What is an Independent Medical Reviewer?

When dealing with long term disability claims, a key figure that often comes into play is the independent medical reviewer. This individual plays a vital role in the process, but what exactly do they do? Who chooses them, and how can they impact the outcome of a case? At Bartolic Law, we have extensive experience working with independent medical reviewers and can provide insights into their role.

Understanding the Role of an Independent Medical Reviewer

An independent medical reviewer, also known as an IME (Independent Medical Examination) doctor, is a professional appointed by the insurance company to evaluate the claimant’s medical condition. Their main responsibility is to provide an unbiased opinion regarding the claimant’s disability status.

The insurance company will select the doctor through a third-party vendor. While they are independent in the sense that they are not employed by the insurance company, they are ultimately paid by them. This can sometimes lead to a conflict of interest, as the insurance company may pressure the IME to provide a favorable report for their own benefit.

The Examination Process

During an independent medical examination, the claimant is evaluated by the selected doctor. The purpose of this examination is to assess the claimant’s medical condition, including any limitations or restrictions they may have. The independent medical reviewer will evaluate the claimant’s medical history, perform a physical examination, and may request additional tests or medical records.

The Impact on Long-Term Disability Cases

The opinion of the independent medical reviewer can significantly impact the outcome of a long-term disability case. Insurance companies often rely heavily on the assessments of these reviewers to determine whether to approve or deny a claim. If the reviewer concludes that the claimant is not disabled or can perform certain types of work, the insurance company may use this as a basis to deny or terminate benefits.

However, it is important to be aware of the potential biases of independent medical reviewers hired by insurance companies. These reviewers may have a vested interest in minimizing the severity of the claimant’s condition to save costs for the insurance company.

The Importance of an Experienced Attorney

Given the significant impact that an independent medical reviewer can have on a case, it is crucial for claimants to have an experienced attorney who can advocate for their rights and challenge any biased or unfair opinions.

An experienced attorney will navigate the complexities of the independent medical review process. They can ensure that the claimant’s rights are protected, gather additional evidence to support the claim and challenge any unfair or inaccurate assessments made by the independent medical reviewer. Moreover, they can advocate for the claimant’s best interests and help increase the chances of a successful outcome in the long term disability case.

At Bartolic Law, we have a proven track record of successfully representing clients in long-term disability cases. We understand the importance and impact of independent medical reviewers and are dedicated to advocating for our client’s rights and best interests. 

Reach Out To Us

An independent medical reviewer plays a crucial role in the evaluation of long-term disability claims. Their assessments can significantly impact the outcome of the case, making it essential to have an experienced attorney who can advocate for the claimant’s rights and challenge any unfair assessments. Contact Bartolic Law today to schedule a consultation and learn more about how we can help you.