Calling it “independent” is largely a courtesy. In an independent medical examination, the defense selects the examining physician, the defense pays the examination fee, and the resulting report typically supports the defense theory of the case. Plaintiffs in Georgia personal injury cases face IMEs as a routine part of litigation, and the way an IME unfolds can affect case value substantially.
Understanding how IMEs work, what to expect during the examination, and how to respond to IME reports allows plaintiffs to handle the process effectively rather than being damaged by it.
What an IME is #
An IME is a medical examination conducted by a physician retained by the defense:
Selection. Defense counsel or the insurance carrier selects the examining physician. The selection considers the physician’s track record, specialty, and relationship with defense interests.
Purpose. To evaluate the plaintiff’s claimed injuries from the defense perspective, identify possible defenses, and produce a report supporting the defense theory.
Distinction from treating physicians. Treating physicians have ongoing patient relationships and treat the patient over time. IME physicians meet the patient once for evaluation purposes only.
Limited scope. IMEs focus on the injuries claimed in the case rather than providing comprehensive medical evaluation.
Documentation. The IME produces a report sent to defense counsel. The plaintiff receives the report through discovery.
The “independent” qualifier #
The term “independent” is technically accurate but practically misleading:
Selection bias. Defense selects physicians who tend to produce defense-favorable reports. Physicians with track records of producing plaintiff-favorable reports get selected less often.
Repeat relationships. Many IME physicians work regularly with defense firms and insurance carriers, generating substantial income from defense work. Some maintain primarily defense-oriented practices.
No treatment relationship. Unlike treating physicians, IME physicians have no ongoing duty to the patient. The relationship is transactional and one-time.
Report orientation. Reports typically emphasize findings that support defense arguments and minimize findings supporting plaintiff’s claims.
Plaintiffs and their counsel should approach IMEs understanding the dynamic rather than expecting genuinely neutral evaluation.
When IMEs occur #
IMEs occur at specific points in cases:
Early in claim handling. Some insurance carriers request IMEs during claim handling before suit is filed. Plaintiff cooperation may be required by insurance contract terms.
During litigation. Once suit is filed, IMEs typically occur during the discovery phase. Court rules govern the process.
Workers’ compensation context. Workers’ comp cases have specific IME procedures that may differ from civil litigation IMEs.
Multiple IMEs. Some cases involve multiple IMEs from different specialists. Defense may seek separate evaluations for different injuries or different specialty perspectives.
Specialist-specific IMEs. Orthopedic injuries may go to an orthopedic IME; neurological issues to a neurologist; psychiatric claims to a psychiatrist; vocational issues to a vocational evaluation.
Cooperation requirements #
The plaintiff’s obligation to attend an IME varies:
Insurance contract requirements. Some insurance policies require cooperation with carrier-requested medical examinations. Refusal can support coverage denial.
Discovery rules in litigation. Once suit is filed, court rules generally require the plaintiff to attend reasonable defense IMEs as part of discovery. Refusal can produce sanctions.
Reasonable accommodation. While attendance is generally required, the plaintiff can negotiate reasonable accommodations regarding scheduling, location, and conditions.
Limitations on scope. The IME should be limited to evaluation of claimed injuries. Plaintiff counsel may object to overreach.
Recording and observers. Some jurisdictions allow plaintiff representatives or recording at IMEs. Georgia practice varies; counsel should know the current state of the law.
Preparing for the IME #
Plaintiff preparation affects IME outcomes:
Understanding the dynamic. The patient should understand the IME is for defense purposes, not for treatment. The examining physician’s questions and methods may differ from those of a treating physician.
Honest and accurate reporting. The patient should report symptoms honestly and accurately. Exaggeration damages credibility; minimization undermines the claim.
Consistent presentation. Symptoms reported to the IME should be consistent with treating physician records. Major inconsistencies suggest exaggeration or fabrication.
Punctuality and professionalism. Arriving on time, presenting professionally, and behaving courteously avoids ammunition for defense character arguments.
Documentation review. The patient should be familiar with their own medical history, including pre-incident conditions, treatments, and prior symptoms.
Pain and limitation accuracy. Patients should describe their current pain and limitations honestly, neither exaggerating to support claims nor minimizing out of stoicism or politeness.
Activity reporting. The patient should report activities accurately. The IME physician may ask about daily activities, work, and recreational pursuits.
What happens during the IME #
The IME follows a predictable pattern:
History intake. The physician asks about the incident, injuries, treatment, symptoms, and current condition. The intake often includes pre-incident history.
Physical examination. Examination of the body areas relevant to the claimed injuries. Components vary by specialty and injury type.
