The Truth About Insurance "Independent" Medical Exams

What You Should Know Before the Insurance Company Sends You to Their Doctor

If you’re pursuing a personal injury claim in New York State, chances are you’ll be scheduled for what’s called an “Independent Medical Exam,” or IME. The name suggests neutrality, but in practice, these exams rarely favor the injured person.

IME doctors are hired and paid by the insurance company, not by you. Their goal is often to reduce or stop your benefits. What happens during that short exam can have long-term consequences for your recovery and your financial future.

At Horn Wright, LLP, our personal injury attorneys help injured clients across New York, including Rochester and Monroe County, understand what’s really at stake in these exams. With preparation and support, you can face an IME with clarity and confidence.

Define What an “Independent” Medical Exam Really Is

An IME isn’t designed to treat you or improve your recovery. Its purpose is to assess your condition and report findings to the insurance company. And despite the word “independent,” these doctors are not neutral third parties. They’re chosen by the insurer, and their reports often reflect that.

In New York State, IMEs appear frequently in claims involving auto accidents, workers’ compensation, and slip-and-fall cases. You might receive a notice in the mail telling you where to go and when to show up, usually with little to no context.

IME appointments often take place at high-volume clinics in cities like Rochester or Albany, where providers conduct dozens of evaluations each week. These doctors may have no prior relationship with you and no intent to build one.

Break Down How IMEs Are Used in Injury Claims

The primary purpose of an IME is not to get another medical opinion. It’s to give the insurer a reason to stop or limit payment.

In New York injury claims, insurers frequently use IMEs to:

• Dispute the origin of your injury
• Deny or reduce wage loss benefits
• Refuse to cover surgery, injections, or long-term therapy
• Declare you “fully recovered” prematurely
• Push for a quick, low-value settlement

For example, after a crash near the New York State Thruway, your provider may recommend extended rehab. If an IME physician disagrees, the insurer might halt payments and argue that continued care isn’t medically necessary.

Explain What Happens During an IME Appointment

IME appointments are structured very differently from regular medical visits. The process is brief, focused on documentation, and often leaves patients feeling like they weren’t heard.

Typical IME process in New York:

• You receive an appointment letter from the insurance company
• The exam takes place at a clinic chosen by the insurer
• The doctor reviews your medical records (sometimes partially)
• You undergo a basic physical exam, usually 15–30 minutes
• No treatment or diagnosis is provided
• You’re not given results during the visit

Many IMEs in Rochester take place in clinics near East Avenue or Westfall Road, where providers conduct back-to-back exams on behalf of multiple insurance carriers.

Their report is sent directly to the insurer and often omits context or subtle symptoms that matter to your case.

Outline How IMEs Can Affect Your Claim in New York State

The IME report often carries significant weight in how your claim moves forward. When the findings favor the insurer, it can derail treatment and delay resolution.

Common consequences of a biased IME include:

• Termination of medical benefits
• Rejection of necessary surgeries or tests
• Reduced compensation for pain and suffering
• Disputes about work capacity
• Delays in case settlements or court dates

We’ve worked with New York State clients whose treatment was interrupted solely because an IME doctor labeled them “recovered,” despite ongoing symptoms and continued care from their treating physician.

Identify the Red Flags in IME Reports

While IME doctors are expected to provide objective evaluations, their reports often contain language that downplays injuries or implies bias.

Look out for red flags like:

• Statements that you “did not cooperate”
• Ignoring pain that lacks imaging evidence
• Attributing symptoms to aging or past injuries
• Repeating phrases used by the insurer
• Making conclusions based on limited or outdated records

In many New York personal injury cases, we’ve seen IME reports that fail to mention months of rehab, misstate exam findings, or suggest a return to work without restrictions, even when multiple treating physicians disagree.

Emphasize the Importance of Legal Support During the IME Process

Going into an IME unprepared can hurt your claim. At Horn Wright, LLP, we support clients across New York through every part of the process.

We help you:

• Understand the purpose of the exam and your rights
• Prepare summaries of symptoms and treatment to bring with you
• Discuss what to say and what not to say
• Log your experience immediately afterward
• Compare the IME report with your actual medical record

When needed, we also challenge inaccurate findings with counter-reports, expert testimony, and well-organized evidence from your treating providers.

Share Practical Steps New York Claimants Should Take Before and After an IME

There are concrete ways to protect yourself from an unfair IME report. Here are steps you can take:

• Stay calm and truthful throughout the exam
• Don’t exaggerate symptoms, but don’t minimize them either
• Bring notes or summaries prepared with your attorney
• Record how long the exam lasted and what was asked
• Let your lawyer know immediately if something felt off
• Keep following your doctor’s care plan, no matter the IME outcome
• Request a copy of the IME report for your records

These details help create a narrative that aligns with your actual medical journey, not just the insurer’s version of it.

Final Takeaway: Know the Purpose Behind the Exam

An IME is not designed to help you heal. It’s a tool that helps insurers protect their bottom line. But with the right preparation, it doesn’t have to threaten your case.

At Horn Wright, LLP, we understand how these exams work and how they’re used to limit what injured people in New York State receive. Whether you’ve been injured in Buffalo, Syracuse, or Rochester, our attorneys are here to help you face the IME process with confidence and clarity.

If you’ve been scheduled for an IME, reach out to us for a free consultation. Let’s make sure your story is heard and your claim stays strong.