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What is a No-Fault IME in a Car Accident Case?

If you sustained injuries in car accident, in New York you are entitled to receive no-fault benefits. No-fault benefits will pay for your medical treatment for the injuries sustained in the accident. You need to make sure that the health care providers you see accept no-fault patients. During the course of your treatment, you will most likely be required to attend no-fault Independent Medical Examinations. Commonly referred to as an "IME," these exams are conducted by doctors who are selected and paid by the insurance companies.

The right to hold a no-fault IME is contained in the insurance policy that is providing the no-fault benefits to a car accident victim. The person examined is a claimant. The exam is often done pre-litigation and determines whether the medical benefits provided by the insurance company should continue.

What Kind of Exam is an IME?
Depending upon the type of injuries you sustained, no-fault IMEs are usually requested in any medical specialty in which you are presently receiving treatment in. The most common specialties are listed below:

  • Pain Management
  • Psychiatry
  • Orthopedics
  • Neurology
  • Chiropractic
  • Acupuncture

Often, accident victims have several different types of injuries. You may be required to attend more than one no-fault IME if your injuries require treatment in various specialties. However, you can only be required to attend an IME for each specialty once, unless the doctor finds that your benefits should continue with treatment. You may then have a follow-up examination.

A no-fault IME will be initially scheduled without any input on your behalf. If the date, place and time are not convenient you can reschedule You can usually reschedule a couple of times.
You should call the place that assigned the IME if you need to reschedule. You should not disregard the notice.

It is a violation of the terms of the insurance policy to fail to attend a scheduled IME, and, if you fail to attend multiple scheduled no-fault IMEs, the insurance company can terminate your benefits.

It is not unusual for a no-fault IME doctor to determine that your injuries are resolved, even if this opinion contradicts your treating doctor. If the IME doctor's opinion is that your condition doesn't warrant further treatment, your medical benefits can be denied or cut off.

However, if the IME doctor finds that you have not reached maximum medical improvement, the insurance company will continue to pay for your medical treatment and you will be scheduled for a follow-up IME weeks later.

What Should I Expect at an IME?
It's important to remember that the IME doctor is not your treating physician. While you must be truthful with the doctor about your injuries, be careful not to offer unnecessary information

Once you arrive at the appointment, you may be asked to fill out paperwork. If you have any questions or if something doesn't look right, it is a good idea to contact your attorney. In addition, you should assume that you're being watched while in the waiting room. IME doctors will often try to discredit your claims of physical pain or limitations by observing you do something you say you can't.

Before the examination, the doctor will have reviewed your medical records associated with the accident. When you meet with the doctor, you will be asked about how the accident occurred, your treatment, complaints, current employment, and how the injuries affect your daily life. The doctor will also ask about past injuries or medical conditions.

The IME doctor will document your responses to his or her questions, as well as their medical findings, and generate a report. This is why it's crucial that you fully understand each question and ask for clarification if you don't understand a question.

Contact an Experienced New York Personal Injury Attorney
If you have been in a car accident and are scheduled to appear for a no-fault IME, and are presently unrepresented, you should contact a personal injury attorney immediately who can advise you of your legal rights. An experienced personal attorney can help you recover the compensation you deserve for your injuries, medical expenses, and time lost from work.

The Popick Law Firm has over thirty years of experience in obtaining compensation for car accident victims as well as those who have been injured in slip and falls, trip and falls, and other accidents. Located in Fresh Meadows, NY, The Popick Law Firm handles personal injury cases in Queens, Brooklyn, Manhattan, the Bronx, as well as Nassau and Suffolk counties. Contact The Popick Law Firm today for a consultation.