In the intricate landscape of your personal injury claim in New South Wales (NSW), an integral step that may occur, whether you were injured in a car accident, at your workplace, at a hospital or in a public space, is that you will be required to attend an 'independent medical examination' which are commonly referred to as an "IME". An IME plays a significant role in your claim, but its nuances and implications are often misunderstood. This article will explain what an IME entails, its purpose, the process, and its impact on your personal injury claim in NSW.
What is an Independent Medical Examination (IME)?
An Independent Medical Examination is an evaluation conducted by an expert medical professional selected independently of both the injured party or the insurer. It serves as an objective assessment of your injuries, your medical condition, your treatment and treatment needs for the future, your potential for recovery and to provide a prognosis of the lasting impact of your injuries following an accident or injury.
What is the purpose of an IME in your personal injury claim?
The primary goal of an IME is to provide an unbiased and expert medical opinion on your injuries. The aim of the IME is to:
- assess the nature and extent of your injuries
- determine the causal relationship between your reported injuries and the details of your accident
- provide an evaluation regarding your need for ongoing medical treatment and care, and;
- estimate your future prognosis.
It is to be differentiated from your treating doctor as the role of your nominated treating medical practitioner is to treat your condition, whereas an IME doctor is engaged to provide information about your condition in relation to your claim.
Importantly, nothing you say to the expert medical professional in your IME will be confidential. The purpose of an IME is for the doctor to gather information about you that can be used to determine your case.
Your lawyers and any responding insurer to your claim, are not medical experts and for the purpose of your claim, they require the opinion of relevant expert medical specialists to determine your injuries or illness and assistance in the monetary calculation of your claims value. When engaging in the claim process, you are legally required to attend any IMEs arranged by your instructing lawyer and the respondent to your claim.
The process of an IME
i. Selection of the independent medical examiner – The insurer or the legal representatives of the injured party usually nominate a suitable medical expert. This expert should possess relevant expertise in the specific type of injury or medical condition in question and be trained in the compensation scheme relevant to your claim.
ii. Examination and assessment – during the IME, the appointed medical examiner conducts a comprehensive assessment of your medical history, current condition, and will consider any relevant diagnostic tests or reports that you bring to the appointment. They may also ask you in detail about the circumstances surrounding you sustaining your injury.
iii. Reporting – following the examination, the independent medical examiner prepares a detailed report summarising their findings. This report includes an assessment of the injuries, their cause, extent, and impact on your life, as well as your ongoing medical needs, and the likelihood of future recovery or impairment.
What can you expect from an IME?
You will be provided with the relevant details of your IME from your lawyer. You will attend the appointment and thereafter the expert medical specialist will produce a report which will be provided to your lawyer detailing their expert opinion.
It is likely that during your claim, the Respondent insurer will arrange their own IME appointment and you must also attend this appointment for their selected expert to do the same. These reports are then relied on by each party to make their arguments and determine the appropriate compensation to be awarded to you in your matter. The reports provide both parties evidence to calculate the value of your claim and are relied upon when negotiating the resolution of your claim.
Possible questions you may be asked
An expert medical specialist will ask a range of questions which may include:
i. What is your past and present medical history?
ii. How did your injury occur?
iii. What are your ongoing symptoms?
iv. How does the injury affect your daily life?
v. What treatment do you receive?
vi. Do you receive any care and assistance from family or friends?
Importance of an IME in your personal injury claim
In the realm of personal injury claims, an IME holds significant importance for several reasons:
i. Objectivity and impartiality – as an independent assessment, an IME aims to provide an impartial evaluation of your injuries. This impartiality helps in ensuring fairness in the claims process.
ii. Clarification and resolution – conflicting medical opinions between the claimant's treating physicians and the insurer's assessment can arise. An IME serves to provide clarity and resolve discrepancies by offering an additional expert opinion.
iii. Impact on claim outcome – the findings and conclusions of the IME report often hold significant weight in your claim and any contested legal proceedings. They can influence the settlement negotiations or court judgments regarding the compensation amount awarded to you as the injured party.
Ultimately, the aim of an IME is to facilitate a fair and just outcome for all parties involved in the personal injury claim, ensuring that the compensation awarded aligns with the claimant's actual injuries and medical needs. Understanding the role and significance of an IME is essential for navigating the intricate landscape of personal injury claims in NSW.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
