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The Compulsory Medical Examination or CME

medical-check-up_BF9hd70rj-300x200Most Plaintiffs in personal injury cases that are in litigation are required to undergo a Compulsory or Independent medical examination also known as the CME. This is an examination that is requested by the opposing side and is done by a physician that is hired by the opposition.

The CME involves a review of records, a physical examination, face to face interview, review of test results, and conclusions. The goal of this examination is to confirm the initial injury diagnosis and determine whether such injury was due to the accident. The physician is also looking to verify that the current symptoms and findings are consistent with the diagnosis made. Lastly, they are looking to determine whether the individual is exaggerating or making up their complaints. This examining physician is not a treating physician and is also considered a hired expert for the opposition. Due to this, it is understood that there is always an element of bias involved in their conclusions.

It is important to keep in mind that by the time the plaintiff enters the examination room, the physician has already had the chance to review all treatment records and other records that were provided to him prior to the examination. The Plaintiff must be prepared for this examination and understand what could potentially be asked by the physician. Hired CME physicians are trained to look for and document potential indicators of fraud and deception during the interview portion of the examination and the availability of all these records prior to the appointment makes it easier for them to find. The physicians look for things such as verbal behavior indicators, omitting information such as prior injuries, too much information, overly specific answers, aggressive reactions to the questions, invocation of religion not to answer the questions and the use of qualifiers such as “honestly” and “truthfully”.

During this interview, the CME physician will go over the plaintiff’s medical history as well their past surgical and treatment history. There are also questions about the plaintiff’s psychological history such as diagnosis or treatment for anxiety, depression, alcohol, or drug addiction. In addition to looking for fraud and deception, these physicians are also trained to look for biopsychosocial factors and behavioral factors such as: unusual or extreme pain rating, job dissatisfaction, a lack of social support, low level of educational achievement, pessimistic attitude, distrust of doctors, and the pain onset being coincident with other life events.

After the review of records and interview is done, the actual physical examination takes place to address all areas of symptoms and complaints. These examining physicians explore the subjective signs and objective findings during the examination, with the objective findings carrying more weight of evidence to support a diagnosis. They are also trained to recognize behavioral signs during the examination such as symptom exaggeration or disease fabrication. The examining physicians even go as far as using sham test to trick the plaintiff into documenting complaints that do not apply.

It is important to keep all these things in mind and to be properly prepared before attending a Compulsory or Independent medical examination or CME. Attorney’s should take the time to meet with their client prior to the CME and have a review of their treatment history, past medical history, as well as current and prior complaints.

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