When writing your IME report it is important to remember that how you say it is just as important as what you are saying. Using incorrect, imprecise, or confounding language will raise red flags and result in uncomfortable and unnecessary cross-examination.
Let’s look at some of the common words and phrases that get Independent Medical Examiners into trouble:
- “Authoritative” to describe a medical text or journal. This term has special legal significance that may allow a cross-examining attorney to question the examiner about everything in the text.
- “Legal” or “legally.” What is and is not legal is usually outside of the area of expertise of most examiners.
- “Draft.” This term alerts counsel to the existence of draft reports that are usually extremely fertile grounds for cross-examination.
- “Work product,” “confidential,” or “privileged.” These terms make it appear as though the examiner is trying to hide something. These are also legal terms that the examiner may have difficulty defining properly.
- “Probable” and “possible.” These ambiguous words should be avoided.
- “Substantially.” This is another ambiguous word to avoid.
- “Obviously” and “clearly.” These terms can be used to make the expert appear patronizing or presumptuous.
- “Appears,” “presumably,” “supposedly,” “is said,” and “evidently.” These terms imply uncertainty.
- “He,” “she,” “it,” “they,” and other pronouns. Pronouns are uncertain. It is best to use a proper noun. For example, it is best to write “Mrs. Jane Smith.”
- Royal “we.” This can be used to make the expert look silly, pompous, or even dishonest.
- “It seems,” “could,” “apparently,” “I believe,” and other hedge words. It is always best to use confident language.
- “Complete,” “thorough,” “meticulous,” “exhaustive,” and other such words to describe the examiner’s chart review, research, or examination. These self-serving words will hold the examiner and her report to an extremely high standard.
- “Patient.” The person being examined is an “examinee” or a “claimant,” not a patient. There is no doctor/patient relationship.
- “Malingering.” In the majority of cases, it is usually better for the examiner to merely document exaggerated pain behaviors, inconsistencies, non-organic findings, and lack of objective findings rather than making a diagnosis of malingering.
- “Alleged,” “credible,” and other words that directly or indirectly opine on the credibility of the examinee. The examiner is a medical expert, not a credibility expert.
- “Dictated but not read” and “electronic signature.” These practices make the examiner appear to be more interested in cranking out reports and collecting fees than in precision and accuracy.
Conclusion
Avoiding these red flag and similar words and phrases will make your IME report more powerful and defensible.
Note: This article is based on the text: Writing and Defending Your IME Report, Babitsky, SEAK Inc.