Short answer: An Independent Medical Exam (IME) is a physical and document review performed by a physician chosen and paid by the insurance company. The exam is “independent” only in name; the IME doctor is hired by the carrier specifically to evaluate your claim and the resulting report is used to challenge your injury claim. In Illinois, you generally cannot refuse an IME if your own policy or a court order requires it, but you have important rights: you can bring counsel, request the report, prepare for the exam, and challenge the report’s conclusions with your own treating physicians.
In my experience handling Chicago auto-injury cases, the IME is one of the most reliably one-sided steps in the claim process. The same 20 or 30 Illinois physicians appear on most IME reports across the major carriers, and their conclusions follow a consistent pattern: injuries are minor, resolved, unrelated to the crash, or pre-existing. Understanding what the IME is and is not protects the case from the report’s predictable outcome.
Who Has the Right to Order an IME
| Scenario | Can the insurer require an IME? |
|---|---|
| Your own insurer on a UM/UIM claim | Usually yes, as a cooperation duty in your policy |
| Your own insurer on a MedPay claim | Usually yes, under MedPay endorsement terms |
| At-fault driver’s liability carrier, pre-suit | No, not without your consent |
| At-fault driver’s defense counsel, after suit filed | Yes, by court order under Illinois Supreme Court Rule 215 |
| Workers’ compensation insurer | Yes, under the Illinois Workers’ Compensation Act |
What Happens at an IME
The exam itself is short, usually 15 to 45 minutes. The IME physician reviews your prior medical records (provided by the carrier), takes a brief history from you, performs a physical examination, and sometimes orders or reviews imaging. The encounter is more cursory than a treating physician visit, and the IME doctor is not your doctor; no treatment is provided.
The report that follows is typically 5 to 20 pages and addresses:
- Whether the claimed injuries are related to the crash (causation)
- The severity of the injuries observed
- Whether the treatment received was reasonable and necessary
- Whether the claimant has reached maximum medical improvement
- Whether any permanency or restrictions exist
- Whether further treatment is justified
The report’s conclusions almost always favor the carrier’s position because the IME doctor is repeatedly hired by the same carriers and earns the next assignment by producing the kinds of conclusions they value.
Recurring IME Defense Patterns
- “Injuries resolved within typical recovery time.” Used to argue ongoing complaints are unrelated to the crash.
- “Symptoms inconsistent with imaging.” Used to argue subjective complaints are exaggerated.
- “Pre-existing degenerative changes.” Used to attribute current symptoms to age rather than crash.
- “Continued treatment not medically necessary.” Used to cut off the medical-bills portion of the claim.
- “No permanent impairment.” Used to deflate the pain-and-suffering and future-damages claims.
The defense counsel will then introduce the IME report at deposition or trial and ask treating physicians to comment on it. The case turns on how well the treating doctors’ testimony rebuts the IME conclusions.
How to Prepare for an IME
- Get counsel involved beforehand. Your lawyer will tell you what to expect, what to say, and what to avoid.
- Bring a record of the exam. In Illinois, you can typically bring a friend, family member, or paralegal to document what happened. Some jurisdictions allow audio recording with notice.
- Be precise about pain. Do not minimize (“I’m doing okay”) and do not exaggerate (“It’s terrible”). Specific descriptions of when, where, and how symptoms occur.
- Demonstrate range of motion accurately. Many IME doctors use range-of-motion as proof of recovery. Do what you can do, no more, no less.
- Disclose pre-existing conditions truthfully. Hiding prior injury gives the IME doctor ammunition. Disclosing it lets your lawyer use Illinois’s eggshell-plaintiff rule.
- Do not extend the exam. Answer questions; do not volunteer additional commentary.
- Request the report. You are entitled to the IME report. Read it carefully with counsel for inconsistencies and factual errors.
Frequently Asked Questions
Can I refuse an IME?
It depends on the basis of the IME. On a first-party UM/UIM or MedPay claim, refusing typically violates the cooperation duty in your own policy and gives the carrier grounds to deny the claim. On a third-party claim before suit, you can refuse. After suit is filed and the court orders an IME under Rule 215, refusing violates the court order.
How long does the IME report take to arrive?
Typically 2 to 6 weeks. You and your lawyer are entitled to a copy. Request it in writing if it does not arrive.
If the IME doctor is wrong, what can I do?
Your treating physicians can refute the IME conclusions. Treating-physician testimony at deposition or trial generally carries more weight with juries than IME testimony because the treating doctor has an ongoing relationship with the patient, while the IME doctor is paid by the carrier for the exam alone.
Will my lawyer attend the IME with me?
Usually not the lawyer personally, but a paralegal or family member is common. Some Illinois courts permit audio recording of the IME; check the specific rule and order in your case.
What if I have a medical condition I didn’t disclose to the IME doctor?
Tell your lawyer immediately. Hidden conditions create credibility problems if they emerge later. Better to disclose now and let your lawyer frame the relationship between pre-existing conditions and the crash injuries.
Authoritative Sources
- Illinois Supreme Court Rule 215 – Physical and Mental Examinations
- 735 ILCS 5/2-1116 – Modified comparative fault
- Illinois Department of Insurance
