or self-insured employer may seek an independent medical examination to see whether the patient's medical condition is work-related and to assess the level of any permanent injury sustained
- In a personal injury suit, the plaintiff's own lawyer may solicit the opinion of another specialist so that the specialist may lend helpful expert testimony at trial. Though plaintiffs usually call their treating physicians as expert witnesses, their attorneys may prefer a medical expert that is better versed in the field, a better communicator on the witness stand, or, in many cases, is much more cooperative and tolerant of the litigation process
Except for the last of these scenarios, it's important to bear in mind that the "IME doctor" isn't your personal physician, has only been retained to evaluate your claims, and is working on behalf of an insurance carrier with the hope of defeating your claims. Skeptics actually criticize this process by arguing that the independent medical examination is neither independent nor a true medical examination. Because these doctors are hired by one side or another with the expectation that they may serve as helpful expert witnesses, these critics question the independence of the evaluation. Others contend that it is not a true examination in cases where the IME doctor rushes through the physical examination, focusing only on the problems articulated in the case and failing to get a full health picture.
Yet, as Dr. Franchetti demonstrated in this video, a properly-conducted IME allows the physician to evaluate the legitimacy of claimed injuries, their cause, the nature and extent of any permanent injury and what, if any, future treatment may be required. All of these issues are highly relevant to a personal injury case, requiring the testimony of a qualified physician to help admit such evidence at trial.