Most long-term disability insurance (LTD) plans will require an independent medical examination as part of their procedure for evaluating LTD claims. In many respects, the independent medical examination required by most long-term disability insurance providers is similar to the special examination required by the Social Security Administration (SSA) for individuals applying for Social Security Disability Insurance (SSDI) benefits. In both cases, regardless of what your specific disabling condition is, you can usually expect that you will be required to submit to at least one medical examination by someone other than your usual healthcare provider at some point during your disability claims process.
Preparing for LTD medical exam (IME) possibilities can be stressful, but reviewing some basic LTD independent medical examination tips can help you feel more confident as you get ready to meet your doctor visit for long-term disability claim requirements. Keep in mind that the details of when and how your own visit will be scheduled are likely to depend on the specifics of your long-term disability insurance policy.
What Happens During an IME?
During the doctor visit for long-term disability claim appointment, a medical professional will conduct an examination to develop their own assessment of your condition. The exact examination will depend partly on the condition for which you are seeking long-term disability coverage. The IME performed on a patient filing for disability with back pain can often look quite different from the examination performed on an individual filing for disability due to multiple sclerosis (MS). Both are likely to differ substantially from the exam for a patient disabled by mental illness. Generally, however, in preparing for LTD medical exam experiences, you can anticipate that the physical assessments, and any questions the physician asks you, will have a logical connection to the diagnosis listed in the paperwork filed for your long-term disability claim.
Independent Medical Examination Ethics and Concerns
The IME is called “independent” because the doctor performing the examination is not one who has been actively involved in your treatment. Instead, they are chosen by the insurance company. Although ethical guidelines established by the American Medical Association (AMA) hold that a healthcare provider’s obligations with respect to the objectivity of diagnostic assessments are unaltered by the special parameters of work for an insurance company or other third party requesting an examination, many people preparing for LTD medical exam have questions and doubts about the genuine objectivity and neutrality of the physician they meet during a doctor visit for long-term disability claim exam. As a result, challenges to IME results are among the more common ways disabled individuals contest unfavorable LTD determinations. If you find yourself in the position of needing to challenge the IME report in your particular case, you may want to review the appeals procedures specified in the terms of your long-term disability insurance policy with an experienced disability law attorney.
LTD Independent Medical Examination Tips: Preparing for LTD Medical Exam (IME) Procedures
There is no way for you to control how the IME will proceed during your doctor visit regarding your long-term disability claim. However, there are a few things you can do to set yourself up for success as you are preparing for LTD medical exam requirements.
Keep a Log of Symptoms
Keep your personal record of symptoms, ideally beginning well before the actual appointment and even before the decision to file for disability. This log is not for the examining physician, but rather for your own reference and to help you organize your thoughts and gain some perspective on the course your condition has followed over time.
You may be asked questions about how your condition has developed and how often you experience your most severe symptoms vs. milder ones. The process of documentation can help you to clarify your thoughts and avoid unintentional inconsistencies brought about by faulty memory. Having the details of your own case history fresh in your mind can be an important part of preparing for LTD medical exam questions.
Review Your Medical Records
Along the same lines, make it a point to obtain copies of your own medical records, and review them carefully ahead of your doctor visit for long-term disability claim date. Be sure you know the contents of your file at the office of every healthcare provider you have seen for your condition, as well as your dossier with both your health insurance provider and the insurance company with whom you are filing your LTD claim.
List Questions From Your Own Care Team
Make a list of questions your own doctor or doctors may have asked of you along your journey through diagnosis and attempted treatments. The doctor conducting the IME may or may not ask you the same questions again, but reviewing those questions and the reasons behind them can often give you some perspective on how a medical professional is likely to think about your set of symptoms and the kinds of information he or she may see as relevant. You may want to consider your review of these previously asked questions side-by-side with your review of the medical records in your patient file, so that you can more easily connect the questions your healthcare team has asked with any diagnostic tests ordered, or treatments suggested, in response to your answers.
Preparing for LTD Medical Exam (IME) Considerations: Personal Presentation
On the day of the appointment, dress and groom yourself cleanly and neatly. Aim to err on the conservative side in your choice of attire and hairstyle, keep any cosmetics minimal, and avoid heavy perfumes or bold jewelry. Like many other LTD independent medical examination tips, the idea in this instance is to show up and cooperate with the process, while keeping your personality, preferences, and any information not directly requested during the doctor visit for long-term disability claim check-in and exam process, strictly private.
LTD Independent Medical Examination Tips: What To Do and Expect During the Appointment
Preparing for LTD medical exams can be stressful. Whether the doctor visit for long-term disability claim actually feels stressful on the day of the appointment, or on the other hand comes as a relief, can depend heavily on individual personality and even to some extent the physical environment and the quality of interactions with office staff. Having a general idea of what to expect during the appointment, and a few LTD independent medical examination tips you can follow during the visit, may make it a little easier to move through the process from check-in to departure with confidence.
Avoid Volunteering Information About Your Condition
When it comes time to actually undergo the examination, avoid volunteering information. Often individuals seeking to “add context” or clarify how symptoms manifest from day to day can inadvertently phrase their ideas in ways that hurt their own case. By simply sharing no information that is not explicitly requested as part of their independent medical examination, individuals can often avoid some of the more common pitfalls associated with medical examinations for disability claims. You may want to extend this general rule not just to your encounter with the examining physician, but to your interactions with staff in the office where you attend your appointment, as well.
Refrain From “Making Conversation”
In a similar vein, it may also be wise to opt out of making conversation, even if you are normally an outgoing person. During your doctor visit for long-term disability claim, casual remarks made in attempts to “fill dead air” can easily come back to haunt you, even if you do not think at the time that they have any bearing on your disability claim. There is no need to be hostile or sullen, but you also have no obligation to act “friendly,” or engage in the social niceties of filling any silence, awkward or not.
Keep It Short and Sweet
Answer questions honestly but succinctly. In keeping with the general principle of avoiding unnecessary communication, keep your answers to any questions posed by the physician performing your IME brief. This does not mean that you should try to conceal any information. On the contrary, it is critical for you to be honest in your responses. Do not, however, elaborate or exaggerate. Instead, keep each answer simple, direct, and to the point. Leave any inferences or connections for the physician to draw, unless you are directly asked.
Correct Inaccuracies
As important as it is to avoid “oversharing” during your doctor visit for long-term disability claim, you still should not allow needless inaccuracies to stand. If you hear a misstatement or detect an inaccuracy in your history as provided to the IME professional, correct the record right away. Speak briefly and avoid speculating on how or why the mistake may have been made, and provide the corrected information and wait for the physician to move on with the examination.
Next Steps as You Prepare For Your Long-Term Disability Examination
You should feel free to request a copy of the report from the physician who performs your IME. Given that there is likely to be several hours if not days between your doctor visit for long-term disability claim appointment and the submission of the physician’s report, you may also want to confirm the reporting procedure with office staff before you leave. One of the most useful LTD independent medical examination tips is that you should be ready to follow-up, especially if you do not hear back within a reasonable period of time. There is no magic solution that will make preparing for LTD medical exam (IME) entirely painless and stress-free, but centering a few key tips can make it easier to navigate an often challenging process.
