All About IMEs (Independent Medical Exams)

Independent Medical Exams (IMEs) are a standard part of insurance claims. An IME is an exam that’s arranged and paid for by the insurer. It’s meant to be a neutral second opinion about your disability or health condition, and is performed by someone who has not previously been involved in your case or assessment in any way. But, since the doctor or other specialist who is performing the exam is being paid and instructed by the insurer, it really can’t be called independent or impartial. When insurers arrange an IME, their goal is to get evidence that will allow them to minimize or deny your benefits. IMEs are a good example of a system with a culture of claims denial.

You may be asked to undergo an IME by your insurer as part of an LTD or car accident claim, or by your employer as part of return-to-work accommodations.

Do I Have to Undergo an IME?

Technically, you do not have to consent to an IME. But practically speaking, if you don’t agree to undergo an IME, the insurer has the right to deny or discontinue your benefits. For better or for worse, it’s in your best interest to participate in the IME in good faith.

How Will I be Treated at an IME?

The examining doctor is required to be fair, objective and non-partisan, but that does not mean they should treat you with indifference or brusqueness. The doctor should behave professionally and is still bound by doctors’ ethical duties even though he or she is not your treating doctor.

How Long Will the IME Take?

Depending on the type of exam or assessment, it could last an hour or two, or take place over the course of several days. Because you may not live in the same place as the IME doctor works, the insurer may make and pay for your travel arrangements to get there and back.

It’s also important to note that since the insurer knows all the details of the exam (time, location, etc.), often they will arrange surveillance at the same time. It’s reasonable to assume that you’re being surveilled from the time you leave home to the time you return from the exam.

Can I See the Results of the IME?

Yes, you have a right to see the report, although the insurer will likely not volunteer to give it to you. You may need to ask the insurer to give it to your own doctor, who can then share it with you. That said, some of the information in the report may be redacted, including the doctor’s observations and notes.

For more about IMEs, you can check out our previous post on Dos and Don’ts of IMEs.