Independent Medical Examinations (IME): Complete Guide for Patients
Last Updated: January 2025Reviewed by: Medical TeamReading Time: 11 minutes
What is an Independent Medical Examination?
An Independent Medical Examination (IME) is a medical evaluation performed by a physician who has not previously been involved in your care. Despite the name "independent," these examinations are typically requested and paid for by insurance companies, employers, or attorneys to obtain an allegedly objective medical opinion about your condition, treatment, and prognosis.
Key Facts About IMEs
No doctor-patient relationship is established
No medical treatment is provided during the exam
Everything you say can be included in the report
The exam is paid for by the requesting party (usually insurance)
You typically cannot choose the examining physician
Results can significantly impact your benefits or case
Important Reality Check
While called "independent," IME doctors are chosen and paid by insurance companies or employers. Studies show IME reports often favor the party paying for them. Understanding this relationship helps you approach the examination with appropriate caution and preparation.
80%
Of IMEs requested by insurance companies
30-90
Minutes typical exam duration
2x
Per year maximum in most states
14 Days
Typical report turnaround time
Purpose and Types of IMEs
IMEs serve various purposes in legal and insurance contexts. Understanding why an IME has been requested helps you prepare appropriately and understand potential implications for your case.
Common Reasons for IMEs
Workers' Compensation
Verify work-related injury or illness
Determine extent of disability
Assess ability to return to work
Evaluate maximum medical improvement (MMI)
Review treatment appropriateness
Calculate impairment ratings
Personal Injury Claims
Confirm injury causation
Evaluate injury severity
Assess future medical needs
Determine permanent impairment
Review treatment necessity
Calculate damages
Disability Benefits
Social Security disability evaluation
Long-term disability insurance claims
Veterans disability assessments
State disability determinations
Functional capacity evaluations
Vocational assessments
Other Purposes
Fitness for duty evaluations
Return to work assessments
Second opinion requests
Pre-employment physicals
Insurance underwriting
Legal competency evaluations
Mandatory IME Timelines
Common Requirements by State
90-day exam: Required after 90 consecutive days of temporary disability (Ohio)
200-week exam: Additional evaluation after 200 weeks of benefits (Ohio)
Twice yearly maximum: Most states limit IME frequency (Pennsylvania)
14-day report deadline: Standard timeframe for report submission
Reasonable notice: Typically 10-14 days advance notice required
The IME Process
Understanding each step of the IME process helps you navigate the examination with confidence and protect your interests throughout.
Step-by-Step Process
1. Scheduling
Receive written notice of IME requirement
Location, date, and time provided
Name of examining physician
Purpose of examination stated
Limited ability to reschedule
Transportation may be reimbursed
2. Pre-Examination
Examiner reviews your medical records
Insurance company provides case information
Questions prepared based on claim issues
No prior contact with examiner
Examiner paid flat fee or hourly rate
3. The Examination
Check-in and paperwork completion
Medical history interview
Physical examination
Functional testing if applicable
No treatment provided
Documentation of findings
4. Post-Examination
Examiner prepares detailed report
Report sent to requesting party
You may request copy through attorney
Report influences claim decisions
May trigger benefit changes
Possible follow-up IME later
How to Prepare for Your IME
Proper preparation is crucial for ensuring the IME accurately reflects your condition and protecting your interests during the examination.
Stay consistent: Ensure your account matches prior statements
Take notes: Document the exam immediately after
Bring support: Have someone accompany you if permitted
Critical Warning
Surveillance is common around IME appointments. Insurance companies may have investigators watching you in the parking lot, waiting room, and surrounding area. Be aware that your activities before, during, and after the appointment may be recorded and used as evidence.
During the Examination
Knowing what to expect during the IME helps you navigate the process effectively while protecting your interests.
Typical Examination Components
Medical History
How injury or condition occurred
Symptoms and progression
Previous medical history
Current treatments and medications
Work and activity limitations
Daily living impacts
Physical Examination
Vital signs measurement
Range of motion testing
Strength assessments
Neurological testing
Specific tests for your condition
Observation of movement/gait
Functional Testing
Lifting capacity if relevant
Grip strength measurements
Balance and coordination
Cognitive assessments if applicable
Pain response testing
Effort and consistency checks
Communication Guidelines
How to Communicate Effectively
Be concise: Answer questions directly without volunteering extra information
Stay factual: Stick to objective descriptions of symptoms
Avoid speculation: Don't guess about causation or prognosis
Request clarification: Ask for explanation if questions are unclear
Correct mistakes: Immediately address any misunderstandings
Document concerns: Note any inappropriate behavior or requests
Red Flags to Watch For
Be cautious if the examiner: rushes through the exam (less than 15 minutes), seems to have predetermined conclusions, asks inappropriate personal questions, performs painful tests repeatedly, or dismisses your reported symptoms. Document these issues immediately.
