What is an IME and Can I Refuse One?

A workers’ compensation IME (Independent Medical Examination) is an examination by a physician selected and paid by the insurance carrier or self-insured employer — not by you and not by the Workers’ Compensation Board. The ‘independent’ label is misleading: the IME doctor is independent of your treating relationship, not of the carrier’s interests. IMEs are authorized by WCL §137, and you generally cannot refuse without risking suspension of benefits. What you can do is prepare carefully, attend with documentation in hand, note everything about the exam, and challenge unfavorable findings with treating-physician responses and, on serious cases, a counter-IME.

An IME is the carrier’s exam, not yours. You can’t refuse it. But you can prepare for it — and challenge the report.

TL;DR

• An Independent Medical Examination (IME) is an examination by a physician chosen by the carrier or employer — not by you, and not by the WCB.
• IMEs are statutorily authorized; you generally cannot refuse without risking suspension of benefits.
• IME reports are typically used to dispute causation, MMI, surgical necessity, work restrictions, and SLU percentage.
• Run the IME Red Flag Checker to identify common problems with IME reports.

What IME stands for

“Independent” is a misnomer. The IME doctor is selected by the carrier and paid by the carrier. They are independent of your treating relationship, not independent of the carrier’s interests.

What an IME involves

You attend an examination at the IME doctor’s office. The exam typically lasts 15-45 minutes (sometimes substantially less than advertised). The doctor:

• Reviews your records (usually a subset provided by the carrier)
• Takes a history from you
• Performs a physical examination
• Reviews imaging if available
• Issues a written report

The report is then provided to the carrier and, if it supports the carrier’s position, used to dispute coverage of treatment, indemnity, or permanency.

Can you refuse?

Generally, no. WCL §137 authorizes IMEs, and refusing without good cause can trigger suspension of benefits. There are exceptions:

• The exam is unreasonable in time or location
• Specific procedural violations
• Documented medical inability to attend

If you have concerns about an IME, the response is to attend with counsel-supported preparation, not to refuse outright.

Preparation

Before any IME:

• Review your timeline and history
• Don’t volunteer information not asked
• Answer all questions truthfully
• Note the time the exam took
• Note who was present
• Note the physical maneuvers performed
• Note imaging and records the doctor referenced
• Write up your own contemporaneous note of the exam afterward

If possible, have someone accompany you. Some claimants record the exam where permissible; check current rules.

What IME reports do wrong

Common IME issues:

• Range of motion measured without goniometer
• No instability testing when ligamentous injury is involved
• Guidelines minimums ignored after surgery
• MMI declared prematurely
• Apportionment without medical foundation
• “No objective findings” when there’s clear surgical history
• Mechanism of injury misstated

Run the IME Red Flag Checker on the report after you receive a copy.

What I see go wrong

• Claimant attends unprepared — no notes, no orientation to likely topics
• Surveillance disclosed during exam — the IME asks about activities visible on surveillance you weren’t aware existed
• Treating physician doesn’t get the IME report to respond
• No counter-IME when warranted on serious cases

What to do next

If an IME is scheduled, get prepared. If you’ve received a problematic IME report, run the IME Red Flag Checker. Contact me directly.

Related pages

• What happens at a workers’ comp hearing?
• Will workers’ comp pay for surgery?
• Can I choose my own doctor?
• Schedule Loss of Use — shoulder
• Schedule Loss of Use — knee