The Role of Compulsory Medical Examinations in Personal Injury

Personal injury accidents – and the injuries that result – come in every shape and size. Anyone who has been hurt in an accident and plans to recover financial compensation from another party for the injuries will most likely have to submit to a compulsory medical examination (CME). While there’s nothing different or unusual about it that should cause you to be concerned, it’s still a good idea to meet with a lawyer beforehand to learn how to best protect your interests. Once referred to by the courts as “independent medical examinations (IMEs),” this term is now solely used by the insurance industry. In fact, defense attorneys and medical professionals are not even permitted to refer to the tests as IMEs during trial.

What to Expect from a CME

An interview that discusses:

  • Medical history
  • How the accident occurred
  • What areas of the body were injured and when they cause pain
  • Primary symptoms
  • Movements or activities that aggravate the injuries
  • Treatment or medication that makes the injuries feel better
  • Activities that have been affected

A medical examination that considers:

  • Signs of exaggeration
  • Previous tests
  • What causes distress (getting on exam table, bending down, etc.)
  • Lifestyle factors

Typically, a person in a serious accident gets initial medical care at a hospital and follow-up care with his or her own physician. From a legal point of view, seeking treatment immediately and in this order can greatly help maximize the value of a personal injury claim by making it harder to disprove the gravity of the injuries. Nevertheless, the insurance company may request their own evaluation to confirm that the injuries really occurred, are as bad as alleged, and are not attributable to a different cause.

In motor vehicle accident cases, a CME is often requested by the injured party’s own insurance carrier in an effort to suspend medical benefits or limit medical treatment under Personal Injury Protection (PIP). A CME may also be sought by an insurance company that suspects the injured party is exaggerating the damage or that thinks it can get away with paying less money. Under Florida law, if the injured party does not want to submit to a CME, he or she can be compelled to do so by the court under certain circumstances.

CMEs are supposed to eliminate the bias that the claimant’s physician may have in his or her favor when assessing the extent of the injuries. However, the flip side is that the doctors who conduct the CMEs may well be biased against the claimant because these doctors are hired by the insurance companies and report to them. Performing CMEs can be very lucrative, so many physicians succumb to the temptation of telling the insurers what they want to hear in order to remain on their payroll. In fact, every insurance company has a handful of medical professionals that are regularly retained for CMEs.

Medical reports favorable to the insurance carrier are commonly manipulated to minimize the details, such as saying that the claimant was not injured in the accident, the injury is due to a preexisting condition, the injury isn’t serious, or the injury has completely healed and does not need any further treatment. It’s not hard to see that physicians have a strong incentive to cooperate with the insurance companies’ unspoken expectation that they submit reports negating injury claims – failing to do so means no more profitable referrals and less job security.

While some insurers pay claims to deserving people and some retained physicians remain objective, CMEs are used far too often to deny legitimate victims justice. To ensure you receive all the compensation to which you are entitled, consult an attorney before signing any insurance documents. As one of South Florida's most respected and oldest law firms, Stabinski Lawhas helped many people sort out their legal rights, responsibilities, and remedies. For 45 years, we have been the trusted advocates for countless personal injury victims, and we are highly experienced in handling a wide range of cases. We also work on a contingency basis, which means that if there is no recovery, there is no fee or cost to you. If you wish to learn more about how our firm can be of assistance to you, we encourage you to contact us for a free consultation by calling 305-643-3100 or filling out a case evaluation form.