• Disability Insurance Independent Medical Exams (IME) FAQ #2

Why is my disability insurance company requesting an IME exam?

When an insurance company sends this notice to the claimant and says – we want to do an independent medical exam, what are they really looking for? Why are they asking for this exam?

Well, realistically what they are going to be looking for, in my opinion, is some way to try to justify the denial of a claim. It may have been that they have reviews of medical records, they have one of their internal reviewers look at it, they have questions about maybe have him go through an IME just to document it. Or it is a way to kind of counter what your own doctors are saying. So IMEs can be a lot of times set up when they are initially going to try to initially approve the claim for benefits, or as the case may serve as a ground in the near future to try to determine the benefits.

When these IME exams are requested, is it the same format for every single exam the doctor is supposed to look for or do insurance companies ask the doctors to look for specific things?

You’ll see sometimes especially in a lot of the ERISA appeals, once you get the claim file, you’ll see where they will have a questionnaire sent to the independent reviewer or doctor and say – this is exactly what we want you to look at, we want you to compare it to the job that they are saying, this is where we want you to focus. Other times it may be more of a general overall exam, in other cases it maybe a functional capacity evaluation.

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Since we represent disability insurance claimants at different stages of a disability insurance claim we offer a variety of different fee options. We understand that claimants living on disability insurance benefits have a limited source of income; therefore we always try to work with the claimant to make our attorney fees as affordable as possible.

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John S. (Alabama)

My Dell & Schaefer experience spanned over 7 years and it was in one word “Relief”. A fantastic relief. Why relief? Because dealing with my disability insurance company was nightmarish and D&S instantly relieved me of all the worry. From the very first conversation I had with Greg Dell, on a Sunday I believe, thru his help, he and his most competent team including Alex Palamara, Danielle Lauria, and Anneli De-Cardenas removed the proverbial 800 pound gorilla off my shoulders. Greg and Alex spent an initial, and draining 3 hours listening in while an insurance rep grilled me on an in-home interview. This was after they had filmed me on two separate previous occasions. They even followed me thru Walmart, cameras on! Yes folks, they will try to catch you doing anything outside the limits of your disability. They don’t want to pay you!

My Dell & Schaefer attorneys told me from the start, be honest when you talk to the insurance company people on that interview. I did and from that interview on, D&S handled everything regarding my policy. I was able to sleep at night knowing I had expert representation. Everything from my disability company went through Dell & Schaefer. This was a huge burden, relieved!

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