Filing A Florida Long-Term Disability Claim? What You Need To Know About The Independent Medical Exam
If you are filing for long-term disability (LTD) benefits in Florida through your employer, you may need to attend an independent medical exam, commonly called an IME. While this sounds like something that might help, the reality is more complicated.
These exams are requested by your insurer, paid for by your insurer, and often used to build a case against your claim. Our experienced Jacksonville long-term disability lawyer explains what to expect and how to protect yourself before you walk through that door.
What an IME Is and Why Florida LTD Insurers Request One
An independent medical exam is a one-time evaluation conducted by a physician chosen and compensated by your insurance company. Unlike your treating physician, who has an ongoing relationship with you and a complete picture of your condition, the IME physician typically spends 30 minutes or less reviewing your records and examining you before issuing a report.
That report carries significant weight in the insurer’s evaluation of your claim. Common ways insurers use IME results to deny or terminate Florida LTD claims include:
- Citing the IME physician’s opinion over your treating physician’s records to conclude that your condition is less severe than claimed
- Using a brief, surface-level exam to dismiss symptoms that only emerge over time or under sustained physical or cognitive demand
- Selecting IME physicians in specialties that do not fully align with your disabling condition, producing reports that miss key functional limitations
- Relying on the IME report as a basis for switching your claim from an own-occupation to an any-occupation standard at the 24-month mark
Most employer-provided long-term disability policies fall under the Employee Retirement Income Security Act (ERISA). ERISA requires insurers to provide claimants with a copy of their complete claims file, including any IME report used to support a denial.
How to Protect Your Florida LTD Claim Before and After an IME
You are generally required to attend an IME if your policy includes that provision, and refusing to go can result in suspension of your benefits. Taking the steps needed to prepare and respond to the outcome helps protect your rights:
- Bring a trusted person with you to observe the exam and take notes on everything that happens.
- Ask your treating physician to provide a detailed narrative report documenting your functional limitations before the IME.
- Request a copy of the IME report from your insurer as soon as it is available.
- Review the report for factual errors or mischaracterizations of your symptoms.
A well-prepared response to an unfavorable IME report, supported by strong treating-physician documentation, is one of the most effective ways to challenge an insurer’s denial.
Schedule a Consultation With Our Experienced Florida Long-Term Disability Lawyer
Insurers often use IMEs to deny Florida LTD benefits. Our Orlando long-term disability lawyer provides experienced legal representation and protects your rights in a claim.
We can review your IME report, your claims file, and your appeal options. Contact Farrell Disability Law to request a consultation at our Orlando or Jacksonville office today.
Sources:
leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0400-0499/0440/Sections/0440.13.html
dol.gov/agencies/ebsa/laws-and-regulations/laws/erisa