Specific testing. Testing relevant to the specialty (range of motion, strength, sensation, gait, mental status, depending on the injury).
Document review. The physician typically reviews available medical records before or during the examination.
Conclusions and report preparation. After the examination, the physician prepares a written report with findings, opinions, and conclusions.
Time and intensity. Most IMEs run 30 minutes to two hours depending on injury complexity. The examination itself may be relatively brief; the report preparation takes additional time.
What patients should not do #
Patients should avoid:
Volunteering information not asked. The patient should answer questions asked but not volunteer additional information that wasn’t requested. Volunteering may produce content the defense will use.
Discussing the case. The IME isn’t the place to argue case theory, criticize the defendant, or discuss the legal aspects of the case.
Exaggerating limitations. Demonstrating more limitation than actually exists damages credibility when defense surveillance contradicts the demonstration.
Minimizing symptoms. Conversely, downplaying symptoms out of pride or stoicism undermines the case.
Bringing companions inappropriately. Most IMEs don’t allow companions in the examination room. The patient should clarify expectations in advance.
Recording without permission. Recording without explicit permission may violate examination ground rules and create complications.
The IME report #
The IME report is a defense document but becomes part of the case record:
Standard content. History, examination findings, review of records, diagnosis, opinions on causation, opinions on permanency, opinions on appropriate treatment, opinions on future care needs.
Common defense-favorable conclusions. Conditions exist but aren’t related to the incident; conditions are related but are minor or resolving; treatment received was excessive or unnecessary; future care needs are limited; permanent impairment is minimal.
Discoverable status. The report is discoverable and the examining physician may be deposed.
Trial use. Defense calls the IME physician at trial to testify to the report’s conclusions. Plaintiff counsel cross-examines.
Plaintiff expert response. Plaintiff’s treating physicians and retained experts may respond to specific IME conclusions in their own testimony.
Cross-examining the IME physician #
IME physician depositions and trial testimony often focus on credibility issues:
Defense work history. How often does the physician work for defense interests? What percentage of practice is defense-related? How much income comes from defense work?
Examination time. How long was the examination relative to the complexity of the issues?
Records review. What records did the physician review? What was excluded or missed?
Disagreement with treating physicians. Why does the physician disagree with the doctors who treated the patient over time?
Methodology consistency. Are the physician’s methods consistent with mainstream medical practice?
Prior testimony. Has the physician taken inconsistent positions in other cases?
Compensation. What is the physician being paid for the evaluation and testimony?
Effective cross-examination can substantially affect how the jury weighs the IME testimony.
Defending against IME conclusions #
Several strategies address adverse IME conclusions:
Treating physician testimony. The treating physicians who actually managed the patient’s care over time typically have stronger credibility than a one-time examiner.
Retained expert testimony. Plaintiff’s retained experts may provide independent evaluation that responds to IME conclusions.
Records consistency. Treating records that consistently document specific injuries and findings carry weight against IME conclusions that minimize them.
Subsequent treatment. Continued treatment for the conditions the IME minimized supports the reality of the conditions.
Functional documentation. Functional capacity evaluations, day-in-the-life videos, and other functional documentation can rebut IME findings of minimal impairment.
Cross-examination effectiveness. Strong cross-examination at trial can substantially reduce the weight given to IME testimony.
When IMEs help the plaintiff #
Occasionally IMEs produce findings helpful to the plaintiff:
Acknowledgment of objective findings. Some IME physicians acknowledge clear objective findings even while disputing other aspects.
Reasonable conclusions in clear cases. In cases with overwhelming evidence, IME physicians may produce relatively reasonable conclusions to maintain professional credibility.
Internal inconsistencies in defense theory. IME conclusions sometimes contradict other defense positions, creating opportunities for plaintiff arguments.
Causation concessions. While disputing severity, IME physicians may concede causation, which helps establish that aspect of the case.
These helpful elements should be identified during IME report review and used strategically.
IMEs as recoverable risk #
The IME is unavoidable in most personal injury litigation, but how it’s handled affects case value. Plaintiffs who arrive prepared, present honestly, and avoid common pitfalls minimize the damage IMEs can do. Plaintiff counsel who effectively responds to IME conclusions through treating physician testimony, retained experts, and strong cross-examination at trial neutralizes much of what defense expects to gain. The cases that handle IMEs well often achieve settlements close to full value despite defense efforts to use IMEs to drive down recovery.
This article is for informational purposes only and does not constitute legal advice. Personal injury cases turn on specific facts and applicable law that vary by case. If you have been injured in Georgia and want to understand your legal options, consult a licensed Georgia personal injury attorney.