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 West Virginia (WV), an Independent Medical Examination (IME) is a tool used by insurance companies or defendants in personal injury cases, including workers' compensation and liability claims arising from incidents such as motor vehicle accidents. The IME is conducted by a medical professional who has not previously treated the claimant. Its purpose is to obtain an objective assessment of the claimant's injuries, the extent of the injuries, and to determine whether the injuries are related to the incident in question. The IME can influence the outcome of a claim or a case by providing an expert opinion on the medical aspects of the case. If a claimant refuses to undergo an IME when properly requested, they may jeopardize their ability to successfully pursue their claim or litigation. The examining physician will review medical records, conduct an evaluation, and produce an IME report detailing their findings. It's important to note that the IME is not intended to offer a second opinion for treatment purposes but rather to inform the defense strategy of the insurance company or defendant.