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The 10 Biggest Legal Mistakes Physicians Make When Filing a Disability Claim (Mistake #4)

Business, Disability Claim Denials, Filing Disability Claims, Publications/Articles
MISTAKE NO. 4: Blindly Attending an Independent Medical Exam


Insurers may ask physicians to agree to undergo an “independent” medical examination, where the insurer chooses and pays the person conducting the examination. This person may not even be a physician. Physicians should protect their rights by first verifying that their policy grants the insurer the right to conduct the exam. They must also ensure that the scope of the examination is required by the policy. For example, a neuropsychological exam may be conducted by a psychologist instead of a physician, and the subjective findings used to deny benefits. If the policy requires only submitting to “medical exams” or exams “conducted by a physician,” the physician may not need to submit to neuropsychological testing. Physicians may also request to be accompanied by an attorney or other legal or medical representatives to ensure that the “independent” medical exam remains independent. Additional prudent measures include receiving the examiner’s curriculum vitae in advance, limiting the scope of the exam to avoid painful, protracted, or intrusive diagnostic tests, having the exam video recorded, and receiving a copy of the examiner’s notes and materials.
Action Step: Physicians should work with an attorney to ensure that their “independent” medical exam does not prejudice their rights.

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