Legal Definitions - independent medical examination

An Independent Medical Examination (IME) is an objective evaluation of a person's medical condition, injuries, or health status conducted by a healthcare professional who has not been involved in that person's prior treatment.

The primary goal of an IME is to provide an impartial, unbiased medical opinion, often requested by an insurance company, employer, or legal party. This assessment helps to determine the nature and extent of an injury, its cause, the appropriateness of current treatment, or the impact of a condition on an individual's ability to work or perform daily activities.

• Example 1: Workers' Compensation Claim

  After a construction worker suffers a knee injury on the job and files a workers' compensation claim, their employer's insurance company might request an IME. A physician specializing in orthopedics, who has no prior relationship with the worker, would examine the knee, review medical records, and provide an independent report on the severity of the injury, whether it's work-related, and the worker's prognosis for recovery. This report helps the insurance company make decisions about benefits and treatment.

• Example 2: Personal Injury Lawsuit

  In a lawsuit following a car accident, the plaintiff claims significant ongoing back pain and disability. The defense attorney, representing the driver at fault, may arrange an IME. An independent neurologist or orthopedist would examine the plaintiff, review all medical documentation, and offer an opinion on the extent of the injuries, if they are directly attributable to the accident, and whether the plaintiff's current treatment plan is reasonable and necessary. This independent assessment can be crucial evidence in court.

• Example 3: Long-Term Disability Application

  An individual applies for long-term disability benefits from their private insurance provider due to a chronic autoimmune condition that severely limits their ability to work. The insurance company might require an IME with a rheumatologist. This specialist would conduct an examination and review the applicant's medical history to provide an objective assessment of the condition's severity, its impact on the applicant's functional capacity, and whether it meets the criteria for long-term disability as defined by the policy. This helps the insurer determine eligibility for benefits.