If you have been injured in a car accident or slip and fall in Ottawa or elsewhere in Ontario, you may be asked to attend an independent medical assessment, often called an “IME.”
These expert assessments are an important part of your case. They are not treatment appointments. Sometimes called “medicolegal assessments”, their purpose is to obtain a medical opinion that addresses the issues in your personal injury case.
IMEs can be arranged by your own legal team, the defence or the insurer. In either case, knowing how to prepare can help you feel more comfortable and avoid common mistakes.
What Is an Independent Medical Assessment (IME)?
An IME is an evaluation by a medical or health professional who is not one of your regular treatment providers. Depending on your injuries, the assessor may be an orthopaedic surgeon, psychologist, psychiatrist, physiatrist, occupational therapist, neurologist, or some other specialist.
The assessor may review your medical records, ask questions about the accident and your symptoms, perform testing, and provide a written report. That report may be used in your injury claim to address issues such as:
- The nature and severity of your injuries
- Whether your symptoms are accident-related
- Your ability to work, study, drive, or manage daily activities
- Your need for treatment, rehabilitation, or future care
- Whether your condition is improving, stable, or worsening
Plaintiff IMEs VS Defence IMEs
A plaintiff IME is arranged by your own lawyer to better understand and prove your injuries. These assessments typically help support your claims for pain and suffering, income loss, medical expenses, attendant care, housekeeping limitations, or future treatment needs.
A defence IME is arranged by the insurer or defence lawyer. The defence is entitled in most personal injury cases to have you examined by an expert, or experts, of its choosing. The purpose is often to test or challenge your claim. The defence expert may agree or disagree (in whole or in part) with the plaintiff expert.
In either kind of IME, the doctor must give an opinion that’s fair, objective, and non-partisan, regardless of who hired them. That said, plaintiff and defence experts still commonly disagree or point out different things.
For example, in a chronic pain case, the plaintiff’s expert often says that the pain itself impairs many aspects of the plaintiff’s life. On the other hand, the defendant’s expert may say that there is “no objective evidence of impairment,” such as a fracture, tear, reduced strength, or restricted range of motion.
Both can be true at the same time. Ultimately, a judge or jury may have to decide whether the plaintiff’s pain is a legitimate impairment and how it has affected their life.
Both types of IMEs matter. How you present, communicate, and participate should be the same at both types of assessments.
Above all, the best thing you can do is be honest and give a good effort on any testing. That gives the assessor the best opportunity to understand your actual symptoms and limitations, whether you are attending a plaintiff or defence IME.
How to Prepare for an Independent Medical Assessment
Preparation does not mean rehearsing or exaggerating. It means being ready to give clear, accurate information.
Before attending, take time to think about your symptoms and how they affect your life. Many accident victims live with pain or limitations every day and begin to normalize them. It can help to think about:
- Where you feel pain or discomfort
- How often symptoms occur
- What makes symptoms better or worse
- How your sleep, mood, memory, or concentration have changed
- What activities you can no longer do, or can only do with difficulty
- How your injuries affect work, childcare, driving, chores, hobbies, and relationships
- What treatment you have received and whether it helped
Don’t memorize or script anything. You’re not rehearsing for a speech. The goal is to give some thought to these things before hand so that you’re not thinking about them for the first time whenever you’re being asked at the IME.
What Should You Do During an IME?
Be polite, cooperative, and truthful. Answer the questions asked, but do not guess. If you do not remember something, say so. If you are unsure, say you are unsure. Avoid overstating your symptoms, but also avoid minimizing them out of embarrassment or a desire to seem “tough.”
Be specific where possible. Instead of saying, “I can’t do anything anymore,” explain what you can and cannot do. For example: “I can carry light groceries, but I cannot lift a full laundry basket without increasing my back pain,” or “I can sit for about 20 minutes before I need to stand or change positions.”
Remember that an IME may start before you enter the examination room. Assessors may observe how you walk, sit, stand, remove your coat, or interact in the waiting area. This does not mean you should act differently. In fact, you absolutely should not act any differently than you normally do. You should be consistent and genuine throughout the appointment.
Giving Maximum Effort
Sometimes you will be asked to complete physical, psychological, or cognitive testing. It is very important you give your best effort on all testing.
Both Plaintiff and Defence experts may employ specialized tests and strategies to assess whether you are giving maximum effort.
On the physical side of things, this doesn’t mean go and hurt yourself. If the physical examination causes pain, say so. Do not push far beyond your limits just to be agreeable. At the same time, you must make a reasonable effort to participate unless a movement is unsafe or intolerable.
The doctor will also check if your answers to her questions make sense. For example, if you are given a psychological test and you check off the box for “I don’t get out of bed most days” but you are still working a full-time job, that doesn’t make a lot of sense, and the doctor will probably point that out.
Effort testing and validity testing are far from perfect. There are all kinds of reasons someone may score poorly. That’s okay – your legal team can work with that so long as you did in fact give your best effort and tell the truth at all times.
Common IME Mistakes to Avoid
The biggest mistake you can make is thinking that it’s helpful to exaggerate or put on a show for the assessor. It’s absolutely unhelpful. Exaggerating or feigning impairments will hurt your case.
Another more common mistake is giving incomplete information. If you forget to mention important symptoms or limitations, the report may suggest they are not significant. Also, if you forget to mention significant things in your medical history, that doesn’t mean they go away. Rather, it means the doctor now has to address your medical history based on the records alone, without getting first hand information from you about how the historic condition affected you.
You should also avoid arguing with the assessor. If you disagree with a question or feel the assessor is skeptical, remain calm. The assessment is not the place to debate the case. Make a note afterward and tell your legal team what happened.
Do not bring documents or people into the assessment room with you unless your legal team has said that this is okay. Do not record the assessment.
What Should You Do After a Defence IME?
For a Defence IMEs, after the appointment, take some time to write down what happened while it is fresh in your mind. Note the time you arrived, how long the assessment lasted, what testing was done, what questions were asked, whether anything unusual occurred, and how you felt afterward.
The Most Important IME Advice: Be Honest and Be Yourself
IMEs are an important part of many Ontario accident claims. They can influence how medical issues are understood by the parties and if a case proceeds to trial, how expert evidence is present to the court.
With preparation, honesty, good effort, and clear communication, you can help ensure the assessment reflects the real impact of your injuries on your daily life.
