What Is an Independent Medical Examination (IME)?

If you have been injured in an automobile accident in New York, you may receive a letter from your insurance company requesting an Independent Medical Examination (IME). For many accident victims, receiving this notice can be confusing and even alarming. After all, you’ve already seen your own doctors and received treatment for your injuries, so why is the insurance company requesting another medical evaluation?

An Independent Medical Examination is a medical evaluation ordered by an insurance company or, in rare situations, a defendant in a personal injury claim. Despite its name, an IME is often performed by a doctor chosen and paid for by the insurance company, not by your treating physician. The outcomes of the examination can have a substantial impact on your no-fault benefits and personal injury claim. Understanding how IMEs work, what your rights are, and how to prepare can help protect your claim and prevent costly mistakes.

Why Did the Insurance Company Request an IME?

Insurance companies frequently request IMEs to analyze injury claims. In New York, no-fault insurers have the legal authority to require claimants to undergo medical examinations when assessing whether additional treatment and benefits are required. From the insurance company’s perspective, an IME serves several purposes. They could want to:

• Verify that your injuries are related to the accident.
• Determine whether your medical treatment is reasonable and necessary.
• Evaluate the severity of your injuries.
• Assess whether you’ve reached maximum medical improvement.
• Decide whether ongoing no-fault benefits should continue.

In certain circumstances, insurance companies schedule IMEs early in the claims process. Others may request an assessment after several months of therapy if they believe your illness has improved or if they wish to contest continued medical expenses.

While insurers define IMEs as objective evaluations, it’s important to realize that the examination could eventually be used to justify decisions to reduce or terminate coverage.

Who Performs the IME and Are They Really Independent?

This situation is when the term “independent” becomes deceptive. The doctor who performs your IME is chosen, scheduled, and compensated by your insurance company or the defense in your lawsuit. They are not your doctor, will not treat you, and are not responsible for your long-term health. Many IME doctors regularly conduct these exams as part of their business and frequently work with the same insurers and defense firms. Therefore, questions often arise regarding their independence.

IME doctors are expected to provide objective opinions, but their findings sometimes differ significantly from those of a claimant’s treating physicians. For this reason, it is critical to understand that the IME is not designed to help you recover. Instead, it is a claims evaluation tool that may influence decisions regarding benefits and compensation.

What Happens During an IME in New York?

An IME is usually shorter and more limited than a regular medical appointment. The examining physician will normally go over the information provided by the insurance company, ask questions about your injuries, and perform a physical examination.

The type of damage involved determines the specific extent of the evaluation. Someone healing from a spinal injury may face different tests than someone being treated for a traumatic brain injury or psychological illness.

Following the examination, the doctor will normally write a written report, which is then sent to the insurance company for approval.

How Long Does an IME Typically Last?

Depending on the severity of the injuries, an examination can span anywhere from 10 to 45 minutes. Some exams may take longer, especially if several injuries are being assessed. Because the evaluation session is often brief, many claimants are surprised by how quickly the doctor draws judgments regarding injuries that could have taken months to treat.

What Questions Will the Doctor Ask?

The IME physician will usually ask questions about:

1. How the accident occurred
2. The injuries you sustained
3. Your current symptoms
4. Your medical treatment history
5. Prior injuries or medical conditions
6. Work restrictions and daily activities
7. Pain levels and physical limitations

It is important to answer questions honestly and accurately. Exaggerating symptoms can damage your credibility, while minimizing injuries may lead the doctor to underestimate the severity of your condition. When answering questions, stick to the facts and avoid speculating about matters you do not know.

What Physical Tests Are Usually Performed?

The physical portion typically focuses on the areas you claim were injured. For an orthopedic or back/neck injury, the doctor may measure your range of motion, ask you to bend, twist, or lift, assess muscle strength, and conduct reflex and sensory tests. Other injuries will require a more specialized examination. Do exactly what is asked, and stop if something causes discomfort—pushing through pain to appear cooperative may encourage the doctor to record a wider range of motion or capability than you actually have.

Your Rights at an IME in New York

You are not powerless when you walk into an IME. New York law and procedure give injured people meaningful protections, and knowing them in advance helps you stay in control of the situation.

Can You Bring Someone With You to the IME?

