Workers Compensation

Tips for Handling an Independent Medical Examination for Workers' Comp

By Sachi Barreiro, Attorney, University of San Francisco School of Law | Updated by E.A. Gjelten, Author and Editor
Learn how to how to prepare for independent medical exams demanded by your employer's insurance company—and how to avoid common pitfalls during the exam itself.

Like a workers’ comp deposition, an independent medical examination (IME) can be a nerve-wracking experience. Your employer’s insurance company may require you to attend an IME when there’s a dispute about medical issues in your workers’ comp case, including the cause of your injuries, treatment you need, if you’re able to work, and whether you’ve been left with any permanent disability. In many states, you may also request your own IME.

The stakes are high at these exams, because the IME doctor’s opinion can affect how much money you get in workers’ comp benefits. So it helps to know how IMEs work and what to expect at the exam. It also helps a lot if you’re well prepared and know how to avoid common pitfalls during IMEs.

How to Prepare For an Independent Medical Examination

Before the IME, you should take several steps that can help the exam go more smoothly:

  • Find out what the insurance company has given the IME doctor and what its questions are. The insurance company will send the examining physician a copy of your medical records. The claims adjuster may also send the doctor a letter with a description of your injury or occupational illness, an outline of the medical care you’ve received, and a list of the disputed medical issues or questions in your case. Ask to see this letter. That way you can correct any mistakes and know what the IME doctor will be looking for.
  • Review your case. Make sure you have a solid understanding of the timeline of events leading up to this point. You should know when and how your accident happened, or when you first began experiencing symptoms of a chronic occupational illness or repetitive stress injury, as well as the medical treatment you’ve received, how much time you took off work, your current physical limitations and symptoms, and what your treating doctor has recommended. If you had previous injuries or physical problems affecting the same part of your body as the current injury, try to recall when those problems were resolved. Go over accident reports, claim forms, medical records, any personal notes you took, and other documents that will help refresh your memory.
  • Arrange to bring help. You may want to consider asking a family member or friend to come to the IME with you. Although helpers can’t interfere with the exam or answer questions for you, they can provide emotional support, take notes, and later act as witnesses if there’s a dispute about the fairness or impartiality of the examining doctor. Depending on the rules in your state, you might also be allowed to have your treating doctor present at the exam.

If you don’t already have a lawyer, this is a good time to consult with one. An experienced workers’ comp attorney can help you prepare for the IME, write an objection to the insurance company’s letter to the IME doctor, and anticipate questions that could trip you up. Your lawyer can also help you challenge the doctor’s report after the exam, if that becomes necessary.

How to Conduct Yourself During the Exam

Plan to arrive for the IME early. If you're too late and miss it, you could risk losing your right to benefits. Be sure to bring any medical equipment or devices that you usually need for your medical condition. When you’re arriving or leaving the doctor’s office, be mindful of the fact that you might be watched or even followed.

Once you’re in the doctor’s office, be polite and respectful to the doctor and staff. While you’re waiting, you may be asked to fill out a questionnaire about your condition. Sometimes, these questionnaires can be too broad and intrusive, asking questions that you’re not legally required to answer. For example, the questionnaire may ask for your entire medical history or about personal habits that have nothing to do with your injuries. Your lawyer, if you have one, can give you advice before the IME on how to approach the questionnaire. But in general, a safe approach is to answer relevant questions about your injuries, medical treatment, and current limitations, but keep it brief. Ask for a copy of the questionnaire for your records.

Throughout the exam, keep a few rules in mind:

  • Be truthful. Always tell the truth, and avoid the urge to exaggerate your symptoms or limitations. An examining physician who has been hired by the insurance company will be looking for any chance to diminish your credibility. If you’re honest, the doctor will have a hard time suggesting that you’re trying to milk your workers’ comp claim for all its worth.
  • Be consistent. Remember that your answers to the doctor’s questions should match accident reports, medical reports, and any prior statements you’ve made. Also, be wary if the examiner asks you the same questions repeatedly. This is probably an attempt to catch you contradicting yourself. Remind the doctor that you’ve already answered the question or refer to the questionnaire you filled out.
  • Remember the purpose of the IME. The doctor is there to assess your condition and give an opinion on the medical issues in dispute. The examiner is not your treating physician, so there is no doctor-patient confidentiality. Anything you say in the exam will be relayed to the insurance company. Don’t ask for advice, don’t volunteer information, and avoid social conversation.
  • Watch out for questions about prior injuries. If you’ve had a previous injury to the same body part, be especially mindful when answering questions along these lines. The doctor may try to play up your old injury as the cause of your current injury rather than your workplace accident. Whenever possible, make a clear distinction between your old and current injuries. For example, if you hurt your back in a car accident ten years ago but fully recovered and didn't have any pain for eight years before your recent work accident, be sure to explain that.
  • Be clear about your current limitations. If it’s one of the disputed issues that led to the IME request, the doctor will probably decide whether and to what extent you have permanent physical or mental limitations as a result of your work injury or illness. This “rating” or percentage of impairments could translate into the amount you receive for a permanent disability award. Because of this, it is important to tell the doctor about all of your current limitations. For example, if you have trouble with overhead reaching or standing for long periods of time, make that clear, even if the doctor doesn’t ask.

Above all, be calm, polite, and respectful. If you come off as defensive or agitated, it will only hurt your case. If you feel yourself getting worked up, ask to take a short bathroom break. If you don't understand a question or don't remember something, say so. Being truthful, reasonable, and credible will help your IME go as smoothly as possible.

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