Independent Medical Examination

An examination by a doctor chosen and paid for by the other side - routine in injury, disability and workers' compensation claims, and not treatment.

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What it means

An independent medical examination, usually called an IME, is a medical examination requested by an insurer, an employer or an opposing party rather than by the person being examined. It occurs across injury litigation, workers' compensation, disability benefits and some auto claims. The name is entrenched and somewhat misleading: the examining physician is selected and paid by the party requesting the examination, and the examination exists to produce an opinion for that party.

The practical consequence flows directly from that. An IME is not treatment and generally creates no doctor-patient relationship. Nothing said during it is confidential from the requesting party; the entire point is a written report to them. The examiner does not manage your care, is usually not going to see you again, and typically spends far less time with you than a treating clinician. Its purpose is usually to address a defined question - the cause of an injury, whether a condition has reached maximum medical improvement, the degree of permanent impairment, or the extent of work restrictions.

Whether you must attend depends on the source of the obligation, and there are three different ones. In litigation, a court may order a physical or mental examination where the person's condition is genuinely in controversy, on a showing of good cause, and the order specifies scope. In workers' compensation and in disability or auto policies, the obligation usually arises from statute or from a policy term requiring the claimant to submit to examination as a condition of benefits, in which case refusing may risk suspension of benefits rather than a court sanction. The rules on what may accompany the examination - an observer, a recording, a chaperone, a translator - differ substantially by state and by context, and are frequently negotiable in advance even where they are not guaranteed.

The report often carries real weight, and where the examiner's conclusion conflicts with the treating clinician's the dispute is commonly resolved on which is better reasoned and better supported rather than on titles. Two things therefore matter. First, accuracy: describe symptoms and limitations truthfully, including good days as well as bad, because exaggeration is the fastest way to lose a genuine claim and examiners are experienced at detecting it. Second, the record: the history given at an IME is compared against everything else on file, so inconsistencies of the ordinary human kind - a date misremembered, a prior injury forgotten - are worth avoiding by reviewing your own history beforehand.

Where this comes from

When people hire a lawyer for this

The most useful advice comes before the examination, not after the report: what the examination is for, what may be asked, whether attendance is genuinely compulsory in your situation, and whether the scope or the conditions can be narrowed by agreement. If you are represented, tell your lawyer as soon as the examination is scheduled rather than afterwards. Keep your own contemporaneous note of when the examination started and ended, what was actually examined and what was asked, because reports occasionally describe tests that a claimant recalls differently and that note is the only counterweight. If a report is adverse, it is not the end: it can be responded to with a treating clinician's rebuttal, challenged on its reasoning, and in many systems answered with an examination of your own.

Worried about the cost? A lawyer can be hired for one part of a case only (limited-scope representation), may be paid from what a claim recovers (contingency fee), or may be free through a pro bono program or legal aid; a court can also waive its own filing fees.

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Related terms

Other entries in the same area of law, each written from the same primary sources.

