One of my pensions has refused my claim and I must see a neutral Orthosurgeon for an IME. What usually happens in this time. Is it just a physical? Thanks.
I have had many IME's (I am on workers comp) which is an Independent Medical Exam. This is usually done by a Doctor who is "Bought Off" to minimize the extent of your physical problems. This is not an appointment to receive any medical advice. The report is then forwarded to your primary physician who will either agree or disagree with the IME. The IMS doctor besides doing a physical exam will respond to questions the insurance has about further treatment and to see if you are now stable so the insurance can start to try to deny payment.
Just know the IME Doctor is not your friend but you need to cooperate. Good Luck!
Last edited by Penelopejf; 11-18-2010 at 10:32 PM.
Reason: You might need an Attorney
The IME for your pension may not be as bad as the ones for work comp but there is one fact that is the same no matter what, the IME doctor is paid by the pension plan and looking out for their best interests not yours. When you go for your exam, it is important that you are courteous, non-confrontational and honest. Answer all questions asked but don't volunteer information. If you aren't sure what a question means, ask. If you don't know an answer to a question, "I don't know" is a perfectly fine answer. If something the doctor is doing causes discomfort, tell him. If it is painful, tell him to stop.
When I had my WC IME, I was early and the doctor was late. While I was filling out a couple questionnaires, the doctor was getting the room ready?!? Then the doctor came out to the front and "chatted" with my husband. The doctor had driven up in a muddy Hummer so they were talking about hunting and black powder shooting. I said something about not being able to do those things anymore. The IME went about as I expected and when I got the report, I read in the narrative that (I) had to give up hunting and competition shooting. Boy am I glad I chimed in because hubby was volunteering information that made it look like we were doing those things, when I had not been able to for almost 3 years.
L2-S1 & SI fusion
High BP & cholesterol
C5-6 6-7 herniations
When I worked in the STD/LTD insurance industry any IME had to be done by an independent doctor who is impartial. Their decisions can not solely sway one way or the other. Attorneys who work in disability and WC law can monitor the "direction" history of the physician's decisions. So any good attorney, if you have WC and are using an attorney, will know or will gather information on the decision history of the doctor. We would often not use certain physicians if we found they too often made decisions to favor us as we felt they were in it to please us thinking they'd get more business but instead we'd cease using them (and I worked for some of the huge companies)
I would recommend taking a history of your physicians, proocedures and medications related to your disabling conditions. They asked me to bring a current medication list but when the doctor (this was for SS) asked about my surgical history I got a bit confused (as did he) as I have a HUGE surgical history. The exam is so fast he didn't have time to review 20+ years of surgery. So if I had that in my hand I could have provided it to him. He had most of the records from my doctors but SS had not provided him with the list of surgical procedures that I had provided to them. I
spine az- i wanna say about you not bringing your sx history is in your favor-you dont need THAT GUY to comment on it-only your treating dr-you will see, that is what will county you didnt need the ss consulting to muddy the water with his opinion about your surgery- especially since he is not a suregeon, especially since he is not your treating dr. when you go to these ss consults-just go, let them due whatever it is ss has asked them to due in regards to your claim-DO NOT volunteer xtra info-count on your treating dr notes only. I say this because i have already been thru it; it was tough,hard,nerve racking-you name it-the whole process cannot be appreciated until you have been thru it-just cuz i had a difficult time doesnt mean someone with less medical issues will-there is no use in comparing, it wont make any sense at all. At the end i finally just got to a point where i said to myself, I no gonna let these eat away at me anylonger-if iwin my claim then great- i knew at that point it had nothing to do with how another person's ssdi was granted-how badly they were disabled or anything-i am glad it is over and i pray for you all to get there soon with a favorable reply-just pray and try to be consistant at all medical evaluatuions-that is all you can do.