An independent medical examination is an important part of any personal injury case, and asbestos lawsuits are no exception. Read on for the details on IMEs and what to expect if you're attending one in connection with an asbestos case.
What is an Independent Medical Examination?
In legal jargon, an "independent medical examination" is one where an injury claimant is examined by a health care professional who is not the claimant's treating doctor. The goal here is to assess the scope and extent of claimed health problems.
An IME can occur in conjunction with other claims besides your asbestos lawsuit. For example, if you have a worker’s compensation claim related to your asbestos exposure, you will probably be sent to a Qualified Medical Examiner (QME). If you have veteran’s claims, the VA Board might ask for an Independent Medical Exam (IME). The doctor who performs the examination will usually be a pulmonologist.
In litigation, your lawyers and the defendant’s lawyers will both want to have you examined. If there is an existing QME report or IME report, both sides might agree that no other exam is needed. The cost of your examination by your attorney's doctors will be part of the costs of the asbestos case, and you will not have to pay out of pocket. Defendants will similarly pay their own doctor to examine you.
You will not be able to choose your examiner, but the doctor should practice ordinary professional courtesy. If you are treated in a way that makes you feel uncomfortable or seems inappropriate, by a physician for either side, let your attorneys know.
Unless you are very ill, avoiding an IME may make your case much harder to prove. Evidence of disease and causation are both crucial to obtaining a fair asbestos settlement.
What Happens at an Asbestos IME?
The medical examination is a straightforward and relatively non-invasive procedure. The doctor will ask you about your medical history and perform a routine physical examination, including blood pressure, pulse, and general health. The doctor will listen to your lungs to see if he or she can hear "crackles" or "rales," which is the sound made by damaged lung tissue as it moves with your breathing. The doctor will also ask you about your work history and exposure to asbestos.
Pulmonary Function Test
You will also have a pulmonary function test (PFT). A PFT measures your lung capacity and the amount of work it takes for you to inhale and exhale. Asbestos scarring causes a reduction in lung capacity, meaning you can’t inhale or exhale as much air as a healthy person. The PFT requires using a mouthpiece to breathe into machines that measure the volume and pressure of your air.
The test will be performed several times, including after you breathe from a bronchodilator, which is similar to an asthma inhaler. The bronchodilator relaxes the muscles in your air passages, allowing for a greater intake of air. This provides a measurement to compare to your normal breathing.
During a PFT, you will be asked to breathe normally and to take deep breaths, expelling as much air as possible. While a PFT itself is painless, it can be uncomfortable if you have trouble breathing. You may find yourself very short of breath even if you usually are not. It’s important for you to endure the discomfort and give the best effort that you can in order to get accurate measurements.
If you are or have been a smoker, it is important that you be up-front with the doctor about that. Emphysema causes increased lung capacity since it destroys the walls between air sacs in the lungs, creating more volume. This is the opposite of what happens with asbestos exposure, so a person with both emphysema and asbestosis can have a lung capacity that meets normal measurements.
The Doctor’s Report
After the examination, the doctor will write a report that includes the findings from the history and physical, the PFT results, and what has been observed by the radiologist examining your X-rays or CT scans. The doctor will also review your medical records and summarize them in the report. The doctor will make a conclusion as to both:
- whether you have asbestosis or pleural placques, and
- what the cause of the condition might be (for example, workplace exposure to asbestos).
If the exam was done for the purpose of obtaining benefits, the report will be forwarded to the relevant agency. If the exam was part of an asbestos lawsuit, the report will become evidence. If your case goes to trial, the IME doctor will probably testify as an expert.
Unsurprisingly, plaintiff’s doctors and defense doctors interpret things differently. This is why each side wants its own doctor to examine you. While it is inconvenient to be examined twice for the same health problems, it is your physical condition that is at issue in your asbestos lawsuit, so the defense is entitled to make its own assessment via an IME. If you are very uncomfortable with this, talk to your attorney and see what provisions can be made to have you accompanied by someone from your lawyer’s office.
Your Present Health
If you are very ill, either from an asbestos-related cancer or some other disease, you might not be able to be examined. An examination is less likely to be required by either side if you have been diagnosed with mesothelioma as the result of a biopsy, because the only known cause of mesothelioma is asbestos exposure.
However, if you are able to attend the examination, you should, because it is the foundation of the extent of your damages (which sets the value of your asbestos case). Also, it may be important to your health. On occasion a medical examination by a highly qualified pulmonologist uncovers symptoms of another health problem. The examining doctor will not provide you with any treatment, but you can take a copy of the report to your regular physician and ask for further assessment or treatment.
Confidentiality of the IME
The results of the examination will be confidential and shown only to those persons who need to see them for the lawsuit. They will not be provided to your personal physicians or become part of your medical record unless you give your doctor a copy yourself.