Over the years of handling auto injury claims, we have seen hundreds of IME reports that cut off PIP benefits. The denials typically center around the force of impact, pre-existing conditions and when your patient is medically stationary. When preparing someone for an IME, whether they are a client of ours or not, we let them know how critical credibility is. Inaccuracies on the specifics of the collision, injuries, and specifically force of impact can cause major problems.
One of the most common mistakes is an assumption about the speed of the car that hit your patient. It’s not unusual for your patient to give a speed when they really don’t know. It’s typically based on how hard the impact felt or the speed limit where the collision happened. Understandably, most providers will note this in the file.
When a patient gives an estimate of speed, you should quickly determine the basis of the estimate – did the patient see the car prior to the impact or have some other way to determine the speed? If not, their answer is a guess and is best left out of the chart notes.