Independent medical examinations (IMEs): what to expect

If you have a workers compensation, transport accident or other injury claim, you may be asked to attend an independent medical examination (IME). Many people feel nervous about this, especially when the examiner is someone they have never met.

This guide explains what an IME is, why it is arranged, what usually happens, and your rights along the way. It also covers what to expect at a psychological or neuropsychological IME.

What is an independent medical examination?

An IME is an appointment with a health practitioner who is not involved in your treatment. They give an independent opinion on questions such as:

• what your diagnosis is, and whether it was caused by the incident
• whether your treatment is reasonable and helping
• what work you can do now, and what might help you return
• whether you have a permanent impairment, and how much

SIRA’s IME fact sheet for NSW workers says an IME gives the insurer or your legal representative an independent opinion to help with decisions about rehabilitation, return to work and entitlements. The TAC also uses independent medical examinations by health professionals it approves, and specially trained doctors carry out its impairment assessments.

IMEs can be done by doctors, psychiatrists, psychologists and other health practitioners. WorkSafe Victoria’s claims manual lists registered medical practitioners, psychologists, physiotherapists and others approved by WorkSafe. It also makes clear that IMEs examine, they do not treat.

Do I have to attend?

Usually, yes. Each scheme has its own rules:

• Victoria (WorkSafe): the agent can require you to attend an IME at reasonable intervals. Not attending may affect your entitlements. You should get at least seven days’ notice.
• NSW workers compensation: you are required to attend necessary IMEs arranged by your employer or insurer. You should receive a letter at least ten working days before, explaining the arrangements and the reason.
• Comcare: changes in 2024 mean Comcare must follow a guide that limits the number of examinations and takes your views into account when choosing the examiner. According to Comcare’s page on SRC Act amendments, a request to attend can now be reviewed.

If the date, place or examiner is a real problem, contact the insurer or agent early. If you have a lawyer, let them know too.

Your rights at an IME

The details vary between schemes, but SIRA and WorkSafe guidance includes:

• Support person: in NSW you can take a friend or relative for support if the examiner agrees beforehand. They cannot answer questions for you or interpret.
• Interpreter: ask for a professional interpreter if you need one. WorkSafe says interpreters should be provided where needed.
• Examiner preference: WorkSafe says reasonable requests for an examiner of a particular gender should be accommodated where possible.
• Recording: in NSW the examiner may ask to record the examination. You have the right to refuse.
• Travel: in NSW, tell your insurer if you need travel costs paid in advance.
• The report: in NSW you can ask for a copy of the report and the documents given to the examiner. In Victoria, agents send IME reports to your treating practitioners unless you ask them not to.
• Employers: under NSW reforms, SIRA’s guidance for health providers says employers and their representatives cannot attend your examination unless you ask them to.

If you have concerns about how an IME was conducted, you can raise them with the insurer, the scheme regulator or, for registered practitioners, the relevant health complaints body.

What happens at a psychological or neuropsychological IME

The interview

The examiner will ask about the incident, your symptoms, treatment, work, daily life, and your health and personal history, including before the injury. This can feel personal, but earlier history helps the examiner give a fair opinion about what the injury has changed.

Questionnaires and tests

You may complete questionnaires about mood, anxiety, trauma symptoms and daily functioning. A neuropsychological IME also includes tests of memory, attention, processing speed and problem-solving. The appointment can take several hours, with breaks.

Validity checks

All good psychological and neuropsychological assessments check whether the results are valid, meaning they reflect a person’s true ability and experience. The American Academy of Clinical Neuropsychology’s 2021 consensus statement says all clinical and forensic evaluations should address this. These checks are routine and are used with every person. They are not a sign that the examiner doubts you. The simplest approach is to try your hardest on every task and describe your symptoms as they really are.

Tips to prepare

• Read the appointment letter so you know the time, place and purpose.
• Bring photo ID, glasses or hearing aids, and a list of your medicines.
• Write down your main symptoms and how they affect daily life, so you do not forget anything.
• Get a good night’s sleep and eat before you go.
• Be honest. Do not play symptoms down or up.
• If you do not understand a question, ask for it to be repeated. It is okay to say “I don’t know” or “I don’t remember”.
• Ask for a break if you need one, especially if you are in pain or tired.
• After the appointment, jot down any concerns while they are fresh.

Feeling anxious beforehand is common. If an IME is likely to bring up distressing memories, let your treating psychologist or GP know so they can help you prepare.

IMEs arranged by your lawyer

Not every IME is arranged by an insurer. Your own lawyer may ask an independent practitioner to assess you, for example for a common law claim, a permanent impairment claim or a dispute. The practical experience is similar.

Whoever pays for the report, the examiner’s job is to give an impartial, evidence-based opinion. In court proceedings, expert witnesses have a duty to assist the court that overrides any duty to the party who engaged them. A good examiner explains the limits of their opinion and considers other possible explanations for your symptoms.

After the IME

The examiner writes a report and sends it to whoever requested it. You may not hear about the findings straight away. The insurer or your lawyer then uses it, along with other evidence, to make decisions or give advice. If you disagree with a decision based on an IME, each scheme has a review or dispute process, and a lawyer can advise you on your options.

How Invictus Health can help

Our psychologists and neuropsychologists provide independent medico-legal assessments for lawyers and insurers, and treating neuropsychological assessments for people who want to understand their own thinking skills. Neuropsychology reports are reviewed by Dr Judy Tang OAM.

If your claim is causing stress, our anxiety and stress counselling is available in person in Preston or by telehealth. You can contact us with any questions.

This article is general information and not legal advice. Speak with your insurer, a lawyer or a qualified professional about your situation. If you are in danger, call 000. For 24-hour crisis support call Lifeline on 13 11 14.