If you have a pending ERISA disability claim, the plan administrator or insurance company may schedule an Independent Medical Examination (“IME”) for you. Your first question may be, “do I have to attend?” While every person’s situation is different, and you should consult with your attorney about the specifics of your case, it is recommended that you comply with reasonable requests by the administrator to have you evaluated in person.
Why, you ask? For starters, most disability policies contain a provision that gives the administrator the right to have you examined. Failure to comply may result in the denial of your claim. For example, in Burke v. Pitney Bowes Inc., 392 F. App’x 570, 572 (9th Cir. 2010), the Ninth Circuit Court of Appeals held that it was reasonable for the plan administrator to request a second IME of the plaintiff and that the plaintiff’s refusal to attend prejudiced the administrator’s ability to decide the claim. The Court found that the termination of disability benefits based on the plaintiff’s failure to attend the IME was not an abuse of discretion.
Second, if your matter ends up in litigation, it is important that you appear reasonable and cooperative to the judge. The focus should be on the merits of your disability claim, not on whether you should have attended an exam.