At some point in a serious personal injury claim in Massachusetts, the insurance company may request that you submit to what they call an Independent Medical Examination, usually referred to as an IME. The name sounds neutral and procedural. The reality is something different, and understanding what an IME actually is before you walk into one can make a significant difference in your case.
What an IME Actually Is
An Independent Medical Examination is a medical evaluation requested and paid for by the insurance company or defense attorneys. The doctor conducting it is not your doctor. They have no prior relationship with you, they are not treating you, and their findings are not protected by patient-physician confidentiality in the same way your treatment records are.
The doctor is typically chosen from a pool of physicians who regularly conduct IMEs for insurance companies. In the personal injury legal community, these doctors are sometimes called “hired guns” because their work consists largely of conducting evaluations for insurance companies and producing reports that, not coincidentally, tend to minimize the severity of the injuries being claimed.
That does not mean every IME physician is dishonest. But the financial structure of how they are selected and compensated creates an incentive that is not aligned with your interests, and the word “independent” is genuinely misleading.
When Can an Insurance Company Require an IME
In Massachusetts, the circumstances under which an insurer can require an IME depend on the type of claim and the stage of the case. Your own insurance company, under your PIP coverage, may have a right to request an IME in certain situations under the terms of your policy. In litigation, the other side typically has a right to have you examined by a physician of their choosing as part of the discovery process.
The important thing to know is that you should always consult with your Worcester personal injury attorney before agreeing to or attending an IME. Your attorney can advise you on whether the request is legitimate given the stage and type of your case, prepare you for what to expect, and in some situations arrange to have someone present during the examination.
What Typically Happens at an IME
IME appointments are often notably brief. Injured claimants who have spent months with treating physicians who know their case in detail sometimes find the IME physician spends 15 to 30 minutes with them. Yet the report that comes out of that brief encounter may run several pages and include conclusions about injury severity, causation, and treatment necessity.
The examination typically involves a review of your medical records, a brief physical examination, and questions about how the injury happened and what your current symptoms are. Be factual and accurate about your symptoms. Do not minimize or exaggerate. Whatever you say during the examination can and will appear in the physician’s report.
The IME physician’s report is then provided to the insurance company and used in negotiations or litigation to argue that your injuries are less severe than you have claimed, that you have already reached maximum medical improvement and do not need further treatment, or that the accident was not the cause of your current condition.
How Your Attorney Fights Back Against an Unfavorable IME
When an IME report comes back with conclusions that contradict your treating physician’s findings, your Worcester personal injury attorney has several tools available.
First, your own treating physicians can provide counter-declarations or testimony about your actual condition, treatment needs, and prognosis. A doctor who has been treating you for months has far more information about your case than a physician who spent 20 minutes with you on a single occasion.
Second, your attorney can depose the IME physician during litigation. Depositions often reveal the extent to which the physician regularly works for insurance companies, how many IMEs they conduct per month, and what percentage of their professional income comes from defense-side work. When a jury learns that a physician conducts 200 IMEs per year for insurance companies and has found significant injury in very few of them, the weight of that physician’s opinion diminishes considerably.
Third, the specific findings of the IME report can be challenged through cross-examination when the case goes to trial. Inconsistencies between the report and the actual medical record, or between the report’s conclusions and standard medical literature, can be exposed effectively by a prepared attorney.
What to Do During an IME to Protect Yourself
Go to the appointment. Refusing to attend when you are legitimately required to do so can have serious consequences for your case. But go prepared.
Be honest and accurate about your symptoms. Do not try to perform disability or exaggerate pain for the examiner, and conversely do not downplay what you are experiencing to seem stoic. Describe your actual condition accurately.
Keep notes about the examination afterward. Write down approximately how long it lasted, what the physician asked you, what physical tests were performed, and any observations you have about how the examination was conducted. Share these notes with your personal injury lawyer in Worcester as soon as possible.
Do not engage in casual conversation with the examiner about topics beyond your medical condition. The examination begins the moment you walk in the door, not when the formal evaluation starts. Everything you say and how you move and carry yourself may be noted.
The Takeaway
An IME is not a routine appointment. It is part of the insurance company’s case strategy. Treating it accordingly, by making sure your Worcester personal injury attorney is involved before you go, means you are not walking into it unprepared while the other side is fully prepared for what the results will show.
