An “independent medical examination” isn’t independent, and it’s not a real medical exam. Here are some things you can do to protect your rights.
Updated 3/11/2025
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When you bring a personal injury claim or lawsuit, you might be required to have what's called an "independent medical examination" (IME). But don't be fooled. An IME isn't independent, and chances are it won't be like any medical exam you've had before. The IME doctor isn't interested in helping you or your case. Quite the contrary.
You should prepare for your IME. We'll provide some tips on how to be ready, and things you can do during and after the exam to protect your rights.
The rules we discuss here generally apply to personal injury claims—car accidents, slip and fall cases, injuries caused by dangerous products, and more. If you have an IME for a workers' compensation or disability claim, different rules will apply. Your lawyer will tell you what to expect.
What's an IME?
First things first. An "IME" should be called what it is: A defense medical exam. The insurance company or the defense lawyer (the "defense") wants to have you examined by a doctor of their choosing. Why? To help them defend—meaning deny, or pay as little as possible for—your personal injury claim.
The defense will set up and should pay for the IME. It will happen at the examining doctor's office. Here are some things to know about the process:
- you should be represented by a lawyer
- the doctor isn't your doctor, and
- the defense is entitled to your medical records before the exam.
You Should Be Represented by a Lawyer
When your case gets to the point of an IME, the defense is playing for keeps. As a rule, nothing good (for you) will come from this exam. It's a rigged game, designed to culminate in a medical report that will deny or downplay your injuries, blame them on you or others, and paint you as a dishonest, money-grabbing faker.
Odds are you know nothing about the process—how to prepare for it, ways to respond to overreaching defense tactics, what to expect during the exam, or how to protect your rights when it's over. An experienced personal injury lawyer knows all these things and more. Don't try to navigate this minefield on your own. Hire legal counsel to guide you through it.
The Doctor Isn't Your Doctor
Above all else, understand that the IME doctor is the defense's doctor, not yours. The defense probably has an ongoing relationship with the doctor, meaning the doctor has worked for them many times in the past. They know the doctor will write an exam report that helps them and hurts you. That's what they're paying for.
Here are some things to keep in mind.
- Anything you say or do can (and probably will) be used against you. The doctor will report to the defense everything you say or do that might hurt your claim. Volunteer that your eyeglass prescription is outdated, and the doctor will report something like "Claimant admitted his eyeglass prescription is outdated. This could explain an inability to see objects like the one claimant alleges caused his fall." You just bought yourself a share of the blame for your injuries.
- Tell the truth, but keep it short. Be courteous, professional, and truthful. But don't be overly friendly, volunteer information, or make small talk.
- The doctor won't treat you. An IME doctor isn't hired to treat you, prescribe medications, or write you a work excuse. Don't ask them to do any of those things. A request for pain medication will show up in the report as "drug-seeking behavior." Ask for a work excuse and the doctor will report "malingering behavior."
The Defense Is Entitled to Your Medical Records
The defense wants their doctor to go on a fishing expedition through your medical records and health history, looking for ways to defeat your claim. Your lawyer will provide them the records they're entitled to have.
If you're not represented, keep these pointers in mind.
- Be ready for a fight. The defense will try to convince you to hand over more records than they're entitled to get. Offer five years—longer for past injuries or chronic conditions that might bear on your claims in this case. If they want to fight, get a lawyer.
- No blank releases. Don't sign any blank, open-ended medical record releases.
- One release per provider. Sign a separate release that names each provider and specifies the range of treatment dates covered.
- Expiration dates. Be sure to put an expiration date on each release.
- You get copies too. Ask your providers to send you a copy of any records they send to the defendant.
When Can You Be Forced to Have an IME?
Don't agree to an IME unless you have to. You can be forced to have an exam in these two situations:
- you've brought a claim under your own insurance policy, or
- you've filed a personal injury lawsuit in court.
A Claim Under Your Own Insurance Policy
You might have to undergo an IME when you bring a claim for benefits under your own car insurance policy. Maybe you were hurt by an uninsured driver and you're claiming uninsured motorist benefits. Or you live in a no-fault state and you're making a claim for personal injury protection benefits. Your insurance company might demand an IME.
Your auto policy almost certainly requires that you attend an exam at the insurance company's expense. Refuse and you've violated (in legal terms, "breached") your insurance contract, giving the insurer grounds to deny your claim.
