What is an IME?

IME is a second opinion. An Independent Medical Examination, or IME, is a medical examination performed by a healthcare practitioner that does not have a prior treating relationship or any other connection with the examinee (person being assessed). 

  • To determine whether the claimant’s injuries are related to the workplace accident and whether the claimant’s injuries are the result of a pre-existing condition.
  • To validate an injured person’s level of disability, impairment, and limitations incurred from the incident in question and whether the claimant’s injury or condition is as serious as he or she claims it is.
  • To provide treatment recommendations, if applicable, to help the injured person recover and to determine whether the claimant has reached maximum medical improvement and whether the treatments the claimant is receiving are appropriate.
  • To discern liability, causality, and future health risks and whether the claimant’s injuries prevent him or her from working and what treatments the claimant needs or will need in the future 

The objective of the IME is to allow stakeholders to receive an unbiased and objective evidence-based picture of a person’s injuries, illness, or impairments so that decisions related to their claim can be based on objective facts rather than biased decisions. This is why IMEs are conducted by an independent physician/healthcare practitioner who has no previous relationship with the injured person rather than the person’s treating doctor.

What will happen during the IME?

The doctor will likely already have your medical record related to the injury if you’ve already seen a treating physician. The insurance company may have additional questions based on those records that they send to the physician. If the insurance company questions whether or not you need surgery or if you need extended time off of work, those questions may be included.

The doctor conducts a full medical exam. This includes questions and physical exams and testing.

Some of the questions are likely things you’ve answered already to other physicians or to the insurance company. Being consistent with your answers is important since the doctor is looking for discrepancies.