Independent Medical Exams (IME): How to Protect Your Workers Comp Rights

What Is an Independent Medical Exam?

An Independent Medical Examination, or IME, is a medical evaluation requested by the insurance company handling your workers' compensation claim. The insurance company chooses and pays the doctor. Despite the name, these exams serve the insurance company's interests, not yours.

Insurance companies use IMEs to:

• Challenge your treating doctor's opinions
• Argue you've reached maximum medical improvement
• Minimize your permanent disability rating
• Deny treatment recommendations
• Claim your condition is not work-related
• Justify terminating your benefits

In California, the IME doctor is officially called a "Defense Medical Examiner" or sometimes a "Qualified Medical Examiner" (QME) depending on the context. Whatever the title, understand that this doctor is not working for you.

When Insurance Companies Request IMEs

Insurance companies typically request IMEs at critical points in your claim:

Early in the Claim

To dispute that your injury is work-related. They want an opinion that your condition is pre-existing or unrelated to your job duties.

During Treatment

To argue against treatment recommendations. If your doctor recommends surgery or extensive therapy, an IME may be used to deny authorization.

When Benefits Are Being Paid

To claim you've reached "maximum medical improvement" (MMI) and can return to work. This stops temporary disability payments.

Before Settlement

To minimize your permanent disability rating. A lower rating means a lower settlement.

Your Rights Regarding IMEs

California law provides certain protections for injured workers facing IMEs:

Reasonable Notice

You must receive reasonable notice of the examination appointment. You can request rescheduling if the timing conflicts with work, medical appointments, or other obligations.

Reasonable Location

The exam should be at a reasonable location. If you're asked to travel an unreasonable distance, you can object and request a closer location.

Travel Expense Reimbursement

The insurance company must reimburse your mileage and other travel expenses to attend the IME.

Right to Have Someone Present

You can bring someone with you to the appointment. This person can observe (though usually cannot be in the exam room for the physical portion) and take notes.

Right to Record

In California, you have the right to audio record the examination. This is powerful protection against misrepresentation of what you said or what occurred during the exam.

Copy of the Report

You're entitled to a copy of the IME report. Your attorney will receive this and review it with you.

The IME Doctor vs. Your Treating Doctor

Understanding the difference between these doctors helps you appreciate what you're facing:

Your Treating Doctor

• Has an ongoing relationship with you
• Sees you multiple times over months or years
• Observes your condition over time
• Focused on helping you heal
• Has no financial interest in the outcome of your claim

The IME Doctor

• Sees you once for 15-60 minutes
• Paid by the insurance company
• Makes substantial income from IME work
• Reputation for favorable reports brings more business
• No stake in your recovery

Some IME doctors are known in the workers' comp community as "defense doctors" because their reports consistently favor insurance companies. They make hundreds of thousands of dollars annually from IME work precisely because they deliver the opinions insurers want.

What Happens During an IME

Knowing what to expect helps you prepare:

Review of Records

Before seeing you, the IME doctor reviews your medical records, the insurance company's file, and often surveillance materials. They come to the exam with opinions already forming.

Interview/History

The doctor will ask about your injury, symptoms, work history, medical history, and daily activities. Every answer is documented and may be used against you.

Physical Examination

The doctor performs tests relevant to your claimed injuries. They're looking for inconsistencies between your reported symptoms and their findings.

Report Writing

After the exam, the doctor writes a detailed report. This often minimizes your injuries, attributes symptoms to pre-existing conditions, and supports whatever outcome benefits the insurance company.

How to Protect Yourself at an IME

Before the Appointment

• Review your medical records: Know your history so you can answer consistently.
• Prepare notes: Write down your symptoms, limitations, and how the injury affects your daily life.
• Get adequate sleep: Arrive alert and rested.
• Dress appropriately: Wear normal clothes but be aware that your appearance is being assessed.
• Arrange recording: Bring a device to audio record the exam.

During the Appointment

• Be truthful: Never exaggerate or minimize. Inconsistencies destroy your credibility.
• Be specific: Describe your symptoms precisely. "My back hurts" is vague. "I have sharp pain in my lower right back that shoots down my leg when I stand for more than 10 minutes" is specific.
• Don't volunteer information: Answer questions asked, but don't ramble or offer extra details.
• Describe your worst days: Many injured workers downplay symptoms. It's okay to describe how bad things can get.
• Report all symptoms: Don't focus only on your primary complaint. Mention every symptom related to your injury.
• Don't perform beyond your limits: If a test causes pain, say so. Don't push through to appear cooperative.
• Note the exam length: Many IME doctors spend minimal time but write lengthy reports. Note how long each portion actually takes.

