The Independent Medical Exam (IME) in a Disability Claim
Your disability insurer can send you to a doctor of its choosing. Here is what an IME is, why the reports often favour the insurer, and how to protect yourself.
Key takeaways
- An IME is a medical exam by a doctor the insurer selects, not your own doctor.
- Your policy usually requires you to attend reasonable IMEs, and refusing can put your benefits at risk.
- IME doctors are paid by the insurer, so their reports often favour the insurer.
- Your treating doctors' opinions still carry weight and can outweigh a brief IME.
- A benefit denial based on an IME can be challenged.
In this article
At some point in a long disability claim, your insurer may send you to an "independent" medical exam. The word independent is doing a lot of work there. Understanding what an IME is, and is not, helps you go in prepared rather than blindsided.
✅Quick answer. An IME is an assessment by a doctor your insurer chooses and pays, used to evaluate your disability claim. Most policies require you to attend reasonable IMEs, and unreasonably refusing can jeopardize your benefits. But because the examiner is retained by the insurer, the reports frequently favour the insurer, and a denial based on an IME can be challenged, often with the stronger evidence of your treating doctors.
What is an independent medical exam?
It is a one-time medical assessment by a physician selected by the insurance company, not a doctor who treats you. The insurer uses the IME report to decide whether to continue, reduce, or deny your benefits. Despite the label, the examiner is chosen and paid by the insurer, which is why the independence is more in name than in practice.
Do you have to attend?
Usually yes. Most disability policies include a requirement that you attend reasonable medical examinations, and an unjustified refusal can be used to cut off your benefits. That said, requests that are unreasonable, repeated, or harassing can be pushed back on. The safe course is generally to attend a reasonable IME while protecting yourself around it.
Why IME reports often favour the insurer
The examiner is retained and paid by the insurer, and some doctors build a practice around this work. A short, one-time exam can miss the reality of a fluctuating condition, and IME reports frequently downplay limitations. This is similar to how surveillance can be used to paint an incomplete picture. It does not mean the report is the last word.
Your treating doctors still matter
A brief IME does not automatically beat the opinions of the doctors who actually treat you over time. Courts often give significant weight to consistent, detailed treating-physician evidence. Keeping up your treatment and documentation is one of the best ways to counter an unfavourable IME.
How to protect yourself at an IME
- 1.Attend a reasonable IME, and be honest and consistent, do not exaggerate or minimize.
- 2.Note the details: how long the exam actually lasted and what was and was not examined.
- 3.Describe a realistic picture, including your bad days and what you cannot sustain.
- 4.If your benefits are cut off after an IME, treat it as a denial you can challenge. A free review can help.
Frequently asked questions
What is an independent medical exam in a disability claim?
It is an assessment by a doctor your insurer chooses and pays, used to evaluate your claim. Despite the name, the examiner is retained by the insurer, so the reports often favour the insurer.
Do I have to attend an IME?
Usually yes. Most policies require attendance at reasonable medical exams, and unreasonably refusing can jeopardize your benefits. Unreasonable or repeated requests can be pushed back on.
Can I challenge a denial based on an IME?
Yes. A brief, insurer-arranged exam does not automatically outweigh your treating doctors' evidence. Denials based on IMEs are frequently challenged and overturned with strong medical support.
How should I prepare for an IME?
Attend, be honest and consistent, and describe a realistic picture including bad days. Note how long the exam lasted and what was examined. Keep up your treatment so your own records stay strong.
Omar Haddad
Legal Writer, Mirza Law
Omar Haddad is a legal writer at Mirza Law in Toronto. He writes about termination, medical and disability leave, and what the law protects when an employee is let go.
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