What Is an Independent Medical Examination?

What Is an Independent Medical Examination?

One doctor's visit could carry more weight in your injury claim than months of treatment records. Here's what you need to know before you walk into that exam room.

Key Takeaways



• An independent medical examination is an exam performed by a certified examiner chosen by the insurance company or defense.
• The IME doctor writes a report about your injuries, their cause and your need for treatment, and that report can affect your settlement or trial.
• Courts in Arizona, California and Colorado can order you to attend an IME and skipping one may lead to penalties or denied benefits.
• IME doctors are paid by the party that requests the exam, so their opinions sometimes conflict with your treating doctor's findings.

An independent medical examination, often called an IME, is a medical exam performed by a certified examiner, often a doctor, who has never treated you. The insurance company or requesting party may request an IME during a personal injury claim to get a second opinion about your physical condition.

If you've been wondering what an IME is and why you received a notice to attend one, you're not alone. These exams confuse a lot of injured people, and the results can shape the outcome of your claim.

What Is the Purpose of an Independent Medical Examination?

The purpose of an independent medical examination is to resolve questions about your medical condition when it becomes a disputed issue in your claim. The insurance company may doubt how serious your injuries are, whether the accident caused them or whether you still need treatment. An IME gives them a medical opinion from a doctor outside your care team.

Workers’ compensation insurers also use IMEs to determine whether a work-related injury still limits your ability to do your job. Disability insurers use them to decide whether your medical condition still qualifies you for benefits. In either case, the insurer paying your claim uses the IME to evaluate whether your benefits should continue.

What Happens During an Independent Medical Evaluation?

In an independent medical evaluation, the examiner reviews your medical records, imaging results and accident reports. The visit typically opens with an interview before moving on to the hands-on portion of the exam.

The physical portion depends on your injuries, but the doctor may check several things, including:

• Your range of motion and flexibility
• Muscle strength and reflexes
• Pain responses during movement
• How you walk, sit, stand and bend
• Signs that match or don't match your reported symptoms

Some examiners note how you move in the parking lot or waiting room, not just in the exam room. The examiner won't prescribe medication or offer treatment because this visit exists to gather information, not to care for you.

What Questions Are Asked During an IME?

While every exam is different, most independent medical examiners ask some version of these questions:

• What symptoms did you notice right after the accident, and what do you still feel today?
• What treatment have you received, and has it helped?
• Did you have any injuries or health conditions before the accident?
• How do your injuries limit your work, hobbies or daily activities?
• What medications are you currently taking?

Don't be surprised if the examiner circles back to the same topic in a slightly different way. Repeating a question is a common technique for comparing your answers against each other. Many injured people keep their responses short and direct, since the interview works more like testimony than a chat with a family doctor.

What Happens After an Independent Medical Evaluation?

Once the exam ends, the doctor who performed the independent medical examination prepares a written report for the party that requested it. The report typically covers the diagnosis, whether the accident caused your injuries, whether your treatment has been reasonable and necessary, and whether you've reached maximum medical improvement. It may also address your ability to work.

Insurance adjusters rely on the report during settlement talks, and attorneys on both sides may use it as evidence if the case goes to trial. The examiner can even testify about the findings in front of a jury.

What Are the Potential Benefits of an IME?

It may sound strange, but an IME may actually help your personal injury case. When the examiner confirms your injuries and agrees they came from the accident, the report becomes strong evidence in your favor. It's harder for an insurance company to dispute findings from a doctor it selected.

An exam can also break a stalemate. Claims sometimes stall because the two sides can't agree on the extent of an injury, and an outside evaluation gives everyone a new data point to negotiate around. Even when the report isn't favorable to you, knowing what the defense's medical position looks like helps your attorney prepare a response before trial.

Do You Have to Attend an Independent Medical Examination?

Whether you must attend an IME depends on who's asking for it and why. If a court orders the exam under Federal Rule of Civil Procedure 35 or a state equivalent, refusing to go can bring serious consequences. A judge can impose sanctions, which may include limiting the evidence you can present or even dismissing parts of your case.

Many auto policies also include a cooperation clause that requires an exam if you claim certain benefits, such as medical payments or uninsured motorist coverage. Skipping the exam in that situation can give the insurer grounds to deny your benefits.

Who Chooses the Doctor for an IME?

In most cases, the party requesting the independent medical exam selects the doctor you’ll see. However, your attorney can object to a particular doctor or push back on unreasonable conditions, and the court decides any disputes.

 

What Should You Not Say During an IME?

Keep in mind that everything you say during the independent medical examination can end up in the report. Exaggerating symptoms tends to backfire because IME doctors look for inconsistencies between what you say and what your records or their tests show. Downplaying pain creates the opposite problem by suggesting you've recovered when you haven't.

Guessing is another common misstep people make. If you don't remember a detail, saying so is a truthful answer. The exam also isn't the place to discuss who caused the accident, your settlement talks or your conversations with your attorney. Those topics fall outside the doctor's medical role, and volunteering that information can only hurt you.

Can an IME Doctor Disagree With Your Treating Doctor?

The IME doctor may conclude that your injuries are less severe than your treating physician believes, that a preexisting condition caused your symptoms or that you no longer need treatment. A disagreement doesn't end your claim, but it may create a conflict in your claim.

Your personal injury attorney has tools to challenge an unfavorable IME report. Your treating doctor's records reflect months of care rather than a single visit, and that history often carries more weight. Attorneys can also question the examiner's methods, point out gaps in the report and cross-examine the doctor at trial. The adjuster, judge, jury, arbitrator or other decision-maker may have to assess which opinion is more persuasive. 

Is an IME Doctor Really Independent?

IThe word "independent" deserves some healthy skepticism. The doctor doesn't work for you or your physician, which makes them independent of your care. But the insurance company or defense pays for the exam, and some physicians perform these evaluations regularly for the same insurers. That's why many attorneys call it a “defense medical examination” instead.

This doesn't mean every IME doctor acts in bad faith. Physicians have professional and ethical obligations regardless of who pays them, and plenty of reports come back fair. Still, understanding the financial relationship helps you take the exam seriously and treat it as part of the legal process rather than a routine checkup.

How Long Does an Independent Medical Examination Take?

Most independent medical exams last somewhere between 30 minutes and two hours. The length of your appointment usually depends on the type and number of injuries involved. A complex case with multiple specialists can require separate appointments.

Facing an Independent Medical Examination? Sargon Law Group Can Help

Sargon Law Group proudly represents injured individuals throughout Arizona, California, and Colorado. If you have an accident claim in these states, you don't have to protect your rights alone. Our team is available 24/7, offers trilingual support, and works on a contingency fee basis, meaning you don’t pay attorney’s fees unless we recover compensation for you. 

If an independent medical examination is on your calendar or your claim has hit a wall, contact Sargon Law Group today to schedule a free consultation with a personal injury lawyer.