The insurance company sends a letter requiring you to attend an independent medical examination with a doctor they’ve selected. The letter uses neutral language about obtaining an objective medical opinion. Don’t be fooled by the terminology or the professional tone.
Our friends at Hayhurst Law PLLC discuss how these examinations are anything but independent. As a car accident lawyer will tell you, insurance companies hire the same doctors repeatedly because those physicians consistently provide opinions that minimize injuries and reduce claim values.
The Truth About IME Independence
Calling these examinations “independent” is misleading marketing. The insurance company chooses the doctor, pays the doctor’s fee, and expects opinions favorable to their position. These physicians know that providing defense-friendly reports leads to repeat business while finding serious injuries means fewer future referrals.
Some IME doctors make hundreds of thousands of dollars annually performing these examinations for insurance companies. Their financial incentive is clear. Support the insurance company’s position or lose a lucrative income stream.
The doctors aren’t committing fraud or lying in their reports. They’re simply interpreting ambiguous findings in ways that favor whoever pays them. Medical opinions often involve judgment calls, and IME doctors consistently make those calls against injured claimants.
What Happens During The Examination
The actual examination is usually brief, sometimes lasting only 15 to 20 minutes. The doctor reviews your medical records beforehand, asks questions about your accident and treatment, performs a physical examination, and writes a report sharing their opinions with the insurance company.
This cursory evaluation contrasts sharply with the relationship you have with your treating physicians who’ve seen you multiple times over months. Yet insurance companies present the IME doctor’s one-time assessment as more credible than your own doctors’ opinions.
The examination typically includes:
- Questions about how the accident happened
- Review of your current symptoms and complaints
- Physical tests of range of motion, strength, and reflexes
- Questions designed to catch inconsistencies with your prior statements
- Observations about your appearance, demeanor, and pain responses
Everything you say and do gets documented and potentially used against you.
Common IME Findings That Hurt Claims
IME reports follow predictable patterns. The doctor often concludes that your injuries were minor, your current symptoms aren’t related to the accident, you’ve reached maximum medical improvement and need no further treatment, or you’re exaggerating your limitations.
These conclusions appear in report after report regardless of the actual injury severity. The language varies but the message stays consistent. You’re either not as hurt as you claim, or something other than the accident caused your current condition.
Some IME doctors specialize in finding pre-existing conditions they can blame for your symptoms. They’ll note degenerative changes on old imaging studies and argue those conditions, not the accident, explain your pain. Never mind that you were asymptomatic before the collision.
How Insurance Companies Use IME Reports
The report becomes ammunition for reducing or denying your claim. Insurance adjusters cite the IME findings to justify lowball settlement offers. Defense attorneys use the report to challenge your treating doctors’ opinions if your case goes to trial.
The insurance company sends you a letter stating their doctor examined you and found your injuries resolved or unrelated to the accident. Therefore, they’re denying further benefits or reducing their settlement offer. The IME gives them cover to take positions they wanted to take anyway.
These reports are particularly effective against soft tissue injuries like whiplash, back strains, and concussions where objective findings are limited. When one doctor says you have significant injuries and another says you don’t, insurance companies always believe the one they paid.
Your Rights And Obligations
Most injury claims don’t give insurance companies the automatic right to demand an IME. If you’re dealing with a third-party claim against someone else’s insurance, you can often refuse the examination without consequence.
However, if you’ve filed a lawsuit, court rules typically allow defendants to require an examination by their chosen physician. Refusing a court-ordered IME can result in your case being dismissed.
Your own insurance company’s policy might include provisions requiring you to submit to examinations as a condition of receiving benefits. Review your policy carefully and consult with an attorney before refusing any examination.
How To Protect Yourself During An IME
You can’t prevent the doctor from writing a negative report, but you can avoid making it worse. Be polite but cautious. Answer questions honestly but don’t volunteer extra information. Stick to facts about your injuries and treatment without editorializing.
Don’t exaggerate your symptoms or limitations. IME doctors are trained to spot inconsistencies and embellishment. If you claim you can’t lift your arm above your shoulder but the doctor sees you easily reach overhead to remove your coat, that observation goes in the report.
Similarly, don’t minimize your injuries trying to seem tough or avoid complaining. If bending forward causes sharp pain, say so. The doctor is evaluating you at this moment, not testing your character.
Bring someone with you to the examination. Most jurisdictions allow you to have a witness present. This person can observe what actually happened during the exam versus what appears in the report. We’ve seen IME reports claim examinations lasted an hour when they actually took 12 minutes.
Recording The Examination
Some states allow you to audio or video record the IME. This creates an objective record of what occurred and what was said. Insurance companies and their doctors often object to recording, which tells you something about their confidence in the examination’s fairness.
If your state permits recording and the doctor refuses to proceed with you recording, that refusal can be presented to the court as evidence of bias. Most judges don’t look favorably on doctors who won’t allow documentation of their examinations.
Responding To Negative IME Reports
Your attorney will obtain a copy of the IME report and review it for inaccuracies, misstatements, and unsupported conclusions. We often find these reports contain factual errors about your medical history, the accident circumstances, or what occurred during the examination itself.
We counter IME reports with opinions from your treating physicians who have far more extensive knowledge of your condition. We might also retain our own medical professionals to review the case and provide contrary opinions.
Background research on the IME doctor can reveal patterns. How many times has this physician examined people for this insurance company? Do their reports consistently favor insurers? How much income do they derive from these examinations? This information can undermine their credibility.
The Financial Relationship Between IME Doctors And Insurers
Some IME doctors conduct hundreds of examinations annually for insurance companies, generating substantial income. Public records sometimes reveal these financial relationships through billing records, testimony in other cases, or required disclosures.
Exposing this financial incentive doesn’t automatically discredit the doctor’s opinion, but it provides context. Juries understand that someone earning $300,000 per year from insurance defense work might not be truly independent.
What IMEs Mean For Your Case Timeline
Insurance companies often schedule IMEs when they’re preparing to make a final settlement offer or defend against your lawsuit. The examination signals they’re taking your case seriously enough to invest in a medical opinion, which can be positive or negative depending on your perspective.
Expect settlement negotiations to intensify after the IME. The insurance company will use the report to justify their position. We’ll use your treating doctors’ opinions and evidence of the IME doctor’s bias to counter their arguments.
When IMEs Actually Help Your Case
Occasionally an IME doctor provides an opinion that helps rather than hurts. If the examination finds objective evidence of injury the insurance company didn’t believe existed, or if the doctor’s opinion supports your need for future treatment, the report can strengthen your position.
This happens rarely, but it does occur. Some IME doctors maintain enough professional integrity that they can’t ignore obvious injuries even when the insurance company hopes they will.
If you’ve been scheduled for an independent medical examination or received an unfavorable IME report, reach out to discuss how to prepare for the evaluation, protect your rights during the process, and effectively challenge any biased findings that work against your injury claim.