What to Expect During an Independent Medical Evaluation (IME) in California

If you’re in the middle of a personal injury claim in California, you might be asked to undergo an Independent Medical Evaluation (IME). IME can be part of the process for various situations, claims, and cases, including those following a car accident, truck crash, or workplace injury. But the thought of a doctor evaluating you and your injuries–– particularly when you already are in a vulnerable spot–– can be a pretty daunting ask. What happens during this type of exam? Can someone prepare for it? How can you make sure the results work in your favor?

Don’t worry. Getting informed is the first step toward handling an IME like a champion.

What is an IME?

An independent medical evaluation IME is essentially an assessment of your injuries by a doctor who the other party hires — usually the defendant’s insurance company or employer, as per California law. It’s called independent because this doctor isn’t involved in your treatment or care. The goal of the IME is to give a neutral, unbiased opinion about the extent of the injuries you suffered from an accident and substantiate whether they are linked to the incident in question. The findings from the IME can significantly impact your claim, so it’s critical to approach this exam with a clear idea of what will be involved.

Why do you have to undergo an IME in the first place?

You may be wondering to yourself, “Why does the insurance company or this defendant get to decide the doctor ?” IMEs and this process are standard practice in California personal injury claims. The other party has the right to request an IME in order to ensure that they are truly getting an independent assessment of your injuries from their perspective. They simply want to verify the claims you’re alleging and ensure you’re not overstating the severity of your injuries, or at least obtain an expert’s opinion on the situation.

What Happens During the IME?

It’s natural to be a little nervous about what’s to come, but knowing what to expect can help ease any worries, make you confidently prepared, and then let you stop dwelling on the matter. An IME typically includes:

1. The Doctor Reviewing Your Medical History: Before the actual physical exam begins, the doctor will likely go over your medical records. The review can consist of your past medical treatments, test results, and previous injuries that could be attributed to your current condition. The goal here is to generate a comprehensive picture of your health and any history that might affect the injury you’re claiming.
2. You’ll be Asked Questions About Your Injury and Symptoms: Expect the doctor to ask you detailed questions concerning your injury, such as how it occurred, what symptoms you are experiencing, and how your condition has impacted your everyday life. The doctor might try to learn how your injury is impacting your ability to do your job, perform daily tasks, or engage in activities you enjoyed prior to the accident. It is imperative to be transparent and honest. Do not minimize your symptoms. Alternatively, do not stretch or exaggerate symptoms and feelings. The doctor is trained to spot inconsistencies in the way you illustrate your injury. Providing an accurate, fair, and factual account of how your injury affects you will help the doctor form a fair opinion.
3. You Will Undergo a Physical Portion of the Exam: The physician will likely perform a physical exam to check your current condition and symptoms. They may test your strength, flexibility, range of motion, and pain level. The examiner may request you to attempt certain movements, or they may apply pressure to specific areas to gauge your reactivity and response. Depending on your injury, the doctor may perform more specific tests related to the injury, including but not limited to taking X-rays and using other diagnostic tools. There is no need to be alarmed by the physical exam. It’s just standard procedure designed to get a clear opinion on your physical limitations after the accident.
4. You Might Undergo Diagnostic Testing: Sometimes, the doctor may order additional testing to attain greater clarity. These could range from imaging (like X-rays and MRIs) to lab tests if they need more details to assess your injuries appropriately. It is particularly commonplace to do such testing for more serious injuries like broken bones, spinal cord damage, and traumatic brain injuries. The doctor uses these tests to verify your claims and determine whether the level of severity of your condition aligns with the findings from your medical history and examination.
5. The Doctor Will Compose an Official Report: Finally, once the IME is completed, the doctor writes up his findings into a report. The report includes their own opinion from the perspective of a medical professional about the injuries, their link to the accident, and their prognosis moving forward. They might also comment on whether you’ll need ongoing care or rehabilitation and whether you’re expected to recover fully. The report is crucial because the other party will use it to either support or challenge your claims. In cases where the doctor conducting the IME believes your injury is less severe than you previously expressed, they may suggest that you are awarded a lesser compensation, which could ultimately lower your settlement.

How Can You Prep for the IME?

You won’t be able to control the outcome of the IME, but there are some things you can do to make sure you’re as prepared as possible. Remember, the doctor is not there to treat you, but to assess your condition. Be truthful about how your injuries affect your life. If you’re struggling with pain, fatigue, or mobility issues, let the doctor know. Being honest helps them get an idea of the real everyday impact of your injury. Before the exam, you should also take time to review your medical records and make sure you’re familiar with the details of your injury, treatments, and any prior conditions that could be relevant. It will help ensure that on the day of you are able to articulate accurate answers if the doctor should ask.

While California law permits the defense to have you undergo an IME, it also gives you the right to legal representation. While not a mandated prerequisite, it is a good idea to have an attorney present during the exam to protect your rights and make sure that every step is conducted fairly. Also, remember this is all for the good of your claim, so stay calm and professional. The IME can feel a little uncomfortable for some, but try to remain composed. The doctor is simply performing their job, and so are you. Cooperate fully, but don’t let the process make you feel pressured into downplaying any aspect of your injury or symptoms.

What Happens After the IME?

The written report completed by the acting physician will be sent to the defense or the insurance company. At this point in the process, they will utilize its contents to determine their position regarding the claim. If the doctor’s report supports your claims, it can help strengthen your case. Alternatively, if the doctor disagrees with your injury portrayal, it could be used to challenge your claims. Your attorney will also review the report carefully, dissecting it and ensuring it is accurate and fair. They will help you move forward and decide the most appropriate next steps.

Are the IME Results Challengeable?

If you feel the IME report was biased or incorrect, you may challenge it. California’s laws actually give you the right to dispute any part of the findings that seem off or unfair. Your lawyers will be instrumental in evaluating the report and determining whether disputing is worthwhile.

Getting through an IME can be intimidating, but it is integral to the claims process. With the right preparation, comprehending what to expect along the way, and having a skilled attorney in your corner, you will be in the best possible position to make certain your injury claim is taken seriously.

Are you facing an IME? Contact the experienced California personal injury attorneys of Moga Law Firm, located at 1010 N Euclid Ave, Upland, CA 91786, at 909-931-2444 to schedule a confidential and complimentary consultation.

Scot Moga

Scot Thomas Moga, a dedicated attorney in San Bernardino & Riverside Counties who represents clients in the many types of personal injury, workers’ compensation and estate planning cases.