If you are pursuing a personal injury claim, the insurance company may require you to attend an independent medical examination (IME). This evaluation is performed by a doctor selected by the defense or insurance company to review your injuries and medical treatment. Although the exam is described as “independent,” it is often requested as part of the insurance company’s effort to evaluate or challenge your injury claim.
Understanding how IME exams work in personal injury cases — and how to prepare for them — can play an important role in protecting the value of your claim. A San Jose, CA personal injury lawyer can help accident victims prepare for an independent medical examination, protect their rights throughout the claims process, and address challenges raised by insurance companies regarding their injuries.
What Is an Independent Medical Examination? What Is an Independent Medical Examination (IME) in a Personal Injury Case?
An independent medical examination is a medical evaluation conducted by a doctor selected and paid for by the opposing party — typically the defendant’s insurance company. The stated purpose of the IME is to provide an objective assessment of your injuries, the treatment you’ve received, and your current medical condition.
In practice, the IME doctor’s role is to review your medical history, conduct a physical examination, and issue a report. That report will address questions such as the nature and extent of your injuries, whether those injuries are consistent with the accident in question, whether your medical treatment has been reasonable and necessary, and whether you have reached maximum medical improvement.
Insurance companies use IME reports as a tool to evaluate claims, challenge the opinions of your treating physicians, and build their case for reducing or denying your compensation.
Why Insurance Companies Request IMEs
Insurance companies request independent medical examinations for strategic reasons. While the examination is framed as a neutral evaluation, the practical reality is that the doctor conducting the exam has been hired by the party opposing your claim.
The most common reasons for requesting an IME include disputing the severity of your injuries, arguing that your injuries are related to a pre-existing condition rather than the accident, challenging the necessity of your ongoing medical treatment, and asserting that you have fully recovered and no longer need care. Insurance companies often use IMEs to:
- Dispute the seriousness of your injuries
- Argue your injuries were pre-existing
- Claim your medical treatment is unnecessary
- Assert that you have fully recovered
- Reduce or deny the value of your claim
IME doctors who regularly work with insurance companies understand what their clients are looking for. Studies and legal analyses have consistently found that IME physicians tend to produce reports that favor the party paying for the examination. This is why many personal injury attorneys and legal commentators refer to IMEs as “defense medical examinations” rather than independent ones.
Because IME doctors are hired by the insurance company or defense attorney, the examination is often referred to by attorneys as a defense medical examination (DME).
Do You Have to Attend an IME?
Whether you’re required to attend an IME depends on the circumstances of your case and the jurisdiction where your claim is being handled.
If your case is in litigation, the defendant can typically request an IME through a formal court motion. In most jurisdictions, courts will grant these requests as long as the examination is reasonably related to the injuries at issue and is not unduly burdensome.
If your claim is still in the insurance negotiation phase, the insurance company may request an IME as a condition of processing your claim. While you’re generally not legally compelled to attend at this stage, refusing may give the insurer grounds to delay or deny your claim.
Your attorney can advise you on whether to agree to an IME, negotiate the conditions of the examination, and in some cases, object to unreasonable requests.
Defense Medical Examination Tips: How to Prepare for an IME
Preparation is critical. The IME is not a routine doctor’s visit — it’s an evaluation that will be used against you if the results are unfavorable. Here’s how to approach it.
Be honest and consistent. The IME doctor may compare what you tell them to your prior medical records and deposition testimony. Any inconsistencies can be used to undermine your credibility. Answer questions truthfully, but don’t volunteer information beyond what is asked.
Describe your symptoms accurately. Don’t exaggerate your pain or limitations, but don’t downplay them either. If you’re having a good day when the exam occurs, make sure to explain that your condition varies and describe what your bad days look like.
Keep the exam focused. The IME doctor may try to engage you in casual conversation before or during the exam. Be polite but aware that everything you say — from the waiting room to the parking lot — may end up in the report.
Know what to expect physically. The exam itself is usually relatively brief — often 15 to 30 minutes. The doctor may test your range of motion, reflexes, and pain responses. Pay attention to what the doctor does and does not examine, as an incomplete examination can be challenged later.
Document the visit. Note the date, time, how long the exam lasted, what the doctor examined, and what questions were asked. Some jurisdictions allow you to bring a witness or record the examination — check with your attorney beforehand.
What Happens After the IME
After the examination, the IME doctor will prepare a written report and submit it to the insurance company or defense attorney who requested it. Your attorney is entitled to receive a copy of this report.
If the IME report contradicts your treating physician’s findings — which it often does — your attorney can challenge it in several ways. Your treating doctor can provide a rebuttal opinion explaining why the IME conclusions are inaccurate. Your attorney can depose the IME doctor, questioning their methodology, the thoroughness of their examination, and their financial relationship with the insurance company. Expert witnesses can testify about the limitations and biases inherent in the IME process.
An unfavorable IME report does not mean your case is over. It simply means the insurance company has a piece of evidence they will try to use against you. A skilled personal injury attorney will know how to address and counter it.
The Bottom Line on IMEs
Independent medical examinations are a common part of personal injury claims, but they are often requested by insurance companies to evaluate, and sometimes challenge, the extent of an injury.
If you are asked to attend an IME, speaking with a personal injury attorney beforehand can help ensure you understand the purpose of the examination and how it may affect your claim. Proper preparation can help prevent the exam from being used to unfairly minimize the impact of your injuries.
Understanding the IME process and preparing for it properly can prevent the examination from being used to unfairly diminish the value of your claim. If you’ve been asked to attend an IME, speak with your personal injury attorney before the appointment. With the right preparation and legal guidance, you can ensure the IME is just one piece of your case — not the defining one.
Frequently Asked Questions About Independent Medical Examinations
What is an IME in a personal injury case?
An independent medical examination (IME) is a medical evaluation performed by a doctor chosen by the insurance company or defense attorney to assess an injured person’s condition and medical treatment.
Do I have to attend an independent medical examination?
If your case is in litigation, a court may require you to attend an IME requested by the defense. If the claim is still in the insurance stage, attendance may be voluntary but refusing could affect claim negotiations.
How long does an IME usually take?
Most IME appointments last between 15 and 30 minutes, although the doctor may review extensive medical records before issuing a report.
If you have questions about an IME or any aspect of your personal injury claim, contact Mitchell & Danoff Law Firm, Inc. An experienced attorney can help you prepare for the examination, protect your rights throughout the claims process, and work to ensure that your injuries are accurately represented and fairly evaluated.