Independent Medical Examination (IME)

When an IME is available

Either the carrier or the employee may select an independent medical examiner in any dispute concerning overutilization, medical benefits, compensability, or disability.

That covers most of what goes wrong in a claim: a denied surgery, a disputed MMI date, an impairment rating you believe is too low, a disagreement about whether you can work.

If both parties agree, the examiner may even be a physician already treating you. The examiner may not render an opinion outside their area of expertise as demonstrated by licensure and applicable practice parameters.

One per accident — and you’re bound by it

This provision most often catches people out. The entitlement is one IME per accident, and the statute says so explicitly to foreclose the argument that a claim involving a back injury and a shoulder injury supports two.

You are also bound by your selection and by that examiner’s opinions. An alternate is available only in four narrow circumstances: the examiner is not qualified to opine on a material aspect of the injury, the examiner ceases to practice in the relevant specialty, the examiner becomes unavailable through injury, death, or relocation outside a reasonably accessible area, or the parties agree.

Choosing an IME physician is therefore a strategic decision, not an administrative one. It is worth making deliberately.

Who pays

The party requesting and selecting the IME is responsible for all associated expenses, including medically necessary diagnostic testing and the physician’s fees.

But there is an important shift: if you prevail in a medical dispute as determined by a JCC order, or if benefits are paid or treatment provided after you obtained an IME based on that examiner’s findings, the employer or carrier pays for the examination.

In other words, a successful IME is often reimbursed.

The 15 day notice rule

The party selecting the IME must identify its choice of examiner to all other parties within 15 days after the date the examination is to take place.

Failure to provide that notification precludes the requesting party from submitting the examiner’s findings in a proceeding before a Judge of Compensation Claims. An IME you paid for and cannot use is a complete waste.

When the carrier schedules an IME

The carrier may contact you directly to schedule its IME. It must confirm the scheduling agreement in writing with you and your attorney at least 7 days before the examination date.

If you fail to appear without good cause, and fail to tell the physician at least 24 hours beforehand that you cannot attend, you are barred from recovering compensation for any period during which you refused to submit to the examination. You must also reimburse the carrier 50% of the physician’s cancellation or no-show fee — unless the carrier failed to provide the required written confirmation.

You can appeal to a JCC for reimbursement if the carrier withholds more than the statute allows.

Consensus IME

A less used option is worth knowing. When a medical dispute arises, the parties may mutually agree to refer you to a physician specializing in the condition at issue for a “consensus independent medical examination.”

The findings of a consensus IME are binding on both parties and resolve the medical dispute addressed. Importantly, agreeing to one does not use up either side’s entitlement to their own IME.

Where IMEs go wrong

• Spent too early. Using your one IME early leaves nothing for the MMI and impairment rating fight that usually matters more.
• The 15 day notice missed—a fatal, avoidable, purely procedural error.
• Wrong specialty selected. The examiner cannot opine outside their expertise, and the choice binds you.
• A missed carrier IME. Compensation barred for the period of refusal, plus half the no-show fee.
• Expecting follow up care. An IME physician may not provide follow up care even where they recommend it. The IME is an opinion, not a treatment relationship.
• Attorney’s fees for fighting an IME. Fees incurred in delaying or opposing an IME, including motions for protective orders, are not recoverable.

What this means for your claim

Treat your one IME as a limited resource. The highest value use is usually the dispute that determines the permanent outcome — the MMI date and the impairment rating — rather than an earlier disagreement about a single authorization.

If the carrier schedules its IME, go. Missing it won’t earn you a scolding; it will bar compensation for that period. If you genuinely cannot attend, notify the physician more than 24 hours in advance and document it.