You’ve been injured, followed your doctor’s treatment plan, and provided medical records. Now, the insurance company is demanding an Independent Medical Examination (IME)—a second opinion from a doctor they choose.
This isn’t just routine. IME doctors are often selected to protect the insurance company’s interests, not yours. They may downplay your injuries, question your treatment, or use the report to deny or reduce your claim.
If you’re in Las Vegas or anywhere in Nevada, it’s critical to understand your rights before attending an IME. How you handle this request can significantly impact your claim—here’s what you need to know.
Why is the Insurance Company Requesting a Second Opinion?
When an insurance company requests an Independent Medical Examination (IME), it’s rarely because they want to confirm your well-being. While they may claim it’s standard procedure, an IME is often used as a tool to challenge your injuries, delay your claim, or reduce your payout.
Understanding why they are making this request—and whether it’s a red flag—can help you prepare.
Common Reasons for an IME Request
Insurance companies use second medical opinions for several reasons, including:
1. Confirming Your Diagnosis and Treatment
- They may claim they need more medical clarity before approving or denying your claim.
- The IME doctor will assess whether your diagnosis matches the reported accident and whether your treatment plan is “necessary.”
- Why it matters: If the IME doctor downplays your condition, the insurance company may reduce or deny coverage for future medical costs.
2. Assessing the Severity and Permanency of Your Injuries
- If your injuries are long-term or disabling, the insurance company may try to limit their financial liability by disputing the severity.
- The IME report could be used to argue that:
- You are recovering faster than expected.
- You can return to work sooner than your treating doctor advised.
- Your condition isn’t permanent and won’t require ongoing treatment.
3. Looking for Pre-Existing Conditions to Blame
- One of the most common IME tactics is to attribute your pain to a pre-existing condition instead of the accident.
- This is especially true for back injuries, joint issues, or chronic pain.
- Example: If you had mild back pain before the accident, they may claim the crash didn’t make it worse—it just aggravated something you already had.
When an IME Request is a Red Flag
Not all IMEs are legitimate. Sometimes, an IME request is a sign the insurance company is preparing to undervalue or deny your claim.
Here are red flags to watch for:
| Red Flag | What It Might Mean |
|---|---|
| The doctor is known to work for insurers | The IME doctor may have a history of siding with insurance companies. |
| You’ve already provided strong medical evidence | They are looking for a reason to dispute your existing records. |
| They request multiple IMEs | Excessive exams may be a stall tactic to delay your claim. |
| You were given little notice or no choice in scheduling | They are hoping you won’t prepare properly for the exam. |
Key Takeaway
If an insurance company is requesting a second opinion, it’s likely because they are looking for a reason to dispute or limit your claim. Knowing why they’re asking and spotting red flags early can help you prepare for what’s ahead.
The IME Process: What to Expect
When the insurance company schedules an Independent Medical Examination (IME), it may seem like a routine step, but it is often a way to challenge your injuries and limit your payout. Understanding what happens before, during, and after the IME can help you prepare and protect your claim.
Step 1: Scheduling and Preparing for the IME
- The insurance company will assign a doctor to examine you and determine whether your injuries match your claim.
- You may have little to no say in who the doctor is or where the exam takes place, but you can research the doctor’s background.
- Being well-prepared for the exam is critical.
What to bring to the IME:
- Copies of your medical records and test results
- A pain journal documenting your symptoms and limitations
- A list of medications, treatments, and doctor visits
- Any assistive devices you use, such as a brace, cane, or crutches
Your rights before the IME:
- You may be able to refuse an unreasonable IME request if it is excessive or unnecessary.
- You can bring a witness or legal representative in some cases.
- You have the right to request a copy of the IME report once it is completed.
- Nevada law requires that IME doctors be properly licensed and impartial. If there are concerns about bias, you may have grounds to challenge the report
Step 2: What Happens During the Exam?
An IME is different from a normal doctor’s appointment. The doctor is not there to treat you—they are evaluating your claim on behalf of the insurance company.
What to expect during the IME:
- The doctor will ask about your accident, injuries, and treatment.
- They will review your medical records but may focus only on certain details.
- A physical examination will take place, often including mobility tests, range-of-motion checks, and strength assessments.
The IME doctor may try to test whether your symptoms match your claims. Some insurance-appointed doctors are known for minimizing injuries or suggesting you are exaggerating your pain.
Important reminders:
- Be polite and cooperative, but do not offer extra details beyond what is asked.
- Answer all questions truthfully but do not downplay or exaggerate your pain.
- Take mental notes of what is said and how the doctor conducts the exam.
Step 3: The IME Report and What Comes Next
After the exam, the doctor submits a report to the insurance company, which may have a direct impact on your claim.
| IME Report Finding | Impact on Your Claim |
|---|---|
| Confirms your injuries | The claim remains valid. |
| Downplays your injuries | The insurance company may reduce your payout. |
| Blames pre-existing conditions | Your claim may be denied or devalued. |
| Suggests you can return to work | Wage loss benefits may be cut off. |
The insurance company will likely use this report to support their decision on your settlement. If the findings are inaccurate or biased, you may need to take action.
Protecting Yourself During an IME
An IME is not a neutral exam—it is an evaluation designed to benefit the insurance company. That is why how you handle the appointment matters.
How to Ensure a Fair Evaluation
- Be factual and concise. Answer only what is asked. Avoid unnecessary details.
