If the insurance company has scheduled you for an “IME,” you’re probably wondering why, and whether you should be worried. These exams can affect your benefits, so it pays to go in prepared. Philly Injury Lawyer helps injured workers get ready for these exams and fights back when the insurance doctor’s report doesn’t match reality.
What an IME Is
IME stands for independent medical examination. Despite the name, it usually isn’t independent. The doctor is chosen and paid by the insurance company. This doctor is not your treating doctor, won’t treat you, and isn’t there to help you get better. Their job is to write a report about your injury, your restrictions and whether you can work.
Do I Have to Go?
Generally, yes. Pennsylvania lets the insurer require an exam with a doctor of its choosing, usually up to twice in a 52-week period, and more often if a workers’ comp judge allows it. If you refuse without a good reason, the insurer can ask a judge to suspend your benefits until you go. The insurer has to pay for your travel and any wages you lose to attend.
Why the Insurer Wants an IME
Most IMEs are scheduled to support one of these moves:
- Saying you have fully recovered and benefits should end
- Saying you can do light duty or other work, which can lower your checks
- Challenging whether certain treatment or surgery is necessary
- Questioning whether your injury is really work-related
How to Prepare
- Be on time and bring a list of your medications and treating doctors.
- Be honest and consistent. Don’t exaggerate, and don’t downplay your pain.
- Describe how the injury affects your daily life, not just the moment of the exam.
- Assume you’re being watched from the parking lot to the exam room.
- After the exam, write down how long it lasted and what was actually tested.
What Happens After
An IME report doesn’t end your benefits on its own. If the insurer wants to stop or reduce your checks based on it, it usually has to file a petition, and a workers’ comp judge decides after hearing from your doctors too. That is where having a lawyer matters most.
Got an IME Notice? Call Us First
Call (215) 735-4800 before your exam. The consultation is free, and you pay nothing unless we win. We Win or It’s Free®.
Frequently Asked Questions
Can I bring someone to the IME?
Often, yes. A family member or friend can usually come with you. Ask us before the exam so we can tell you what to expect.
What if the IME doctor says I can go back to work?
That opinion alone doesn’t stop your benefits. If the insurer files a petition, your treating doctor’s opinion goes in front of a judge as well. Keep treating and keep following your doctor’s restrictions.
Is an IME the same as an IRE?
No. An IME is about whether you’ve recovered and what you can do. An Impairment Rating Evaluation measures your permanent impairment and can change how long benefits last.
Pennsylvania Law in Plain English
Under Pennsylvania’s Workers’ Compensation Act, an injured worker can be required to attend reasonable exams by a doctor the employer chooses. Refusing without a good reason can lead a judge to suspend benefits, but the insurer still needs a judge’s decision or your agreement to end them based on the doctor’s opinion.
