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#3 - Does my patient have to go to the Independent Medical Exam (IME)?

#3 Does my patient have to go to the Independent Medical Exam, also called an IME?

For Providers, Insurance Medical Exams (IME)

QUESTION: Does my patient have to go to the Independent Medical Exam, also called an IME?

ANSWER: The PIP carrier can’t force your patient to go to an IME. However, they will inform them that based on Oregon PIP statute, your patient is required to cooperate with their PIP carrier, and by not going to the IME they’re in breach of not complying with their PIP policy contract. Technically, they do not have to attend the IME, but if they don’t go they’re not cooperating and their PIP benefits will be stopped.

Does my patient have to go to the Independent Medical Exam, also called an IME?

The PIP carrier can’t force your patient to go to an IME. However, they will inform them that based on Oregon PIP statute, your patient is required to cooperate with their PIP carrier, and by not going to the IME they’re in breach of complying with their PIP policy contract.

Technically, they do not have to attend the IME, but if they don’t go they’re not cooperating and their PIP benefits will be stopped.

The irony however about your patient going to the IME is that if your patient doesn’t attend the IME, the PIP carrier is going to cut off the payments for their medical treatment. But, if they do go to the IME, 95% of the time the report that the IME doctor writes following their exam will justify the insurance company stopping your patient’s PIP coverage.

The good news is that if your patient does comply with the PIP carrier’s requirement and they do go to the IME, nine times out of ten, we’re able to have our client’s PIP benefits restored, despite what the IME report states.

If our client does not attend the IME, it is unlikely that we’ll be successful in having their benefits reinstated, which is why we advise our clients to go ahead and attend the IME.

If your patient has received a letter from the PIP carrier requiring them to attend an IME, the most beneficial thing they can do is to talk with an experienced personal injury attorney. The lawyer will provide a no-fee, no-obligation initial consultation where they’ll ask your patient a number of questions about their accident and injuries. Learning about the details of your patient’s accident and injuries will help the attorney provide your patient with specific advice for their unique situation. They will also explain to your patient the upsides and the downsides for them by going to the IME and helping them determine if attending the exam is in their best interest.

We want your patient to get the guidance they need to make the best possible decision for their circumstances. Whether we represent them or not, we’ll help your patient understand the IME process and the steps they need to take to protect their PIP benefits.

We’re here to be a bridge of support for you and your patients.

We have developed a robust library of information for your patients who have been injured in an accident, which can be found in the INJURED? START HERE portal on our website.

There are 40 topic-focused articles, with accompanying videos, organized into the four categories that include the personal injury claim-related questions we’re asked most often, which include:

Each article provides advice and guidelines to help your patients navigate each phase of the personal injury claims process. Whether we represent your patient or not, we are passionate about them knowing how to protect their rights, get the medical care they need, and avoid the mistakes that can harm their personal injury claim.

Each article provides advice and guidelines to help your patients navigate each phase of the personal injury claims process. Whether we represent your patient or not, we are passionate about them knowing how to protect their rights, get the medical care they need, and avoid the mistakes that can harm their personal injury claim.

Additionally, if it would be helpful to have the information we feature on our website available in your office to pass along to your patients, we’ve developed brochures for each of the four article series -- in both English and Spanish that we’re happy to send to your office. Please complete the form below and we’ll get them out to you promptly.

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