What is an Independent Medical Examination?
I firmly believe what you call something is important. This is why I tell the lawyers and staff at my office to not use the phrase, “Independent Medical Examination.” What I am talking about, of course, is a Defense Base Act insurance company medical examination.
Under the Defense Base Act, the insurance company will usually schedule a medical examination for you to attend. There is usually nothing “independent” about the DBA insurance company chosen doctor. This isn’t always the case, but is usually the case. That is why I call it what it is: a "Defense Medical Examination" or a "DBA insurance company medical examination." I call it what it is.
With that in mind here are a few tips on getting through the “DBA insurance company medical examination:
You Have to Cooperate
The DBA insurance company is paying this doctor to examine you. You are required to cooperate in the examination. You don’t want to sit in court and have the doctor tell the judge about how you did not cooperate.
You must be polite, cooperative, and nice to the doctor. Do not have any type of attitude with the doctor. You catch more flies with honey than vinegar; it is the same with this doctor. Again, you don’t want to sit in court and have this doctor testify that you were a jerk during the examination.
But know this: everything you say to the doctor can and will be used against you in a court of law. Depend on it.
You May Have to Attend Multiple Defense Medical Examinations
Most Judges are going to allow (or require) you to see more than one DBA insurance company doctors. I realize that this can quickly start to feel tedious. But still you actually have to attend and cooperate.
Always Tell The Truth
This is my mantra for my DBA practice and it should be yours too. You have to be honest with the insurance company doctor about everything. You also have to be completely honest with your attorney and the judge with the details relating to your DBA case. I guarantee that if any of these people think you are lying or exaggerating a detail you will not receive your benefits, you will not get the help you need and you will lose your case.
Symptoms and injuries are no exception to the "honest rule". You don't need to exaggerate your pain or fake your symptoms in order get more sympathy, empathy or help. This will not make the process of getting your benefits go faster. In fact it will do the opposite, it will lose your case. Plain and simple.
The DBA Insurance Company's Doctor's Role
This doctor is not seeing you to get you better. Instead, the doctor is seeing you to help the DBA insurance company defend your case. The questions will be asked in a manner to minimize your injuries and try and discredit you and your case. The DBA insurance company is sending you to this doctor because they believe he will hurt your case. This can come in many different variations.
The Doctor Has All Your Records
It isn’t unusual for injured civilian contractors to receive a medical release form from the insurance company handling their DBA claims. Injured civilian contracts are often told that it is necessary to release their entire medical records to the insurance company in order to get benefits, the truth is that these companies are often hoping to find any information they possibly can that will help them minimize or deny your DBA claim for compensation. That's right. The insurance adjuster is simply looking for reasons to deny your claim. They know they can make a lot of money by delegitimizing your DBA claim so they will try every time.
While you definitely shouldn’t hide any relevant injuries, symptoms, or conditions in your medical history, you should realize that—even though some records will need to be released—much of your medical history probably isn’t relevant to your current claim. The insurance company handling your DBA benefits does not necessarily need access to your entire medical record, even though it may request that you sign an unlimited medical release.
If you are being asked to release your full medical records to settle a Defense Base Act claim, protect your privacy by seeking out a well-seasoned DBA attorney.
He/She Has Tricks Up Their Sleeve
These doctors have all these tests that are specifically designed to catch you in lie. They want to prove that you're faking your injury. Whether it’s moving this way or that way or pinpricks, you need to know that this is how they will brand you as a liar. Be sure to answer all the questions truthfully. Some folks think they have to convince the doctor that they are really injured so they fudge a tad here and there. Which, in reality, "fudging" is a case killer. Take your time and be certain of your answer before you respond to the doctor.
The doctor may try and talk to you while doing the movements. The doctor is trying to distract you so that you don’t report pain on movement. Don’t fall for this trick. If you feel pain on movement while the doctor is talking, politely interrupt the doctor and tell the doctor that you are having pain.
Who Pays the Travel Costs of Going tothe DBA Insurance Company Doctor?
In a recent appeals case, the court held that trial Judge wrong in ordering the DBA claimant to attend the defense medical examination and not requiring the DBA insurance company to pay the cost of the claimant attending the examination.
The appeals court ruled, the judge “erred in ordering claimant to bear the costs of his attendance at employer’s medical and vocational examinations in San Diego. Employer must bear the cost of obtaining its own evidence.”
Now let’s talk practicalities. Will you have to attend the medical examination when the insurance company puts up the money? Yes. Will the case be delayed fighting over this point? Yes.
Delays mean that the DBA insurance company doesn’t have to pay for your medical treatment and/or weekly benefits until later. Guess who profits over this delay?
So, look, unless cost is a real issue, this is where it might be smart to pick your fights. Otherwise, you might end up with a two- or three-year delay in your getting benefits based on a small amount of money. You can always make the cost of reimbursement for having to attend the DBA insurance company examination as one of your costs that you are entitled to.
But I understand that sometimes cost is a real factor. For instance, if the DBA insurance company schedules an examination a long way from where you live and you have to travel, you’ll be spending a lot on just getting there. And the chances of the DBA insurance company paying for those expenses are small and you’ll have to fight over the issue.
Finally, you (read: your lawyer) should be prepared to cite the recent Appeals court case that held that the DBA insurance company has to pay for you attending the defense medical examination. You may be successful in convincing the DBA insurance company that they have to pay for you attending their medical examination.
If you have any questions about what you have read here or about "DBA medical examinations" in general get a FREE copy of my book, Win Your Defense Base Act. This book will guide you through the steps of not only building your DBA case but winning it too.