What Happens at a Workers’ Comp Independent Medical Examination?
A workers’ compensation independent medical examination (IME) can affect how your injury, treatment needs, and ability to work are evaluated. If you are recovering from a workplace injury, preparing for another medical appointment while managing missed paychecks and ongoing symptoms can be challenging.
An IME is generally an evaluation by a physician selected by an employer or insurer to assess your condition and provide an opinion about your workers’ compensation claim. Although the examination may resemble a regular medical appointment, its purpose and potential impact on your benefits are different.
At Schilling & Esposito PLLC, we help injured workers in Richmond and throughout Central Virginia understand the workers’ compensation process, including what to expect when an insurer requests an independent medical examination.
Knowing why the examination is scheduled, what the physician may evaluate, and how the findings could affect your claim can help you prepare. If you have received an IME notice and have questions about your rights, contact us to discuss your situation.
Why Is an IME Requested?
An employer or workers’ compensation insurer may request an IME when it needs an additional medical opinion about your workplace injury. In Virginia, these examinations can help resolve disagreements about your diagnosis, treatment, work restrictions, or whether your job caused your condition.
For example, the insurer may question whether a recommended procedure is necessary or whether you can return to work with restrictions. The examination may also help clarify the extent of your injury or whether you have reached maximum medical improvement, meaning your condition has stabilized as much as reasonably expected with treatment.
An IME does not mean your claim will be denied. However, the physician's findings may influence decisions about medical treatment, wage loss benefits, and other aspects of your claim.
What Happens During the Examination?
An IME typically involves reviewing your medical history, discussing your injury, and conducting a physical examination relevant to your condition. The exact process will depend on your injury, the questions the insurer wants answered, and the physician's approach. During the appointment, the physician may:
Ask how the workplace accident happened and when your symptoms began.
Review your medical records, diagnostic tests, and treatment history.
Ask about your current symptoms, daily activities, and ability to perform job duties.
Examine your injury, assess movement or strength, and conduct other relevant tests.
Ask about previous injuries or medical conditions that could affect your current symptoms.
The physician may also ask when you returned to work, whether your symptoms have changed, and what activities make them worse. Answer honestly and as accurately as you can. If you cannot remember a date or detail, say so rather than guessing.
An IME is generally intended to provide an assessment for the requesting party, rather than to establish an ongoing treatment relationship. The physician may not prescribe treatment or take over your care. Your regular treating doctor may continue managing your recovery separately.
How to Prepare for an IME
You can take practical steps to make the appointment more manageable and help the physician understand your condition. Preparation does not mean trying to influence the findings; it means providing accurate information about your injury and limitations. Before the examination:
Review the appointment notice and confirm the date, time, location, and any instructions.
Gather a list of medications, treatments, procedures, and relevant medical history.
Think through how the injury occurred, when your symptoms began, and how they have changed or developed over time.
Describe your actual work duties and any tasks you struggle to perform.
Ask your attorney about the purpose of the examination and any questions you have about the process.
During the appointment, explain your symptoms in concrete terms. For instance, if standing for extended periods increases your back pain, describe how long you can typically stand and what happens afterward. Avoid minimizing your limitations, but do not exaggerate them either.
If you need an interpreter, have mobility limitations, or have questions about bringing someone with you, address those concerns in advance. Whether an accompanying person is permitted may depend on applicable arrangements.
Can an IME Affect Your Workers’ Compensation Benefits?
Yes. An IME report may influence decisions about your medical care, work capacity, and eligibility for certain benefits, particularly when the insurer disputes your treating physician's conclusions. However, the report does not automatically determine the outcome of your claim.
The physician may agree with your treating doctor, recommend a different course of action, or conclude that you can perform certain work duties. If the report conflicts with your treating physician's opinion, the insurer may rely on it when evaluating whether to authorize treatment or continue benefits. Disagreements may require additional medical evidence or legal action.
Virginia provides a framework for resolving these disputes. Under Virginia Code § 65.2-607, an employer may request a qualifying medical examination, while Virginia Code § 65.2-603 generally requires employers to provide necessary medical attention for compensable workplace injuries, subject to the statute’s terms.
If an IME raises concerns about your treatment or ability to work, keep any correspondence you receive and discuss the findings with our Virginia workers' compensation attorneys. A report that disagrees with your treating physician is not necessarily the final word on your claim.
What if You Disagree With the IME Report?
You may disagree with the physician's conclusions, especially if you believe the report does not accurately reflect your symptoms, medical history, or physical limitations. If you disagree, identify the specific issues rather than assuming the entire report will be disregarded. Some useful steps may include the following:
Ask an attorney to review the report and explain how it could affect your claim.
Discuss any medical disagreements with your treating physician.
Identify factual errors, missing records, or statements that do not reflect what occurred during the examination.
Keep records of treatment recommendations, work restrictions, symptoms, and communications from the insurer.
Virginia workers’ compensation disputes are handled through the Virginia Workers’ Compensation Commission. Depending on the circumstances, the parties may need additional medical evidence or a formal decision from the Commission. The appropriate response will depend on the dispute, the available evidence, and the procedural posture of your claim.
You should also pay attention to any deadlines stated in official notices or legal documents. If benefits have been reduced, denied, or suspended following an IME, prompt legal guidance can help you understand what options may be available.
Contact Our Virginia Workers’ Compensation Attorneys for Guidance
An independent medical examination can provide information that affects your workers’ compensation claim, but its findings do not automatically settle every dispute about your injury, treatment, or benefits. Understanding the physician's role, preparing accurate information, and responding thoughtfully to an unfavorable report can help you protect your interests.
At Schilling & Esposito PLLC, we assist injured workers in Richmond and throughout Central Virginia with questions about workplace injuries and workers’ compensation disputes. Our attorneys, Tom Schilling and Mark Mario Esposito, can help you understand the IME process and evaluate the next steps based on your circumstances. Contact us to schedule a consultation.