Compulsory Medical Examination

Compulsory medical examinations are an extreme step, and one you should avoid if possible, but they are sometimes needed in order to resolve an injury claim.  And, because of Georgia’s state laws for workers compensation claims, this is especially true when workers are hurt. 

How are compulsory medical examinations done?

A compulsory medical examination is carried out by a qualified physician—never by an insurance adjustor or anyone else without proper medical training.  Depending on how the compulsory medical examination was negotiated, the insurer may have a go-to doctor that they ask you to use, a list of doctors for you to choose from, or the choice of doctor may be negotiated by both sides in the case.  The goal should be to use a doctor who is considered independent, objective and unbiased—not someone who is hired by the insurer.  However, in reality, insurers try to get a doctor of their own preference when possible. 

You should expect that the doctor has one goal in mind: to decrease or defeat your insurance claim. 

That means that you should prepare ahead of time with your lawyer, and carry yourself in much the same way you would if you were facing questions from a hostile attorney. 

Should I agree to a compulsory medical examination?

No, not if you can help it. 

Insurance companies use compulsory medical examinations to deny claims.  If it is possible to negotiate a resolution without this exam, that’s often the best route forward—but speak to your lawyer first. 

If you do agree to the examination, there are at least five ways it can go against you:

1. The doctor may decide you’re not really injured, or that at least one of your injuries is not real. 
2. The doctor may decide that the injury is not as severe as you claim. 
3. The doctor may agree that the injury is real, but claim it was caused by something else, not by the accident or injury that your insurance claim is for.  For example, they may claim it was there long before the accident. 
4. The doctor may claim they have found evidence that you made the injury worse by lack of proper care, or that it was worsened because of a pre-existing condition.  That means you’re at least partly responsible for your own injury. 
5. The doctor may simply disagree with major parts of your own doctor’s diagnosis, casting doubt on the medical evidence you’re using in your case. 

It only takes one of these to completely derail your injury claim, and potentially get it denied.  And considering that the doctor is usually biased in favor of the insurer, the odds are not good. 

What should I do if I have to take a compulsory medical examination?

There are three important steps you need to take:

1. Discuss with your lawyer whether there are alternatives.  If your policy does not require you to submit to this kind of exam, you may be able to negotiate a claim without it.  The Atlanta personal injury lawyers and workers compensation lawyers of John Foy & Associates can help you, and we offer a free consultation. 
2. Prepare with your attorney ahead of time.  They should be able to coach you on how to handle hostile questions, how to say no to things you aren’t required to do, and how to ask clarifying questions of the doctor where appropriate. 
3. Schedule an exam with your own doctor on the SAME day.  You don’t want the insurance company’s doctor to be the only authority on record, and you don’t want any room for doubt because your own exam was weeks or months later.  If you don’t already have one, work with your lawyer to get a doctor who understands this process and is truly independent of your insurer. 

Get Help With Your Injury Claim

A good lawyer will not let an insurer deny your claim by setting up an examination with a doctor who may not have your best interests at heart.  Let us help you.  John Foy & Associates has over 20 years of experience fighting on the side of those who were injured—and we charge NOTHING if we can’t get you money.  Let us give you a free consultation.  Fill out the form to your right or call us at 404-400-4000 to get your FREE consultation today.