What Is an Independent Medical Examination?
An Independent Medical Examination (IME) is a medical evaluation requested by an
insurance company, typically performed by a doctor of their choosing. Despite the
name, these exams are anything but "independent."
The purpose of an IME is to obtain a medical opinion that the insurance company can
use to deny, reduce, or terminate your benefits. The examining doctor is paid by the
insurance company and often has a financial incentive to minimize your injuries.
The Truth About "Independence"
Studies have shown that IME doctors who consistently find in favor of claimants
quickly stop receiving referrals from insurance companies. The financial reality
creates an inherent bias, even if unconscious.
When Can They Request an IME?
Insurance companies typically request IMEs in these situations:
- Personal injury claims: To dispute the extent of your injuries
- Workers' compensation: To determine if you can return to work
- Disability claims: To challenge your inability to work
- Auto accident claims: To minimize damages or dispute causation
- Health insurance disputes: To deny coverage for treatment
Your obligation to attend depends on your policy language and the type of claim.
In many cases, your policy includes a "cooperation clause" that may require you
to submit to a reasonable medical examination.
California Note
Under California law, an insurer may request a medical examination when the
claimant's medical condition is in dispute. However, California courts have held
that the examination must be conducted reasonably. Cal. Code Civ. Proc. section 2032.020
governs IMEs in litigation. Key protections include:
- You can have an observer present (such as an attorney or nurse)
- The exam must be conducted within 75 miles of your residence
- You can record the examination (audio or video)
- You're entitled to a copy of the examiner's report
Your Rights During an IME
Many claimants don't realize they have significant rights before, during, and after
an IME. Know these rights and exercise them:
Right to Advance Notice
You're entitled to reasonable notice before the exam, including the doctor's name, specialty, and location.
Right to Reschedule
If the time or location is unreasonable, you can request rescheduling. Document your request in writing.
Right to an Observer
In most states, you can bring a witness or have someone observe the examination.
Right to Record
Many states allow you to audio or video record the examination. Check your state's laws.
Right to the Report
You're typically entitled to receive a copy of the IME doctor's report and any notes.
Right to Limit Scope
The exam should only address conditions relevant to your claim. Refuse unrelated inquiries.
What Happens During an IME
Understanding the process helps you prepare and protects you from common tactics:
Arrival
Check-In and Observation
The insurance company may have someone watching how you arrive, walk from your car, and move in the waiting room. Some IME doctors specifically note how claimants behave when they think no one is watching.
History
Medical History Interview
The doctor will ask about your injury, symptoms, prior medical history, and daily activities. Everything you say will be in the report. Be accurate and consistent with your medical records.
Exam
Physical Examination
The exam is often brief; many IMEs last only 15-30 minutes. The doctor may perform range-of-motion tests, strength tests, and other evaluations. Some tests are designed to detect "malingering."
Report
Written Report
The doctor prepares a written report for the insurance company. This may take days or weeks. The report will contain opinions about causation, diagnosis, treatment, and prognosis.
Common IME Tactics to Watch For
The "Friendly Doctor" Approach
The examiner may be warm and conversational, making you feel comfortable. This can
lead you to minimize symptoms ("I'm really doing much better") or make admissions
("I played golf once last month").
The Rush Job
Some IME doctors spend only 10-15 minutes with you, then write a lengthy report.
They may skip thorough testing but reach sweeping conclusions about your condition.
Document how long the actual exam took.
Leading Questions
"So you're able to drive without problems?" implies you should answer yes. Reframe:
"I can drive short distances, but I experience significant pain after 20 minutes."
The Surveillance Trap
Be aware that you may be under surveillance before, during, and after the exam.
How you walk to your car, whether you carry a heavy bag, how you move when you
think no one is watching. All this may end up in the report.
Important: The Report Is Not Final
An unfavorable IME report is not the end of your claim. Your treating physicians'
opinions typically carry significant weight, and IME reports can be challenged
through rebuttal evidence, cross-examination, and your own medical experts.
After the IME: Next Steps
- Request the report: You have a right to receive a copy
- Review carefully: Check for errors, misquotes, or misrepresentations
- Compare to your records: Note any inconsistencies with your treating doctors
- Get a rebuttal opinion: Your doctor can respond to the IME findings
- Document your objections: Put any concerns in writing
- Consider legal help: If the report is being used to deny your claim
California Note
In California workers' compensation cases, you may be entitled to choose from a
panel of Qualified Medical Evaluators (QMEs) rather than seeing an insurance
company-selected doctor. This provides more balance in the evaluation process.
See Labor Code section 4062.1 for details on requesting a QME panel.