An independent medical examination (IME) is a medical examination of a personal injury claimant or plaintiff by a medical doctor, psychologist, or other health care provider who is not the claimant or plaintiff’s treating physician or health care provider.
For example, an insurance company (insurer) may request an IME of a workers’ compensation claimant to determine the nature of the injury and provide an expert opinion on whether the injury was caused by a recent workplace accident or is a preexisting injury. Or a defendant (or the defendant’s insurer) may request an IME of a personal injury claimant or plaintiff during the investigation or litigation of a liability claim related to a motor vehicle accident or other incident.
The purpose of an IME is to provide an expert opinion from the treating physician for purposes of defending the claim or litigation—not to provide the injured claimant or plaintiff with a second opinion or with medical treatment. The physician conducting the IME will typically review the medical records of the claimant or plaintiff, interview and evaluate the claimant or plaintiff during the IME, and prepare a report with the physician’s findings (an IME report).
A claimant or plaintiff generally must submit to an IME or lose the right to pursue the insurance claim (workers’ compensation) or liability claim in litigation.
In Texas, an Independent Medical Examination (IME) is often utilized in the context of workers' compensation claims and personal injury litigation. The Texas Workers' Compensation Act allows insurance carriers to request an IME to evaluate the extent of an injury, the impairment rating, and the necessity of medical treatment. The Division of Workers' Compensation (DWC) sets rules for how these examinations are to be conducted. For personal injury cases outside of workers' compensation, the rules of civil procedure allow a defendant to request an IME if the plaintiff's physical condition is in controversy. The court may order an IME to determine the cause, extent, and medical treatment of injuries claimed. Failure to comply with an IME request can result in consequences for the claimant, such as the dismissal of the claim or limitations on the evidence that can be presented. It's important to note that the IME is not for the purpose of providing medical treatment but rather to obtain an objective assessment of the injuries related to the claim or litigation.