• Assumption of Risk and Liability WaiversThe defense that a person who knowingly took on a danger cannot complain of it - and the signed waiver that tries to make that agreement explicit before the gym, the ski slope or the trampoline park.
• Comparative and Contributory NegligenceRules that decide what happens to a claim when the injured person was also partly careless - and they differ sharply from state to state.
• Contingency FeeA fee arrangement in which the lawyer is paid a percentage of what is recovered, and is paid no fee if nothing is recovered.
• Damages in a Personal Injury ClaimThe categories of loss an injured person can be compensated for - the bills and lost earnings, the pain and the lost enjoyment of life - plus the separate and rarer category meant to punish, and the state caps that limit some of them.
• Dog Bite LiabilityWho pays when a dog injures someone - the strict-liability statutes most states have and what they cover, the older "one-bite" rule that survives in the rest, negligence and leash-law claims that exist under either, the defenses of trespass and provocation, landlord and keeper liability, how homeowners' insurance responds, and the dangerous-dog proceedings that run alongside the civil claim.
• Dram Shop and Social Host LiabilityWhen a bar, restaurant, liquor store or private host can be held responsible for injuries caused by someone they served alcohol to - the statutes that create the claim in most states and the very different standards they set (visibly intoxicated, under the legal drinking age, or both), the states with no claim at all, social-host rules for minors, what must be proved, the notice requirements, and who can sue.
• Emotional Distress Claims (IIED and NIED)When the law compensates psychological harm on its own, without a physical injury - the intentional-infliction tort and its "outrageous conduct" threshold, the negligent-infliction claim and the limits states put on it (the impact, zone-of-danger and bystander rules), the proof a claim needs, and how these differ from the emotional-distress damages that ride on any ordinary injury claim.
• Insurance Bad FaithAn insurer's duty to deal fairly with its own policyholder - and the separate claim that arises when it does not.
• Joint and Several LiabilityWhat happens when more than one person is responsible for the same injury - the traditional rule that each is liable for the whole judgment, the modern rules in most states that limit it by share of fault or by type of damages, contribution between defendants, the effect of settling with one of them, and why the rule decides who actually pays when one defendant is uninsured or bankrupt.
• Loss of ConsortiumThe claim of a spouse - and in some states a child or parent - for what an injury to a family member took from the relationship itself: companionship, affection, household services and the marital relationship, what has to be proved, why it is derivative of the injured person's claim, and how it is pleaded, valued and settled.
• NegligenceCarelessness that the law treats as a legal wrong because it fell below the level of care a reasonable person owed to someone else.
• Negligence Per SeThe rule that breaking a safety statute - running a red light, serving alcohol to a minor, violating a building code - can itself establish that the defendant was careless, without the jury deciding what a reasonable person would have done.
• Premises LiabilityThe responsibility of whoever owns or controls property for injuries caused by its condition - the slip on the wet floor, the broken stair, the unlit car park - and the rules that make the visitor's reason for being there matter.
• Product LiabilityA claim against the maker or seller of a product that injured someone because of how it was designed, how it was made, or what it failed to warn about - and the federal rules that can shut some of those claims down.
• Res Ipsa LoquiturThe doctrine that lets an injured person prove negligence from the accident itself when the cause is unknown but the event is one that does not ordinarily happen without carelessness - its elements, the exclusive-control requirement and how it has loosened, what the doctrine does procedurally (an inference, or a presumption shifting the burden), and where it is and is not used.
• Strict LiabilityLiability for harm without any showing of carelessness - the rule for abnormally dangerous activities, for defective products in most states, and, under many state statutes, for the owner of a dog that bites.
• Subrogation and Medical Liens on a SettlementWhy an injured person does not keep the whole settlement - the right of health insurers, Medicare, Medicaid, ERISA plans, workers' compensation carriers and hospitals to be repaid from a recovery for the treatment they paid for, how each kind of lien is created and enforced, the rules that reduce them, and why the liens have to be resolved before the check is cashed.
• Suing the Government for an Injury (Tort Claims Acts)Why an injury caused by a government employee or a public property defect follows different rules - sovereign immunity and the statutes that waive it, the written claim that must be presented to the agency before any lawsuit and the short deadline for it, the exceptions that keep immunity (discretionary functions, most intentional torts, certain activities), damage caps, and the no-jury and no-punitive-damages rules.
• Vicarious Liability (Respondeat Superior)The rule that makes an employer liable for harm its employee causes while doing the job - the reason the trucking company, the hospital or the delivery firm is the defendant, and the reason "independent contractor" is fought over so hard.
• Workers' CompensationThe state no-fault system that pays medical care and part of lost wages for an injury at work without any proof of fault - and, in exchange, takes away the right to sue the employer, though not the right to sue anyone else who caused it.
• Wrongful Death ClaimA claim brought by surviving family members or an estate when someone dies because of another party's wrongful act.

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