- Do not speculate. If you do not know an answer, say so. Do not guess.
- Stick to describing your symptoms as they are. Do not minimize or exaggerate your pain.
- Document everything. Take notes immediately after the exam about what was said and done.
- Follow up with your own doctor to document any discrepancies.
Additional Tips for Your IME
| Do | Avoid |
|---|---|
| Arrive on time and act professionally | Being overly friendly or chatty with the IME doctor |
| Bring medical records and assistive devices | Speculating about your condition or treatment |
| Clearly describe your pain and limitations | Exaggerating or downplaying your symptoms |
| Wear comfortable but appropriate clothing | Appearing too healthy if you are experiencing real pain |
Key Takeaway
An insurance-ordered IME is rarely in your best interest. However, by preparing properly, understanding your rights, and handling the exam carefully, you can protect your claim.
If the IME report misrepresents your injuries or downplays your condition, you have options—next, we’ll explain how to challenge a biased IME report and protect your right to full compensation.
What if I Disagree with the IME Report?
If the Independent Medical Examination (IME) report contradicts your doctor’s findings or downplays your injuries, you are not powerless. Insurance companies use IME reports to justify reducing or denying claims, but there are steps you can take to challenge an unfair report and protect your rights.
Common IME Issues That Can Hurt Your Claim
Insurance companies often rely on IME reports that contain:
- Minimized injuries – The doctor claims your condition is less severe than what your treating physician has documented.
- Pre-existing condition claims – The IME suggests that your pain is not related to the accident, but rather from an old injury or underlying health issue.
- Conflicting medical opinions – The IME doctor disagrees with your treating physician, giving the insurance company grounds to question your claim.
- Suggestions that you can return to work – If the report states you can resume normal activities, the insurance company may cut off wage loss benefits.
Steps to Challenge an Unfair IME Report
If the IME report is inaccurate, taking quick action is key. Here’s what you can do:
1. Get a Second Opinion from Your Doctor
- Schedule a follow-up appointment with your treating physician.
- Ask them to review and respond to the IME findings in writing.
- If needed, request updated medical tests to further document your condition.
2. Request a Copy of the IME Report and Review It Carefully
- You have a right to see the report—request a copy as soon as possible.
- Look for inaccuracies, contradictions, or missing information.
- Compare the IME findings with your past medical records and doctor’s notes.
3. Have Your Attorney Challenge the IME Findings
- If the IME report contains biased or inaccurate information, a lawyer can dispute its validity.
- An attorney may:
- Provide medical evidence that contradicts the IME report.
- Cross-examine the IME doctor’s history of working for insurance companies.
- Argue for a new IME with a different, neutral doctor if the first one was unfair.
4. File a Formal Dispute if Necessary
- In some cases, you may be able to file a formal dispute with the insurance company regarding the IME findings.
- If the insurer refuses to reconsider, legal action may be necessary.
Key Takeaway: The IME doctor’s opinion is not final. If the report misrepresents your injuries or unfairly impacts your claim, you have options to challenge it and present stronger medical evidence.
When to Seek Legal Help
An IME request is often a sign that the insurance company is looking for ways to weaken your claim. If the IME results in an unfair report, or if the insurance company is using it to delay or deny your case, legal representation may be necessary.
Signs That You Need an Attorney
If you are facing any of the following issues, it may be time to speak with a lawyer:
- The IME report contradicts your medical records and downplays your injuries.
- The insurance company is using the IME to deny medical treatment or cut off wage benefits.
- You believe the IME doctor was biased or had a history of favoring insurers.
- You were pressured into multiple IMEs, raising concerns about fairness.
- The insurance company is ignoring evidence from your treating doctor.
How an Attorney Can Help
| Legal Advantage | What It Means for Your Claim |
|---|---|
| Challenging a biased IME report | Ensures your injuries are accurately represented. |
| Negotiating with the insurance company | Prevents unfair denials or reductions in compensation. |
| Demanding a new IME with a neutral doctor | Provides a second, unbiased medical opinion. |
| Filing a lawsuit if needed | Holds the insurance company accountable for unfair tactics. |
Key Takeaway: If an IME is being used against you, having an experienced attorney can make the difference between a denied claim and a full settlement.
Jack Bernstein Injury Lawyers: Your Advocates in the IME Process
For over 40 years, Jack Bernstein Injury Lawyers has been fighting for injury victims in Las Vegas who have been unfairly treated by insurance companies.
Why Choose Jack Bernstein Injury Lawyers?
- Direct, hands-on legal representation—not just a case manager.
- Proven success in challenging biased IME reports and unfair insurance tactics.
- No fees unless we win—we fight for you without upfront costs.
- Free consultations to review your IME and discuss your legal options.
If your insurance company is using an IME against you, you don’t have to face them alone. Jack’s got your back.
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Contact Us for a Free Consultation
If you have been injured in an accident, contact Jack Bernstein Injury Lawyers for a free, no obligation consultation with experienced Las Vegas accident lawyers. You will gain an advocate for every stage in the claims process until you have the compensation you deserve.
Jack Bernstein Injury Lawyers is available to help you handle your injury claim in the Las Vegas metropolitan area and beyond. Jack Bernstein and his team can offer you the personalized service and legal representation you deserve after an accident.
Call us at (702) 633-3333 or contact us today for a free consultation to discuss your case.
