Getting injured at work is stressful enough. Then you receive a letter saying you need to see a doctor you’ve never met for an “independent medical examination.” This request can feel invasive and confusing, especially when you’re already being treated by your own physician. An IME isn’t actually independent in most cases. The insurance company pays for it. They chose the doctor. And they’re hoping that the doctor will give them ammunition to reduce or deny your benefits. That doesn’t mean you can ignore the request.
What These Examinations Really Are
Independent medical examinations are one-time evaluations conducted by physicians selected by your employer’s workers’ compensation insurance carrier. The stated purpose is to get an objective medical opinion about your injury, treatment needs, and ability to work. In reality, IME doctors tend to produce reports favorable to whoever’s paying them. They often downplay injury severity, question whether your condition is work-related, or claim you can return to full duty when your treating physician says otherwise. These exams aren’t about providing you with medical care. The doctor won’t be treating you going forward. They’re simply evaluating your condition to provide an opinion to the insurance company.
When Insurance Companies Request Them
IME requests typically come at specific points in your claim:
- When you’ve been off work for an extended period
- Before approving expensive treatments or surgery
- When determining permanent disability ratings
- If there’s a dispute about returning to work
- When your treating doctor recommends restrictions, the employer doesn’t want to accommodate
The insurance company may also request an IME if they suspect you’re exaggerating your symptoms or if they believe your current treatment is excessive. A New Mexico work injury lawyer can review the timing and stated purpose of an IME request to determine if it’s reasonable or if the insurer is fishing for reasons to deny your claim.
Your Legal Obligations
Under New Mexico law, injured workers must cooperate with reasonable requests for medical examinations. Refusing to attend an IME without a valid cause can result in suspension of your benefits. However, you have rights during this process. The examination must be conducted at a reasonable time and location. You can’t be required to travel hundreds of miles or attend appointments scheduled during times that would be impossible for you to make. The examination should be relevant to your claimed injury. If you hurt your back, the insurance company can’t force you to undergo a psychiatric evaluation unless there’s a legitimate reason connected to your claim.
What Happens During The Exam
IME appointments are usually brief. Don’t expect the thorough examination your treating doctor provides. Many IME doctors spend 15 to 30 minutes with injured workers, reviewing records and conducting a limited physical assessment. The doctor will ask about your injury, how it happened, your symptoms, and your medical history. They’ll perform some basic tests and range of motion assessments. Some may order additional diagnostic studies, though this is less common. Everything you say can end up in the report. Be honest, but don’t volunteer information beyond what’s asked. Don’t downplay your pain, but don’t exaggerate either. Inconsistencies between what you tell the IME doctor and what you’ve reported to your treating physician can be used against you.
Preparing For Your Appointment
You can bring someone with you to the examination. Having a witness present can be valuable if questions arise later about what was said or done during the exam. Take notes about the appointment duration, what tests were performed, and any significant statements made by the doctor. Dress appropriately so the doctor can examine the injured area. Bring a list of all medications you’re currently taking and any recent diagnostic test results. Know the name and contact information for your treating physician. Your New Mexico work injury lawyer should receive a copy of any IME report as soon as it’s produced. These reports often contain errors, mischaracterizations, or conclusions not supported by the medical evidence.
How Reports Impact Your Case
IME reports carry significant weight in workers’ compensation proceedings. Administrative law judges often give them considerable credibility because they’re supposedly “independent” evaluations. When an IME report contradicts your treating physician’s opinions, you may need to fight harder to protect your benefits. Your attorney can challenge the report by pointing out factual errors, questioning the doctor’s methodology, or highlighting conflicts with objective medical evidence like MRI results or surgical findings. Sometimes the insurance company uses IME reports to argue you’ve reached maximum medical improvement when your treating doctor disagrees. This determination affects whether you’ll continue receiving temporary disability benefits and how permanent disability is calculated.
Getting Legal Help
IME requests often signal that the insurance company is preparing to reduce or terminate your benefits. Don’t face this process alone. Davie & Valdez P.C. has represented injured workers in New Mexico for over 35 years and understands how to challenge biased medical opinions that threaten your financial security and access to necessary treatment. Contact our office to discuss how we can protect your rights throughout the workers’ compensation process.