After the Appointment

• Document everything: Write down what happened while it's fresh, including questions asked, tests performed, and how long each portion took.
• Report concerning behavior: If the doctor was rude, dismissive, or the exam was unusually short, tell your attorney.
• Continue treatment: Don't let the IME disrupt your ongoing medical care.

Common IME Tactics and How to Counter Them

"Symptom Magnification"

IME doctors often accuse injured workers of exaggerating symptoms. They use "validity tests" that supposedly detect faking. Many of these tests are scientifically questionable.

Counter: Be consistent. Describe symptoms the same way every time. Don't exaggerate, but don't minimize either. If you have good days and bad days, say so.

Waddell Signs

Some doctors use "Waddell signs" to claim you're faking. These tests were never meant to detect malingering, but some IME doctors misuse them for that purpose.

Counter: Your attorney can challenge misuse of Waddell signs. Legitimate experts criticize this practice.

Attributing Everything to Pre-Existing Conditions

IME doctors commonly blame your symptoms on age, prior injuries, or degenerative conditions rather than the work injury.

Counter: Be clear about how you felt before the work injury. If you were functioning normally before the accident, emphasize this.

Claiming Full Recovery

After minimal examination, IME doctors often declare you've fully recovered and can return to unrestricted work.

Counter: Your treating doctor's ongoing observations carry significant weight. Continue documenting your limitations.

Minimizing Treatment Needs

IME reports often recommend less treatment than your doctor prescribed, calling recommended procedures "not medically necessary."

Counter: Your treating doctor can respond with detailed explanations of why treatment is needed.

The Qualified Medical Evaluator (QME) Process

California has a specific process for medical disputes in workers' comp cases:

If You Have an Attorney

Your attorney and the insurance company each select their own medical evaluator, called an Agreed Medical Examiner (AME). If they can't agree, a Panel QME process begins where the state provides a list of three doctors and each side strikes one.

If You Don't Have an Attorney

You're entitled to a Panel QME. The state provides three names, you can strike one, and the insurance company strikes one. The remaining doctor performs the evaluation.

QME vs. IME

QME reports carry official weight in the workers' comp system. IME reports are just opinions the insurance company pays for. However, both can significantly impact your case.

Challenging an Unfavorable IME Report

If the IME report damages your claim, your attorney has several options:

Deposition

Your attorney can depose the IME doctor, asking detailed questions under oath. Many IME opinions fall apart under careful questioning.

Rebuttal Reports

Your treating doctor or another expert can write a detailed rebuttal explaining why the IME conclusions are wrong.

QME Evaluation

In disputes, the QME opinion often carries more weight than an insurance company's IME.

Expose Bias

Research may reveal the IME doctor's history of consistently favoring insurance companies. This bias can be presented at trial.

Attack Methodology

If the IME doctor used flawed testing or made conclusions unsupported by the examination, this can be challenged.

Recording Your IME

California law gives you the right to audio record your IME. This is one of your most powerful protections.

Why Recording Matters

• Prevents misquoting of your statements
• Documents how long the exam actually took
• Captures any inappropriate behavior by the doctor
• Provides evidence if the report contradicts what occurred

How to Record

• Bring a smartphone or recording device
• Inform the doctor you're recording at the start
• Keep recording for the entire appointment
• Preserve the recording and give a copy to your attorney

What If They Object?

Some IME doctors dislike being recorded. California law is on your side. If they refuse to proceed, document this and contact your attorney immediately.

Frequently Asked Questions

Why Legal Representation Is Essential

IMEs are designed to help insurance companies, not injured workers. Without experienced legal representation, you face these examinations without understanding the stakes or knowing how to protect yourself.

An experienced workers' comp attorney will:

• Prepare you thoroughly for what to expect
• Review the IME doctor's history and track record
• Ensure your rights are protected during the exam
• Obtain and analyze the IME report
• Challenge unfavorable findings through deposition and rebuttal
• Present your treating doctor's opinions effectively
• Navigate the QME process if disputes arise

We work on contingency. You pay nothing unless we win your case. Consultations are free and confidential.

Don't Face the IME Alone

An unfavorable IME report can derail your entire workers' compensation claim. Benefits get denied. Settlements get reduced. Treatment gets blocked. The stakes are too high to go in unprepared.

If you've received notice of an IME, or if you've already attended one and received a damaging report, contact us immediately. We can help protect your rights and fight for the benefits you deserve.