¿Qué Es un IME?
An Independent Medical Examination (IME) is a medical evaluación requested by an insurance carrier — Sin Culpa, or liability — and performed by a médico of the carrier's choosing. The purpose of the IME, from the carrier's perspective, is to obtain a medical opinion that minimizes or eliminates their obligation to pay benefits or damages.
The word "independent" is somewhat misleading: IME médicos are typically paid a significant fee by la aseguradora, perform dozens or hundreds of IMEs per year for carriers, and have professional relationships with the carrier's legal team. This is not to say all IMEs are dishonest — but the financial relationship between IME médicos and carriers is well-documented and is routinely explored in cross-examination en el juicio.
Your Rights During an IME
In Nueva York, you have the right to have your abogado or a representative present during the IME. You must attend the IME when validly requested — failure to appear can result in suspension of Sin Culpa benefits or Sin Culpa payments. However, you are not requerido to submit to any examen físico procedure that causes pain or that your médico has directed you to avoid for medical reasons.
You should bring a list of all treating médicos, all medications, and all diagnoses to the IME. You should not volunteer information beyond what is directly asked. If you are uncertain how to answer a question, it is acceptable to say "I don't know" or "I can't remember." Do not speculate or estimate.
How Your MAIC Records Protect You Against IME Denial
The single most effective protection against IME-based claim denial is a comprehensive, objective clinical record from your treating médicos. IME médicos frequently argue that injuries are pre-existing, exaggerated, or not causally related to the accident. A treating médico's record that includes objective rango de movimiento measurements, MRI findings with specific level and severity documentación, NCV/EMG study results, and functional resultado data is extremely difficult to dismiss with a one-time examination.
MAIC's clinical records are specifically structured to counter the most common IME arguments — including the pre-existing degeneration defense, the delayed tratamiento argument, and the inconsistency argument. If your Sin Culpa or Sin Culpa benefits are cut off after an IME, MAIC's treating médicos can provide documentación support for your appeal or arbitration. Call (888) 991-5290 to discuss your situation.