What Is an Independent Medical Examination | How to Beat IME

If you have an open long-term disability claim with an insurance company, there will likely come a time when they ask you to attend an independent medical examination (IME). An IME is an assessment conducted by a doctor chosen by the insurance company to provide an impartial opinion about your medical condition and ability to work. This might sound intimidating at first, especially if you’ve heard horror stories about IMEs, but understanding the process can make all the difference.

Today, I’ll answer the question: What is an IME, and how can you beat it? You’ll also learn about IME doctor tricks to watch out for, as well as actionable tips to prepare for and succeed in your appointment. This guide is designed to help you navigate the IME process with confidence and protect your claim.

As a disability and employment lawyer at Resolute Legal, I’ve helped countless clients face these exams. Whether you’re worried about what to expect, how to prepare, or how to present yourself, this article has you covered. Let’s dive in.

This article is part of our Ultimate Guide to Long-term Disability.

Can my company send me to get an independent medical assessment?

Yes, most insurance companies can send you for an independent medical examination (IME). This authority typically stems from a clause in your disability insurance policy allowing them to obtain a second medical opinion. However, there are rules and limitations they must follow. For example, your policy might specify how many IMEs they can request or how far you’re required to travel.

The key takeaway: As long as the insurer’s request aligns with the terms of your policy, you’re obligated to attend the IME. Refusing to cooperate could lead to suspension or termination of your benefits.

Why you should always attend your IME

Attending your IME isn’t just about complying with your insurance policy—it’s about protecting your credibility. Refusing to attend gives the insurer an easy excuse to cut off your benefits. Even if the IME report isn’t favourable, a skilled lawyer can challenge the findings. However, they can’t fight the consequences of you not showing up.

Let’s address some common reasons people hesitate to attend and why it’s critical to overcome them:

“I don’t want to go. They can’t prove anything if I don’t go.”

Refusing to attend an IME might seem like an easy way to avoid scrutiny, but it often leads to serious consequences. Insurers view non-compliance as a violation of your policy, giving them grounds to terminate your benefits. Always attend the IME to protect your claim, even if you have concerns. These can be addressed with the help of a lawyer.

“The doctor has terrible reviews or doesn’t specialize in my condition.”

Unfortunately, you don’t get to choose the doctor. If the insurer’s chosen doctor seems biased or unqualified, this often reflects poorly on the insurance company, not you. The courts may view this as unfair, strengthening your case.

“It’s too far or inconvenient.”

Travelling to an IME can be a hassle, but accommodating their request shows your willingness to cooperate. If travel poses significant challenges, document these difficulties; this might help your case later.

Read Dr. Kim Mailman’s Case Study to learn why attending an IME can actually help your case.

How to prepare for an independent medical examination

1. Understand the Purpose: The independent medical examination is meant to evaluate your condition and its impact on your ability to work. Be ready to discuss your symptoms, medical history, and daily limitations.
2. Practice Answering Questions: Rehearse talking about your condition clearly and concisely. Stick to answering the questions asked without volunteering unnecessary information.
3. Avoid Bringing Notes or Documents: The doctor should base their assessment on the information provided by the insurer and their own examination. Bringing additional materials might complicate the process.
4. Plan for Logistics: Ensure you have reliable transportation and a backup plan in case you feel unwell after the exam.

How to beat an IME exam: tips for success on the day

1. The IME starts when you leave home: Be mindful of your behaviour from the moment you step out. Insurers often conduct surveillance to compare your actions with what you report.
2. Be polite and cooperative: A good attitude can go a long way in creating a favourable impression. Avoid being defensive or confrontational.
3. Don’t exaggerate or downplay symptoms: Honesty is crucial. Attempting to mislead the doctor can backfire and damage your credibility.
4. Push through the exam: Show effort, even if it’s difficult. Demonstrating your determination can leave a positive impression on the doctor.
5. Avoid secretly recording: While tempting, recording the IME without disclosure can harm your credibility and may need to be disclosed if you pursue legal action.
6. Thank the doctor: A simple gesture of gratitude at the end of the appointment helps reinforce a positive impression.

IME doctor tricks you need to know about

Some IME doctors use subtle tactics to assess your effort and honesty. For example, they may:

1. Perform tests that measure effort: IME doctors may use tests designed to assess effort rather than ability. These tests often aim to expose individuals who might be exaggerating symptoms.
2. Fake tests: Some IME doctors conduct fake tests to provoke pain in ways that are impossible given your specific injury. These are used to justify denying benefits if they believe symptoms are overstated.
3. Observe behaviour: IME doctors often watch for cues beyond formal testing. This includes how you behave in waiting areas or during casual interactions.
4. Compare reports to surveillance: They may review your medical history or surveillance footage to find inconsistencies in your reported symptoms and lifestyle.
5. Watch you outside: IME doctors frequently observe people in parking lots and waiting areas, noting how they walk, sit, or act. These observations often appear in reports to justify stopping benefits. Always stick to your work restrictions, as someone may be watching.
6. Lengthy intake forms: IME doctors may ask you to complete lengthy intake forms to observe how long you can sit or write. Be mindful of your limitations and take breaks if necessary.

Being aware of these IME doctor tricks can help you avoid falling into common traps.

Next step: After an IME

Once the IME is over, the doctor will submit their report to the insurance company. You may not receive a copy directly. The insurer will review the report and decide whether to continue your benefits. While waiting, take the following steps:

1. Document your experience: Write detailed notes about the IME as soon as possible. Include:
   • Arrival and departure times
   • The nature of the tests performed
   • Any notable interactions or observations
2. Consult your lawyer: Share your notes with your lawyer to ensure your rights are protected.

Need legal advice for a disability insurance medical exam?

If you’re facing an independent medical examination, preparation is key to safeguarding your disability benefits. At Resolute Legal, we can provide trusted guidance and representation to help you confidently navigate this process.

Free book offer