After a workplace injury, you expect your medical care and recovery to be straightforward. But many injured employees are surprised when their employer’s insurance company requires them to attend an Independent Medical Exam (IME). This exam can have a major impact on your benefits, your treatment plan, and even your ability to continue working. Understanding what happens during an IME—and what to do if you disagree with the results—can help protect your rights throughout your workers’ compensation claim.
What Is an Independent Medical Exam in a Workers’ Compensation Case?
When you file a workers’ compensation claim, your employer’s insurance carrier may request that you attend an IME. This evaluation is meant to provide an objective, second opinion about your injury, treatment, and recovery progress. However, because the insurance company selects and pays the IME doctor, the process can sometimes feel more like an investigation than a neutral review.
An IME may be requested to determine:
- Whether your injury is related to your job.
- Whether your medical treatment is appropriate and necessary.
- Whether you can return to work—and under what conditions.
- Whether you’ve reached maximum medical improvement or have a permanent disability.
These findings often play a critical role in whether your benefits are approved, continued, or denied.
Who Chooses the IME Doctor and What to Expect
In most states, the Independent Medical Examination (IME) doctor is chosen by the employer’s workers’ compensation insurance company. While IME doctors are expected to provide an objective, third-party medical opinion, many of them work with insurers on a regular basis. This doesn’t automatically mean they are biased, but it can influence how they view your injury or work capacity.
Before your IME appointment, the insurance company typically sends the doctor a packet of information that may include:
- Your accident and injury report
- Medical records from your treating providers
- Diagnostic imaging such as X-rays or MRIs
- A list of specific questions the insurer wants answered, often focused on work restrictions, treatment needs, or return-to-work status
This information guides the IME doctor’s evaluation, which is meant to address the insurer’s concerns—not to provide treatment or manage your recovery. Because of this, the IME report may differ from the opinion of your treating physician, especially regarding disability status or whether additional treatment is necessary.
Preparing for an Independent Medical Exam
To protect your interests, it’s important to be prepared. You can request access to the same documents that were sent to the IME doctor. Reviewing them will give you insight into what issues the insurance company is questioning.
At the exam, you’ll likely be asked about your symptoms, treatment, and limitations. Unlike your personal doctor, the IME physician does not have a treatment relationship with you. This means there is no doctor-patient confidentiality—anything you say or do can appear in the doctor’s report and may influence the insurer’s decisions about your benefits.
Here are a few important guidelines to follow:
- Arrive early so your appointment isn’t rescheduled or marked as a missed visit.
- Be polite and cooperative, but do not overshare details unrelated to your injury.
- Answer questions truthfully and consistently with what you’ve told other providers.
- Avoid exaggerating your pain or minimizing your symptoms.
- Take notes after your appointment, including how long it lasted and what tests were performed.
How IME Findings Influence Workers’ Compensation Benefits
The IME report will be sent directly to the insurance company, and it can significantly affect the outcome of your claim. A favorable report may support continued medical treatment and wage replacement benefits. However, if the IME doctor concludes that your condition isn’t work-related, that your treatment is excessive, or that you can return to work, your benefits may be reduced or denied.
The insurer may rely on this single report even when your treating physician disagrees. Because of this, many workers find it beneficial to have a knowledgeable attorney review the IME report and determine whether it’s fair or accurate.
Disputing an Unfavorable IME Report
If the IME doctor’s findings contradict your treating physician’s opinion or don’t reflect your true condition, you have the right to dispute the report. A workers’ compensation attorney can help you:
- Request a copy of the IME report and identify inconsistencies.
- File a formal objection with the insurance company.
- Arrange for another examination by an independent physician.
- Cross-examine the IME doctor in a deposition or hearing.
- Present medical evidence from your own doctors to support your claim.
Challenging an IME report requires careful documentation and understanding of workers’ compensation procedures. Having legal representation ensures that deadlines are met and evidence is properly presented.
Common Mistakes to Avoid During the IME Process
Many workers unintentionally make small mistakes that can negatively impact their claims. To avoid problems:
- Don’t miss or reschedule the exam without authorization.
- Don’t exaggerate or change your description of pain or symptoms.
- Don’t discuss your case beyond medical facts.
- Don’t sign any additional forms without understanding them fully.
- Don’t assume the doctor is there to help you recover.
Remember, the IME doctor’s goal is to provide an opinion to the insurance company—not to treat or advocate for you.
Examples of How IME Results Can Affect a Claim
Consider a construction worker who suffers a knee injury on the job. His treating doctor prescribes several months of physical therapy. The insurance company orders an IME, and the doctor concludes that the worker has recovered enough to return to full duty. As a result, the insurer cuts off benefits prematurely. By hiring a workers’ compensation attorney and obtaining a second opinion, the worker successfully challenges the IME report and resumes therapy until he can safely return to work.
In another case, a warehouse employee experiences chronic back pain after years of heavy lifting. Her treating physician recommends surgery, but the IME doctor claims the injury is age-related rather than work-related. With the help of an attorney, additional medical evidence is submitted linking the injury directly to workplace conditions, restoring her eligibility for benefits.
These examples highlight how IME findings can shape the direction of your case—and how strong legal advocacy can help correct unfair assessments.
Why Working with a Workers’ Compensation Attorney Matters
Navigating an IME alone can be stressful, especially when your health and livelihood are on the line. A skilled workers’ compensation attorney can:
- Review and challenge biased medical reports.
- Ensure that your rights are protected during the claims process.
- Present persuasive medical evidence from your treating doctors.
- Advocate for fair compensation, continued treatment, or permanent disability benefits if needed.
An attorney also understands how insurers interpret IME results and can anticipate potential disputes before they harm your case.
Protecting Yourself During the IME Process
While you can’t always avoid attending an IME, you can protect yourself by understanding your rights and maintaining consistency in your medical history. Keep copies of all reports, treatment notes, and correspondence. Stay organized and communicate regularly with your lawyer about developments in your claim.
If you suspect that the IME was biased or inaccurate, speak with your attorney immediately. They can take steps to challenge the findings and request additional evaluations to support your recovery and financial security.
Need Legal Help? Brandon J. Broderick, Attorney at Law is One Phone Call Away
If an Independent Medical Exam is putting your workers’ compensation benefits at risk, you don’t have to face the insurance company alone. At Brandon J. Broderick, Attorney at Law, our experienced workers’ compensation attorneys help injured employees nationwide protect their rights and secure the benefits they deserve. We’ll review your IME report, gather supporting evidence, and fight to ensure your recovery isn’t compromised by an unfair or inaccurate evaluation. Don’t let one doctor’s opinion determine your future—our team is ready to stand by your side and advocate for the outcome you deserve.