Your Rights and Protections
While IME requirements may be mandatory for your claim, you still have important rights and protections during the process.
Legal Rights During IMEs
Right to Information
Receive advance written notice
Know the purpose of examination
Identity of examining physician
Copy of final report (through attorney)
Understanding of exam procedures
Explanation of tests performed
Right to Reasonable Accommodation
Reasonable travel distance
Accessible examination location
Interpreter services if needed
Breaks during lengthy exams
Accommodation for disabilities
Rescheduling for valid reasons
Right to Observer
Many states allow observers
Must be 18+ years old
Cannot be attorney or paralegal
Cannot interfere with exam
Can take notes in some jurisdictions
Audio/video recording varies by state
Right to Refuse
Inappropriate or unrelated tests
Examinations causing severe pain
Tests beyond scope of condition
Invasive unnecessary procedures
Note: refusal may affect benefits
Consult attorney before refusing
Protections Against Abuse
You Are Protected From
Harassment or intimidation during examination
Unreasonably frequent IME requests (typically limited to 2 per year)
Examinations by unqualified physicians
Tests that could cause injury or harm
Discrimination based on protected characteristics
Retaliation for exercising your rights
Impact on Your Case
IME results can significantly influence your workers' compensation claim, disability benefits, or personal injury case. Understanding this impact helps you appreciate the examination's importance.
How IME Reports Are Used
Insurance Decisions
Approve or deny claims
Terminate or reduce benefits
Authorize or deny treatment
Determine settlement amounts
Calculate impairment ratings
Assess return to work capability
Legal Proceedings
Evidence in hearings
Expert testimony basis
Settlement negotiations
Mediation discussions
Trial presentations
Appeals documentation
Weight Given to IME Reports
Judges and hearing officers often view IME doctors as "experts" and give significant weight to their reports, sometimes even more than treating physicians. This makes the IME critically important to your case outcome.
Challenging IME Results
Options If You Disagree
Request your treating physician provide contrary opinion
Seek second independent examination
Document inconsistencies in IME report
Challenge examiner's qualifications or bias
Present surveillance or other contradicting evidence
File formal appeal or request hearing
Common Concerns About IMEs
Many patients have legitimate concerns about the IME process. Understanding these issues helps you approach the examination with appropriate caution.
The "Independence" Question
Reality of IME Independence
Despite being called "independent," IME doctors are selected and paid by insurance companies or employers. Some IME physicians earn substantial income from these examinations, creating potential conflicts of interest. Studies show IME reports frequently favor the party paying for them.
Common Issues with IMEs
Brief Examinations
Average exam only 15-30 minutes
Cursory physical examination
Limited time for history
Rush to predetermined conclusions
Contrast with lengthy reports
Report Inaccuracies
Misstatement of symptoms
Incorrect medical history
Omission of important findings
Exaggeration of abilities
Minimization of limitations
Bias Indicators
Consistent findings against claimants
High volume of insurance work
Template-like reports
Dismissive of treating physician opinions
Focus on return to work regardless of condition
Frequently Asked Questions
Can I refuse to attend an IME?
Generally, refusing an IME can result in denial or termination of benefits. However, you may have valid reasons to reschedule or request different arrangements. Always consult with your attorney before refusing an IME to understand the potential consequences.
Is everything I say during the IME confidential?
No. There is no doctor-patient confidentiality in an IME. Everything you say or do can be included in the report and used as evidence. The examiner works for the requesting party, not for you.
Can I bring someone with me?
This varies by state and type of examination. Many states allow an observer who is at least 18 years old and not your attorney or medical provider. Check your state's specific rules or ask your attorney.
How can I get a copy of the IME report?
You typically have the right to obtain a copy, though the process varies. If you have an attorney, they can request it. Otherwise, you may need to request it from the insurance company or through formal discovery procedures.
What if the IME doctor was rude or inappropriate?
Document the behavior immediately, including specific quotes and actions. Report it to your attorney, the insurance company, and consider filing a complaint with the state medical board. This behavior may help challenge the report's credibility.
Can I record the IME?
Recording policies vary significantly by state. Some allow it, some prohibit it, and others require consent from all parties. Check your state's laws or consult your attorney before attempting to record.