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What To Expect When You Are Examined By The Insurance Company Doctor

The insurance company has the right under Maryland law to send you to a Doctor of their choice for a medical opinion, but NOT for treatment. They may do so within reason (both geographic location and frequency). The insurance Company is sending you to their Doctor for their benefit, not yours! They will use that Doctor's opinion to verify the opinion of your treating physician and/or to fight your claim. The following is a list of things you should be aware of when you go:

  • The examining physician will probably not spend much time with you;
  • The examining physician is not required to keep anything you say in confidence;
  • The examining physician will not provide you with his medical opinion (he will be required to provide a written report of his findings);
  • Do not wear flashy clothes, jewelry or high heels;
  • Contrary to the letter you will receive from the insurance company, you do not have to bring any of your test results with you;
  • The examining physician and/or his staff will watch how you walk, move and/or remove some articles of clothing and compare your movements to what you say you are physically capable of doing during the examination for any inconsistencies;
  • The examining physician will ask if you were injured previously.   You should be very honest with your answers;
  • The examining physician will ask you for your present complaints.   Answer his questions fully, but without any exaggeration;
  • Only answer the examining physician's questions - do not volunteer any information;

Do not be late or miss your appointment since that can delay your right to benefits or result in a Commission order that you must pay for the missed appointment. You should treat the examining physician respectfully but you are entitled to respect in return. The examining physician does not have the right to perform any invasive tests on you such as X-rays or EMG/Nerve conduction studies;If anything happens during the exam that makes you uncomfortable, you have the right to stop the exam and leave. However, we advise, if possible that you contact our office before doing so.

  

Your visit to the insurance company doctor is a necessary evil that is often required and you are entitled to be reimbursed for the miles you travel to see the examining physician as well as any lost time from work. However, there are times that the exam can be beneficial to you if the Doctor's opinion concurs with your treating physician. Therefore, you should be respectful but weary.