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What is a Minnesota No-Fault IME?

Dave Langevin - Thursday, June 06, 2013

Anyone claiming Minnesota No-Fault benefits as a result of a car accident may eventually be asked to attend an Independent Medical Examination (IME).

What is an Independent Medical Examination (IME)?

An IME is a one-time physical examination conducted by a doctor chosen exclusively by the Minnesota insurance company providing No-Fault benefits, sometimes referred to as PIP benefits, or Personal Injury Protection benefits. I refer to these one-time examinations as Adverse Medical Examinatiosn (AME) because, in my opinion, there is nothing "independent" about them.  In my experience, I see the same set of doctors repeatedly used for these examinations, reaching the same opinions and conclusions time and time again.  In fact, I can usually predict what the report will say even before my client attends the examination.

Do I have to Attend the IME / AME?

99% of the time the answer is yes.  Under Minnesota Statutory No-Fault law, Minnesota common law, and the insurance contract providing the No-Fault benefits, an individual is required to attend the examination. Following a Minnesota car accident, the insurance company providing No-Fault benefits has a duty to pay for all reasonable and necessary medical expenses, lost wages, mileage, and replacement services. However, the No-Fault insurance company has the right to send an individual to a doctor of its choosing to obtain an opinion regarding the reasonableness and necessity of the accident related treatment.

What Happens at the IME / AME?

Most of my clients have described the examination as follows:

  • Sit in the lobby;
  • Fill out a sign in sheet; and
  • Meet with doctor for a few minutes bending back and forth a few times while answering some questions about how the accident occurred and maybe some questions about injuries and medical treatment following the car accident.

Most of my clients are able to get in and out of the examination in less than one hour.

What Should I Do, or Not Do, During the IME / AME?

Before, during, and after the examination you should always keep in your mind the fact the insurance company doctor will be an advocate for the insurance company, not you. The doctor is being paid by the insurance company to examine you and to write a report about your physical condition. The doctor is not seeing you for the purpose of recommending treatment or care; therefore, a doctor-patient relationship is not created.

I give the following advice to my clients before the examination:

  • Listen carefully to the questions, and give truthful, brief answers.  Do not be evasive, but do not offer information not directly asked in the question. Do not engage in friendly conversation with the doctor.
  • Tell the truth. Tell the doctor all about the pain and discomfort you have suffered as a result of the car accident.  If you do not tell the doctor about an accident related injury it will not appear in his/her report.
  • Do not discuss any conversations you have had with an attorney about your case.  These conversations are privileged and not allowed.  If the subject of attorneys comes up, simply state you are not allowed to talk about that.  The doctor should understand and respect the attorney-client privilege.
  • Do not allow any laboratory tests, puncturing of your skin, blood draws, or urine analysis.
What Happens After the IME / AME?

The doctor will provide the Minnesota No-Fault claim adjuster a report within a few weeks of the examination. Most of the time No-Fault benefits are terminated at this point.  A copy of the report will be mailed to you and/or your attorney.

Can I Still Receive Medical Treatment After my No-Fault Benefits Have Been Terminated?

Yes. However, you should speak with your attorney after the termination of benefits to develop a strategy for the best way to handle the fact the No-Fault insurance company is no longer paying No-Fault benefits. There are numerous options available to deal with the fact your No-Fault benefits have been terminated.

I always tell my clients to continue receiving treatment, even after the No-Fault benefits have been terminated, if my clients are in pain, and the treating doctors believe there is treatment available to help him/her recover from the pain and suffering of the car accident.

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