An Independent Medical Examination, or IME, is a process where the insurance company requires you to see a doctor they choose, not your regular doctor.
Whether it's to question how your injury happened or to re-evaluate the severity, the insurance company uses these exams to check up on your claim—and possibly to cut back on the benefits you're receiving.
Why does the insurance company send you to an IME in the first place? The short answer is: they want their own doctor to check out your condition. Your regular doctor might say you’re completely unable to work, but the insurance company may want a second opinion to either back that up—or dispute it. The IME doctor might look at things like:
Basically, they’re trying to find any reason to lower or deny your claim. It can definitely be frustrating, but going to the IME is really important—skipping it could seriously hurt your case (we’ll explain why later). The insurance company uses the info from the IME to figure out how much compensation you should get—or whether you should get any at all.
When you go to an IME, the doctor will look over the medical records the insurance company gives them, ask you questions about your injury, and do a physical exam. But remember, this doctor isn’t there to treat you—they’re there to answer whatever questions the insurance company wants answered.
That could mean checking out your level of disability or taking another look at your diagnosis. Sometimes, the doctor might even have specific instructions from the insurance company, so the exam might feel more focused—or even rushed—compared to a regular doctor’s visit.
Even if it seems quick, what happens during that appointment can have a big impact on your claim.
Skipping an IME? Definitely not a good move. If you refuse to go or miss the appointment without a solid reason, the insurance company is almost guaranteed to hold it against you.
They can take the issue to a hearing, and if the judge sees you’ve skipped multiple IMEs without a good excuse, they might decide to suspend your workers' comp benefits. Picture this: you’re in court, and the judge says, “No more benefits until you show up to the next IME.” Not exactly where you want to be.
If you’re scheduled for an IME, make sure you go. If you’re sick or really can’t make it, call the number on your appointment letter to reschedule. Just don’t overdo it with rescheduling—it could raise eyebrows with both the insurance company and the judge.
Not all IME doctors are completely unbiased, and it’s good to keep that in mind. These doctors are hired by the insurance company, so there’s a chance their evaluations could lean in the company’s favor.
While some IME doctors are fair, others might downplay your injury, question whether you really need more treatment, or try to make your disability seem less serious—all to help the insurance company.
This can seriously impact your case, including your medical benefits and the compensation you’re entitled to. The IME doctor’s report could even be used to lower or deny your claim, so it’s important to go in prepared. Knowing there might be some bias helps you stay aware and ready to advocate for yourself during the process.
Being honest is super important during your IME, especially when it comes to your medical history. If you’ve had a past injury or condition—even if it feels unrelated—you’ve got to mention it. Insurance companies are always looking for reasons to challenge your claim, and if they find out later that you didn’t bring up an old injury, they might accuse you of hiding something—or even fraud.
I get it, it might seem like talking about that old basketball injury from way back could mess up your case, but trust me, it’s way better to be upfront. Being open now stops the insurance company from saying you were trying to cover something up. When it comes to IMEs, it’s always better to play it safe and keep things honest.
At the IME, it’s really important to give your best effort during the exam. If you hold back or make it seem like you’re more injured than you really are, the doctor might think you’re "malingering"—basically, faking or exaggerating your symptoms—and that can seriously hurt your case.
Even if you’re in pain, try your best during the physical tests. If something honestly hurts, let the doctor know, but don’t push yourself past your limits. The goal is to be cooperative, honest, and consistent. Anything less could give the insurance company a reason to downplay your injury or cut your benefits.
Feeling nervous about going to the IME by yourself? You’re not alone. The good news is, you’re allowed to bring someone with you—like a friend or family member—to sit in during the exam. Having someone there can help keep things accountable and make you feel a bit more at ease.
You can also record the IME for your own protection, but there’s a catch: you need to let the insurance company know ahead of time. Check your appointment letter for instructions on how to do that. Just keep in mind, recording might make the exam feel a little more tense, but it also encourages the doctor to stick to the rules. If it makes you feel more confident and you follow the proper steps, recording can be a solid way to keep things fair and accurate.
Curious about how often you’ll have to go to an IME? The short answer is, there’s no set number. The insurance company can schedule an IME pretty much anytime during your workers' comp case, and they might even send you to more than one if they feel it’s needed.
That said, they’re not going to go crazy with it—IMEs cost them money, so they’ll usually space them out to avoid unnecessary expenses.
Some insurance companies might send you for IMEs more often to keep tabs on your condition as your case moves along. If you feel like you’re being sent to the same doctor again and again, don’t lose hope.
Even though it’s frustrating, showing up to all those appointments gives your lawyer a chance to push back if there’s any pattern of unfair or biased evaluations from the doctor.
When getting ready for your IME preparation is everything. The insurance company has to give you at least seven business days’ notice before the exam, so make the most of that time. Talk to your lawyer and your treating doctor to get a clear idea of what the IME is for and what you should expect.
Keep in mind, an IME isn’t like a regular doctor’s visit. Don’t be shocked if the waiting room is packed and your time with the doctor feels super quick. That’s why taking notes is a smart move—write down when the exam starts and ends, plus anything important that happens during it. Those notes can be really useful later if the IME report doesn’t match up with what actually went down, or if your lawyer needs to push back against the findings.
How you act during the IME can really affect the outcome, so it’s important to handle yourself the right way.
First off, show up on time and be polite. Sure, the doctor is hired by the insurance company, but being respectful can help keep things neutral. If you’re rude or uncooperative, it’s more likely to backfire with a bad report, which could hurt your case.
When answering questions, keep it simple and stick to what they ask—don’t volunteer extra info. Be clear and factual, especially when talking about your accident and symptoms. Make sure your story is consistent with your medical history. If they give you a questionnaire, take your time filling it out, and don’t forget to mention any past injuries or conditions. The last thing you want is for them to accuse you of leaving something out.
Finally, if something they ask you to do during the exam hurts, don’t try to push through it—be honest and tell them. This way, you’re not at risk of being labeled as exaggerating or not trying your best.
Believe it or not, the insurance company might be keeping tabs on you before and after your IME. It’s pretty common for them to do surveillance to see if your actions match what you’re saying in your workers' comp case. They might record you leaving your house, heading to the IME, and even going about your day after the appointment.
For example, if they catch footage of you carrying heavy shopping bags after you told the doctor you can barely lift anything, it’s not going to look good for your case. That’s why it’s so important to stay consistent. Be aware of what you’re doing, and make sure your actions line up with your injury. It’s not about being paranoid—just keeping in mind that they might be watching and are probably on the lookout for anything that doesn’t add up.
If you get your IME report and it doesn’t seem accurate or feels biased, don’t freak out—you can push back. Start by making a copy of the report to keep for your records. Then, pull out the notes you took during the exam and compare them to what’s in the report. Did the doctor skip a test they said they did? Did they claim you had no trouble moving when that clearly wasn’t true? Jot down every difference you notice.
Once you’ve gone through it, share everything with your lawyer. They can use your notes to challenge the IME report, especially if it’s obvious the doctor didn’t do a thorough or fair exam. The more specific details you can give, the better your lawyer can fight back and protect your rights.
Dealing with an Independent Medical Examination can feel overwhelming, but you don’t have to navigate it alone. If you have questions or concerns about your IME or anything related to your workers' compensation case, I’m here to help.
Feel free to give me, Rex Zachofsky, a call at 212-406-8989. We can talk through your situation, and I’ll do my best to guide you in the right direction. No pressure—just a conversation to make sure you’re taking the right steps to protect yourself.
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