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Disability Insurance Doctors Must Exercise Reasonable Care

Filing Disability Claims

In Arizona, although a formal doctor-patient relationship does not exist between an Independent Medical Examination (IME) doctor and a disability claimant, the IME doctor may still be liable if he fails to exercise reasonable care while administering the IME.  Ritchie v. Krasner, 221 Ariz. 288, 294 (Ct. App. 2009).

This was held in Ritchie v. Krasner. The dispute in this case arose between relatives of the decedent, Jeremy Ritchie, and several physicians, including Jeremy’s IME doctor.  Jeremy suffered a severe back injury while at work, which made him unable to continue working.  In order to receive compensation for the period when he could not work, Jeremy was required to undergo an IME.  Prior to the IME, Jeremy signed a notice, which stated:

It is very important that you realize that no Doctor/Patient relationship exists between you and Dr. Krasner. . . . This is done to insure that all findings will be neutral, and that the evaluators are completely independent and not involved in your disability claim or source.

The IME doctor failed to diagnose Jeremy with a spinal cord compression.  Instead, the IME doctor advised Jeremy to go back to work.  Unfortunately, the condition of Jeremy’s spinal cord compression worsened and eventually Jeremy had to be hospitalized for further treatments.  This time, though, the doctors diagnosed spinal cord compression; but because it went unattended for eight months following the IME, part of Jeremy’s spinal cord was permanently damaged, leaving him in considerable pain.

Jeremy’s family sued the IME doctor, alleging the IME doctor misdiagnosed Jeremy’s medical condition—a deviation from the standard of care which a physician owes a patient.  This negligence, they contended, increased Jeremy’s risk of injury and contributed to his ultimate death.  The IME doctor, on the other hand, argued that he did not owe Jeremy a duty to exercise reasonable care because, as the signed agreement indicated, no formal doctor-patient relationship exists between IME doctors and their IME patients; therefore, even if he was negligent in treating Jeremy, he could not be liable.

The Arizona court disagreed with the IME doctor, holding that “even absent a formal doctor-patient relationship, a doctor conducting an Independent Medical Examination (“IME”) owes a duty of reasonable care to his or her patient.”  Id.  Therefore, the signed notice which recognized an absence of a doctor-patient relationship was deemed irrelevant.

The duty of care imposed on IME doctors is not uniform nationwide.  In fact, in some jurisdictions IME doctors do not have a legal duty of care toward their IME patients.  See Smith v. Radecki, 238 P.3d 111 (Alaska 2011).  Additionally, the standard of care may be lower for an IME doctor compared to that of a treating physician.  Therefore, even if you undergo an IME, you should still receive treatment and care from your own doctor who you trust.

Disability insurance claimants should also understand that IME doctors are hired and paid by disability insurers, so they may not be looking after your best interests during an IME.  And if the law holds IME doctors to a lower standard of care, this may afford them greater flexibility to render opinions that favor disability insurance companies—even when these opinions are not completely accurate.  Therefore, if you have filed for disability benefits, you should seek an attorney who will closely scrutinize the IME process to make sure your evaluation is administered appropriately.

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