If you’ve filed a long-term disability (LTD) claim through a private insurance provider, there’s a good chance you’ll be asked to attend an Independent Medical Examination (IME) at some point in the process. While it may sound routine, the outcome of an IME can significantly impact your disability benefits—especially if the insurer is looking for reasons to deny, reduce, or terminate your claim.

Understanding how IMEs work, what your rights are, and how to prepare is critical if you want to protect your claim and ensure fair treatment.

What Is an Independent Medical Examination?

An Independent Medical Examination (IME) is a medical assessment arranged and paid for by the insurance company, not by you or your treating doctor. The insurer chooses a physician—often a specialist—to evaluate your condition and provide a report on whether you are truly disabled under the terms of your policy.

Despite the name, these assessments are not always as “independent” as they sound. Insurers use IMEs to gather evidence that may contradict your medical records or support their decision to deny or end your benefits.

Why Do Private Insurers Request IMEs?

Private insurance providers use IMEs to:

• Reassess ongoing claims after a certain period (e.g., after the “own occupation” period ends, usually at 24 months)
• Challenge the medical evidence submitted by your treating physician
• Determine your functional capacity and whether you can return to work
• Build justification to deny or cut off benefits

IMEs are especially common in psychiatric disability claims, chronic pain cases, and any situation where the disability is based on subjective symptoms or lacks objective test results.

How IMEs Can Impact Your Disability Claim

The report generated from an IME carries significant weight with your insurer—even more so than the opinions of your own doctors. That’s because the IME is considered a “third-party assessment,” even though it is initiated by the insurer.

If the IME doctor concludes that:

• Your condition is not as severe as reported;
• You are capable of some form of work (even if it’s not your usual job);
• There’s insufficient objective evidence to support your claim;
  then the insurance company may deny your application, terminate your ongoing benefits, or refuse to approve an appeal.

Red Flags to Watch Out For

Not all IMEs are conducted fairly. Be cautious of these common issues:

• Brief or superficial assessments that don’t reflect the full scope of your condition
• Inaccurate or incomplete reports that misrepresent your symptoms or statements
• Biased or insurer-friendly doctors who regularly conduct assessments for insurance companies
• Examiners who don’t specialize in your condition, leading to uninformed conclusions

It’s important to remember that IME doctors are not your treating physicians. They are not there to provide treatment or help you recover. Their role is to assess you—often with the insurer’s financial interest in mind.

Your Rights When Attending an IME

If you’re scheduled for an IME, you still have rights. Here’s what you should know:

• You must be given reasonable notice of the appointment time and location.
• You can request information about the examiner, including their credentials and area of specialization.
• You are not required to undergo invasive procedures or tests unrelated to your condition.
• You can bring a support person or request a recording (though the insurer may object—speak to a lawyer first if this is a concern).
• You can—and should—ask for a copy of the IME report. This can help you respond if it contains errors or unfair conclusions.

If the IME report leads to a denial or termination, you have the right to appeal—and legal help can make a big difference.

How to Prepare for an IME

An IME is not just a doctor’s appointment—it’s part of a legal and insurance process. Preparation matters.

Here’s how to get ready:

1. Be honest, but focused. Don’t downplay your symptoms, but don’t exaggerate either. Stick to the facts of how your condition affects your daily life and work.
2. Review your symptoms and history. Be ready to explain your medical history, current symptoms, treatment efforts, and how your condition limits your ability to work.
3. Know your job demands. Be prepared to explain your job duties and why you can’t meet them due to your condition.
4. Avoid unnecessary conversation. Everything you say (and do) may be included in the IME report—even small talk.
5. Take notes afterward. Write down what was asked, how long the exam lasted, and anything that seemed off. This can be useful later, especially if the report misrepresents your interaction.

What to Do If Your Benefits Are Denied After an IME

If your insurer uses the IME to justify denying or terminating your benefits, don’t panic—but don’t wait, either.

Here’s what to do:

• Request a full copy of the IME report and your claim file.
• Speak to a disability lawyer immediately. They can help you challenge the report, obtain stronger evidence, and represent you through the appeal or legal process.
• Keep all documentation from your treating doctors up to date and consistent. This helps rebut any unfair findings in the IME.

Final Thoughts

Independent Medical Examinations can play a decisive role in the outcome of your disability claim. While insurers present them as neutral evaluations, they’re often used to find reasons to deny benefits—especially in private insurance claims.

If you’re scheduled for an IME, take it seriously. Prepare carefully, understand your rights, and seek legal advice if anything feels off or if your benefits are impacted.

You deserve a fair and unbiased assessment—not one designed to protect the insurer’s bottom line. And if that fairness is in question, you don’t have to face it alone. A disability lawyer can help level the playing field and protect the benefits you’re entitled to.

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