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 Connecticut, an Independent Medical Examination (IME) is often utilized in the context of workers' compensation claims and personal injury litigation. State statutes and regulations govern the use of IMEs to ensure that they are conducted fairly and for appropriate purposes. For workers' compensation, Connecticut General Statutes Section 31-294f authorizes commissioners to order an IME to resolve disputes about the medical condition or capacity of the claimant. The IME is meant to provide an objective assessment of the injury and its relation to the claimant's employment. In personal injury cases, Rule 35 of the Connecticut Practice Book allows a court to order a party whose physical or mental condition is in controversy to submit to a physical or mental examination by a suitable licensed or certified examiner. The purpose of the IME in these cases is not to offer medical treatment but to obtain an expert opinion on the extent of the injuries, causation, and potential impact on the claimant's life, which can be critical for the defense in assessing liability and damages. Failure to comply with an IME can lead to consequences such as the loss of the right to pursue the claim.