What to Do When the IME Doctor Disagrees With Your Doctor

When dealing with a workers’ compensation claim, you might come across an independent medical examination (IME). While this exam is meant to provide an impartial medical opinion, it’s not uncommon for the IME doctor to disagree with your treating physician. This situation can be frustrating and intimidating, but it doesn’t mean your claim is lost.

Here’s a clear, actionable guide to help you navigate this challenge while protecting your rights and recovery.

What Is an IME and Why Does It Matter?

An independent medical examination (IME) is often requested when there are disputes or uncertainties about a workers’ compensation claim. Typically scheduled and paid for by the insurance company, the IME doctor evaluates the worker’s medical condition, reviews their history, and may recommend whether they can return to work.

Though the IME is labeled “independent,” the term can be misleading. Since the insurance company selects and compensates the IME doctor, there’s often a risk of bias toward minimizing the insurer’s liability.

Common Areas of Disagreement Between Your Doctor and the IME Doctor

IME doctors may have viewpoints that differ from your treating physician regarding:

• The severity of your injuries
• The necessary treatments for your recovery
• Whether your injury prevents you from returning to work
• Your residual functional capacity (the tasks you’re able to perform after your injury)

Unfortunately, courts often weigh an IME doctor’s opinion heavily, even if it’s less thorough than your own physician’s assessment. But don’t worry, there are ways to challenge and address conflicting opinions.

Steps to Take 

If you find yourself in this predicament, stay proactive. Here are key steps you can take:

1. Advocate for Your Health and Recovery

Your health should always come first. If the IME doctor suggests you return to work while you’re still in pain or feel unready, share your concerns first with your treating doctor and, if needed, with your employer and insurance provider. Pushing yourself too hard can worsen your condition, potentially jeopardizing both your recovery and your claim.

2. Get a Second Opinion or Additional Medical Evidence

Ask your treating doctor to provide thorough, documented evidence of your condition. Request clinical notes, diagnostic tests (such as MRI or X-ray results), or referrals to specialists for a second opinion. All of this can help strengthen your case. 

If possible, compile a clear timeline showing how your injury limits you from performing work tasks. Detailed medical records often outweigh an IME’s findings.

3. Discredit the IME Doctor’s Report Where Necessary

Review the IME report carefully with your attorney. Look for inconsistencies, incomplete data, or errors, such as:

• Misinterpretations of your medical records
• Omissions of critical symptoms or test results
• Opinions based solely on a brief or inadequate examination

If the IME doctor’s findings are factually incorrect or if they lack proper credentials, you and your attorney can challenge the report directly with the insurance company or during a workers’ compensation hearing.

4. Understand State Rules About IMEs

IME laws vary by state, including how the doctor is chosen and how their findings are used. Some states allow injured workers to pick an IME doctor, while others leave this entirely to the insurer. Knowing your state’s IME guidelines can help protect your rights.

For example, in states with strict licensing and impartiality requirements, you may be able to dispute the credibility of a biased IME. Consult an experienced workers’ compensation attorney to interpret local laws and maximize your claim.