You've Filed a Personal Injury Lawsuit
When you file a lawsuit for damages against a person who injured you, you must participate in a process called "discovery." During discovery, the defense can demand that you have an IME. Note that you can't be forced to attend an exam before you file suit, because you're not obligated to cooperate with the other side's insurance company.
In most states, court rules—called the "rules of civil procedure"—dictate when you must attend an IME. If you refuse, the court can penalize you by, for example, limiting or dismissing your claims. You might be able to find your state's rules of civil procedure on the state court website.
How Will Your IME Be Used?
In most cases, the defendant will try to use your IME to:
- prove that you weren't injured
- prove that your injuries weren't caused by the accident, or
- discredit you.
You Weren't Injured
The doctor will be looking for evidence that you weren't injured, or if you were, that your injuries are nowhere near as painful or disabling as you say. For example, if you claim a low back injury, the doctor will ask you to do walking or leg-lifting tests designed to reproduce low back pain. Should you not respond as expected, the doctor will report that you're faking or exaggerating your injuries.
Your Injuries Weren't Caused by the Accident
When they can't prove you weren't hurt, the next best thing is to show that your injuries were caused by something that gets the defense off the hook. In legal terms, they're looking to defeat "causation."
Let's return to our low-back injury example. Does your medical history include low back problems? Do you play golf, run, or lift weights? Do you work at a job that requires repetitive bending, stooping, lifting, or carrying? The doctor will point to these as the cause of your injury so the insurer doesn't have to pay.
Discrediting You
If the doctor can't defeat injury or causation, what's left is to discredit you—to make you look like a liar, someone who's just looking to avoid work, or who wants to cash in on a nonexistent or minor injury.
For example, the doctor's report might point to inconsistencies between what you reported during the IME and what you told a treating doctor. Or it might note that you walked, stood, and sat normally while in the waiting room (yes, they're watching) but then limped or complained of pain or limitations during the exam.
If it makes you look bad, expect it to show up in the doctor's report.
How to Prepare for an IME
Your lawyer will guide your preparation for the IME. Here are some of the things you'll probably do.
Role-Playing Exercises
Your lawyer will play the part of the doctor, asking you questions like those the IME doctor will ask. After each session, counsel will explain where you did well and where you need to improve. The more time you spend working with your lawyer, the lower the odds that you'll be surprised during the exam.
Based on your injuries, the lawyer might tell you what tests the doctor is likely to perform, and what those tests are intended to show.
Review Your Medical Records
At a minimum, you should carefully review all the medical records your lawyer provided to the defendant. Among other things, the doctor will be looking for inconsistencies between what you report during the exam and what's recorded in your records. You should be as consistent as possible.
Refresh your memory about past injuries and conditions appearing in your medical history. Chances are you'll be asked about some of them. Deny something that's in your records and the doctor will report that you lied. If you're surprised by past injuries that come up during the exam, you're more likely to give answers that hurt your claim.
Review Other Statements Too
Finally, if you've given any other statements about your injury, how it happened, your treatment, or your recovery, review copies of those statements as well. Chances are the doctor has them, too.
What to Expect During the IME
Let's start with what not to expect. Don't expect a complete medical exam like you'd get from a treating doctor. Remember: The defense isn't paying for an exam. They're paying for a report. The doctor has to examine you to prepare that report, but the exam will focus almost exclusively on the parts of your body you claim were injured.
In addition, don't expect the doctor to discuss or explain their findings once the exam is finished. The doctor will prepare a written exam report and send it to the defense. Your lawyer will get a copy of the report from them.
Expect to Be Questioned
The specifics will vary from one exam to the next, and some of the questioning might be done by a member of the doctor's staff. In general, expect to be asked about some or all of these topics:
- your health and medical history, specifically including all prior injuries from any causes (work, slip and fall, motor vehicle, sports or recreation activities, or others)
- all treatments you received for those prior injuries
- whether you completely recovered from your prior injuries and, if not, any lasting disabilities you experience
- how the incident giving rise to your claim happened
- how you were injured in the incident
- a detailed description of each injury you claim to have suffered because of the incident
- all medical treatments you've received for those injuries, including whether the treatments helped you get better or provided any relief from your symptoms
- if you claim to still have pain from your injuries, a detailed description of the pain, when and how often you experience it, what brings it on, and what (if anything) provides relief
- whether you feel you're disabled from working or limited in your ability to perform daily activities and, if so, why
- whether you were evaluated by a vocational rehabilitation specialist because of your injuries and, if so, whether you were found to have work limitations
- how long you were off work after you were injured, and whether you returned to work with or without limitations
- whether you expect to get future medical treatment for your injuries
- whether you think your ability to work in the future will be impacted by your injuries, and
- any accidents or injuries you suffered after the incident, whether you've been treated for any of those injuries, and whether you experience disabilities or limitations because of them.
