Independent Medical Assessments: What Are They And How Can I Prepare?

What is an independent medical assessment (“IME”)?

If you have been injured and are advancing a tort and/or accident benefits claim, it is quite likely that at some point you will be asked to attend one or more IME’s. These assessments are also known as “medical-legal assessments” (when arranged by your own personal injury lawyer), “defence medical examinations” (when arranged by the tort defence lawyer), or “insurer examinations” (when arranged by your accident benefits insurer). They are an important part of your tort and/or accident benefits case as the expert reports generated from these IME’s can influence the compensation or benefits that you receive.

Whichever name is used, these IME’s are all similar in nature. Subject to some exceptions, they typically involve a one-time assessment of you by a health care professional or other medical-legal expert, whereby the assessor is not seeing you for treatment purposes (i.e. to provide you with medical/psychological/vocational treatment and care), but rather for purposes of preparing a report in which the assessor provides an opinion on specific questions relevant to your claim.

How does the IME process work?

Whomever is referring you to the IME, be it your lawyer, the defence lawyer, or the accident benefits adjuster, will select the expert assessor and book the appointment. That same person will also send to the assessor records relevant to the IME (e.g. medical records, employment records, photographs of the accident, etc.). Finally, that same person will also send a referring letter to the assessor setting out the specific questions or issues for which the assessor is being asked to provide an opinion.

Common referral questions include, but are not limited to:

• Your diagnoses, impairments, and/or disfigurements;
• Causation (i.e. the likelihood that the subject accident/incident caused your injuries and impairments);
• In a tort case, whether:
  • your impairments pass the legal “threshold”;
  • you have suffered or will suffer a loss of income, loss of competitive advantage, and/or loss of earning capacity;
  • you could benefit from future care, goods, and/or services;

• In an accident benefits case, whether:
  • your impairments meet the requisite disability test for entitlement to income replacement benefits;
  • you have attendant care needs;
  • a proposed treatment plan is reasonable and necessary;
  • you have sustained a catastrophic impairment.

Although the assessor may not be formally asked to provide an opinion on your credibility per se, you should be aware that most assessors will nevertheless comment in their reports on your presentation; such as whether you:

• appeared to answer questions in an honest and forthright manner;
• engaged in pain behaviours or behaviours that suggested you may be exaggerating your symptoms;
• appeared to put forth a good and genuine effort at testing;
• passed validity tests.

Once an IME is complete, the assessor will prepare a report that is sent to the referral source (i.e. the lawyer or adjuster that requested the IME). The timing for the delivery of the report can vary depending upon the type of IME; namely:

• the context in which the IME takes place, since:
  • in the tort context:
    • other than deadlines for serving expert reports prior to pre-trial, there are no rules as to how quickly a medical-legal report needs to be delivered after the IME takes place;
    • reports generated from defence medical examinations must be delivered “forthwith” (i.e. as soon as possible) after the IME;
  • in the accident benefit context, there is no deadline for how quickly the assessor must prepare the report, but once the report has been delivered to the insurer, it must be delivered to you within ten days;
• the type of IME, since some IME reports tend to be longer than others which may impact how quickly the report can be drafted (e.g. future care and neuropsychological reports often tend to be longer than, for instance, orthopaedic or physiatry reports).

How can I prepare?

Below are some “do’s and don’ts” for attending IME’s:

• Do be truthful.
  • Do accurately disclose your pre- or post-incident health issues, even if you think it may hurt your case.
  • Do not exaggerate nor minimize your symptoms.
• Do put forth a good effort at testing.
  • Do not put in a half effort at testing in the hopes that the findings will make you look more impaired than you are.  Many tests performed during IME’s have built-in validity tests designed to reveal genuine results as opposed to those that have been manipulated.

• Do not use “absolute” words.
  • Do not use absolute words such as: never, always, everything, nothing, can’t, or don’t…unless you are 100% sure they apply 100% of the time.
  • Do use words that give you some flexibility such as: rarely, usually, generally, typically, sometimes, or most of the time.
  • Do qualify your answers, if appropriate, such as: “yes, but with difficulty” or “can’t…for long/repetitively/without pain.” 

If you are represented by a personal injury lawyer, your lawyer should make you feel comfortable and prepared for any IME.  Do not be shy to ask questions.

Thomson Rogers offers free consultations so please feel free to reach out to us at any time. We are here to help.

Deanna Gilbert is a personal injury lawyer and a partner at Thomson Rogers. Her practice is devoted to representing Plaintiffs in personal injury litigation including cases arising from motor vehicle accidents, medical malpractice, slip and falls, product liability and assaults. Deanna can be reached at 416-868-3205 or by EMAIL.

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