The 10 worst mistakes IME examiners
By Steven Babitsky, Esq.
The Independent Medical Evaluation
(IME) reports that physicians prepare are playing an increasingly
important role in workers’ compensation cases, personal
injury litigation, and long-term disability claims.
Each year physicians prepare
hundreds of thousands of IME reports, which are read and utilized
by judges, hearing officers, and plaintiff and defense attorneys
to decide and settle claims.
Physicians are frequently called
upon at depositions, hearings, or trials to support, justify,
and defend each and every word of their IME reports. With this
in mind, we turn to the 10 biggest mistakes physicians make
in writing their IME reports.
No. 1 mistake: Not answering
the questions asked. Physicians frequently do not answer
the questions posed by the referring client. These physicians
either opine in areas they were not requested to address or
do not answer questions posed by the client.
Solution: Get a clear
understanding of the questions the referring client wants answered.
No. 2 mistake: Expressing
opinions outside their area of expertise. Physicians
make the mistake of straying from their areas of expertise and
expressing opinions in areas in which they are not truly an
Some examples include opining
in areas outside of their medical discipline and specialty and
using legal and other terms for which they do not know the definition.
Solution: Stay in your
sandbox (area of true expertise) and check your reports for
words and terms you cannot define.
No. 3 mistake: Not listing
the medical records reviews. Doctors mistakenly refer
generally to the medical records they reviewed. These physicians
open themselves to endless questions about what records they
did and did not review.
list and precisely describe all of the medical records and other
documents you reviewed prior to preparing your IME report.
No. 4 mistake: Not taking
a detailed history. Physicians frequently do not document
an accurate history in their IME report. This can and will lead
to many questions at deposition, hearing, or trial about the
inadequate or incorrect history and how that affects the validity
of the physician’s opinions.
Solution: Include a
thorough, well-written, and accurate history as a part of your
No. 5 mistake: Not documenting
the results of a physical exam. Physicians often perform
a detailed physical examination, but make the mistake of not
thoroughly documenting the exam.
Remember the old medical maxim,
“If it is not documented, it was not done.”
Solution: Check your
IME report to make sure all of the tests performed and all of
the findings made are clearly and accurately documented in the
No. 6 mistake: Not properly
wording an opinion. Physicians frequently perform a
complete review of the medical records, an extensive physical
examination, and a draft detailed IME report that fails due
to poor wording.
that the main reason for your examination and report is to express
your opinion in a legally sufficient and defensible manner.
Familiarize yourself with the legal terms of art for expressing
your opinions which usually are based upon a reasonable degree
of medical certainty or based upon a reasonable degree of medical
No. 7 mistake: Not properly
proofreading reports. Physicians frequently do not
carefully proofread their IME report before it is finalized.
Each mistake reduces the value of the report and calls into
question the precision of the IME physician and the validity
of her opinions.
Solution: Take the
steps necessary to catch and correct all misspelled words, transcription
errors, and grammatical mistakes before your IME report is finalized
and released to clients, attorneys, judges, and hearing officers.
No. 8 mistake: Expansive
and overly friendly transmittal letters. Physicians
can, and often do, ruin an otherwise excellent examination and
IME report by including an overly friendly or detailed cover
letter to the client. This letter will be used by opposing counsel
to show or imply bias.
Solution: Write a short
(one-sentence) cover letter. Make it objective and devoid of
any extraneous information.
No. 9 mistake: Improper
formatting. Physicians often spend many hours on their
review of the records, examination, and dictation of the IME
report with little or no thought concerning how the report is
to be formatted. An IME report which is not properly formatted
is very difficult to read and is of little value to the client.
Solution: Use topic
headings, 11-point or larger font, and short, concise paragraphs
to properly format your IME reports.
No. 10 mistake: Using
hedge words. Physicians often inadvertently use hedge
words, such as “it seems,” “I think,”
“I believe,” “it appears,” “it
could,” or “apparently,” in their IME reports.
These hedge words lessen the impact of their findings and conclusions.
Solution: Use precise,
powerful, and persuasive language in your IME reports and avoid
using hedge words.
If you avoid these 10 mistakes
as an IME, your credibility will increase and you will be more
effective in the courtroom.
Babitsky, Esq., is the president of SEAK, Inc. and is the co-author
of Writing and Defending Your IME Report: The Comprehensive
Guide. For further information, visit www.seak.com or call 508-548-9443.