Expect to Be Examined
The doctor will do some kind of physical examination, but don't be surprised if it's remarkably brief. Again, the purpose of the exam isn't to determine the state of your health. It's to look for evidence that hurts your case.
Things to Do (and Not Do) During the Exam
While you should be courteous and professional (even if the doctor isn't), don't be chatty, try to make small talk, or volunteer information. Answer all the doctor's questions completely and truthfully, then stop talking. Don't offer explanations unless you're asked. If you're asked to explain something, keep it short, truthful, and to the point.
The IME isn't your chance to tell your side of the story. That opportunity will come at another time. When in doubt about whether you should say or do something, keep this in mind: Nothing you say or do will win your case, but you might lose it (or decrease its value).
Steps You Can Take After the IME
Once the exam is finished, there's more work to be done. Your lawyer knows what steps to take to protect your rights. If you're without counsel, here are some things to consider.
Keep Detailed Notes
Write down everything you can recall about what the doctor and the doctor's staff said and did while you were in the office. Note how long you were questioned, as well as any topics that were emphasized during the questioning. Make a note of how long the physical exam lasted, what the doctor did, what you were asked to do, and anything the doctor might have said during the exam.
Make notes about any errors in the IME report. If the report includes medical statements or conclusions that differ from what your treating doctors have said, be sure to highlight those differences. Your lawyer will raise these errors when negotiating a settlement of your claim, or during cross-examination of the IME doctor at trial.
If you've filed a lawsuit, you can probably use your notes to refresh your memory when you testify in a deposition or at trial. Understand that when you use your notes this way, the court rules require that you provide a copy of them to the other side's lawyer. Be sure that all notes are truthful, factual, and accurate.
Get Information About the IME Doctor
Your lawyer will find out—or might already know—about the IME doctor's relationship with the insurance company and its lawyers. As part of discovery, counsel will send the defense interrogatories (written questions that must be answered under oath and in writing) asking, among other things:
- how many IMEs the doctor has done for the insurance company or its lawyer within the last five years
- how many IMEs the doctor has done for other insurance companies or their lawyers within the last five years
- how many IMEs the doctor has done for claimants or plaintiffs' lawyers during that same time period
- how much the doctor charges for an IME
- how many IMEs the doctor does in a typical month
- what percentage of the doctor's time is spent doing IMEs as opposed to doing hands-on patient care, and
- what percentage of the doctor's total income comes from doing IMEs as opposed to doing hands-on patient care.
Send a Copy of the Report to Your Treating Doctor
Your lawyer might want your treating doctor to review the exam report for medical accuracy. If your doctor agrees (some don't want to get involved) and identifies problems with it, your lawyer will set up a phone call to review the issues. When your doctor's concerns are significant, your lawyer might ask them to write a letter describing the problems and inaccuracies.
Consider Hiring Your Own Independent Examining Doctor
Suppose the IME report is particularly bad, and the defendant relies on it to make a low settlement offer. Your lawyer might hire an independent, non-treating doctor to examine you and write a report. This will be a doctor who's familiar with how IME doctors work, and who understands how to write a report that counters the harm a bad IME report can do.
If you're representing yourself, don't do this without first speaking to an experienced personal injury lawyer.
Next Steps
An IME can be a crucial part of your personal injury claim or lawsuit. The purpose of the exam is to give the insurance company ammunition to deny your claim, reduce the amount the insurer pays you to settle, or convince a jury to decide against you. There's a lot at stake—far too much to go it alone.
You need an experienced personal injury lawyer to help you prepare for the IME, guide you through the process, and do damage control once the IME doctor issues a report. You're not just up against the insurance company's doctor—you're up against its lawyers, too.
Here's how to find an experienced personal injury lawyer who's right for you and your case.
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