In most cases, you may be able to bring a friend, family member, interpreter, or other observer with you to the examination. Having another person present might provide support and assist in documenting what happened during the appointment.

However, the rules regarding observers can vary depending on the circumstances and the type of examination being conducted. Some insurance companies or examining physicians may object to the presence of more people.

If you are concerned about attending the examination alone, talk to your attorney first. An expert personal injury lawyer can help you understand your rights and whether adjustments are available.

Are You Entitled to a Copy of the IME Report?

Yes, in a personal injury lawsuit, this is an important protection. Under New York’s civil practice rules, the party that arranged the examination must provide a copy of the examining doctor’s detailed written report, with their findings and conclusions, in exchange for your own medical reports. Court guidelines also demand that the IME report be exchanged within a specific duration following the exam (usually 45 days). Your attorney may be able to prevent that doctor from testifying at all if you never properly serve the report.

What Happens If You Miss or Refuse to Attend?

Failure to attend a properly scheduled IME might lead to serious repercussions. In New York’s no-fault insurance system, insurers can deny or terminate payments if a claimant fails to attend for a required examination without a valid reason. Potential consequences could include:

• Suspension of no-fault benefits
• Denial of future medical expense claims
• Delays in processing your claim
• Additional disputes with the insurance company

If you are unable to attend an examination due to illness, transportation concerns, or another valid cause, please tell your attorney and insurance company as soon as possible. In some cases, the appointment can be rescheduled.

Ignoring the warning can lead to unnecessary problems and compromise your claim.

How an IME Can Affect Your Personal Injury Claim

The IME report can significantly impact your case, either positively or negatively. A positive report could strengthen your position. A negative report gives the insurer or defense grounds to argue that you are less injured than you claim, that your treatment was excessive, or that your problems are due to something other than the accident. 

What Happens If the IME Doctor Disputes Your Injuries?

An IME doctor may determine that you have recovered, that no further treatment is required, or that your injuries are degenerative or pre-existing rather than the result of an accident. A negative report does not indicate the end of your case. Your own treating physicians, who have checked you numerous times over the years, frequently have great credibility, and a brief, one-time exam by a retained doctor can be contested on those same grounds. Your attorney can cross-examine the IME doctor, point out inconsistencies, emphasize the short duration of the exam, and offer your treatment doctors’ documents and evidence to refute the conclusions. A disputed-injury report is a hurdle, not a decision.

Can an IME Be Used to Cut Off Your No-Fault Benefits?

Yes, and this is exactly what no-fault IMEs are generally intended to do. If the IME doctor determines that your continued treatment is no longer medically necessary, the insurer may deny coverage for future accident-related care. 

The good news is that benefits cutoffs can be challenged. A no-fault refusal based on an IME can be contested in arbitration or litigation, in which the insurer must justify its decision and you may offer opposing medical evidence. If your no-fault benefits have been revoked following an IME, you must act promptly because deadlines apply when disputing the denial.

How to Protect Yourself Before, During, and After an IME

You can’t control the doctor’s opinions, but you can take steps to protect yourself during the IME.

Before the examination:

• Review your medical history and treatment records.
• Arrive on time.
• Dress comfortably.
• Follow your doctor’s treatment recommendations.
• Discuss any concerns with your attorney.

During the examination:

• Be honest and accurate.
• Do not exaggerate symptoms.
• Do not minimize your pain or limitations.
• Answer only the questions asked.
• Remain polite and professional.

After the examination:

• Write down everything you remember about the visit.
• Note how long the examination lasted.
• Document any unusual interactions or concerns.
• Notify your attorney about what occurred.

Many experienced personal injury lawyers recommend creating detailed notes immediately after the examination while the events are still fresh in your memory. These notes may become valuable if disputes arise regarding the contents of the IME report.

How a Personal Injury Attorney Can Help With Your IME

Insurance companies routinely use IMEs to evaluate claims and, in some cases, to justify reducing or terminating benefits. Without proper guidance, accident victims may unknowingly make mistakes that harm their cases.

At Greenberg & Stein P.C., we understand the tactics insurance companies use to minimize payouts. Our legal team works closely with clients throughout every stage of the claims process, including Independent Medical Examinations, to help ensure their rights remain protected. Contact us at 212-681-2535 to schedule a free consultation to review your case.