If you’ve filed a workers’ compensation claim in Washington, chances are you’ll be scheduled for an Independent Medical Examination (IME). These evaluations can significantly affect your claim, for better or worse, and often become a turning point in the outcome of your case.
Understanding how IMEs work, why they matter, and what to do before and after your exam can help you protect your benefits and make informed decisions.
What Is an IME?
An Independent Medical Examination is a one-time evaluation performed by a medical provider who is not involved in your regular treatment. IMEs are requested by the Washington State Department of Labor and Industries (L&I) or self-insured employers to obtain an objective opinion about your:
- Work-related injury or illness
- Treatment plan
- Ability to work
- Degree of permanent impairment
While these evaluations are meant to be neutral, the provider’s report can carry more weight than your attending physician’s opinion, especially when it comes to approving or denying treatment and benefits.
Why IMEs Are Controversial
Although intended to be impartial, IMEs are often viewed with skepticism by injured workers. That’s because:
- IME doctors are selected and paid by insurers or L&I
- Some providers are known for favoring claim denials or minimizing injuries
- Examinations can feel rushed or superficial
- IME reports frequently contradict those of attending physicians
The outcome of an IME can impact nearly every aspect of your claim, which is why it’s critical to prepare ahead of time and understand what’s at stake.
How an IME Can Affect Your Workers’ Compensation Claim
A negative IME report can influence several key decisions in your case:
1. Approval or Denial of Treatment
If your attending physician recommends surgery, extended physical therapy, or pain management, L&I may require an IME before authorizing the treatment. An unfavorable IME can result in delays or outright denial of care.
2. Time-Loss Compensation
Time-loss benefits are designed to replace a portion of your wages if you can’t work due to your injury. If an IME provider believes you can return to work, even if your doctor disagrees, your wage replacement may be cut off.
3. Permanent Partial Disability (PPD) Awards
PPD ratings are used to calculate compensation for long-term impairments. These ratings are often based on IME reports, which can dramatically affect the amount you receive, or whether you receive a PPD award at all.
4. Vocational Rehabilitation
If you can’t return to your previous job, L&I may offer vocational training. IME findings can determine whether you qualify for these services.
5. Claim Closure
In many cases, a favorable IME for the insurer leads to claim closure, even if you are still recovering or have unresolved medical needs.
How to Prepare for an IME
Although you can’t refuse an IME, you can take steps to ensure the exam reflects your condition accurately:
Before the IME:
- Review your medical history. Know your diagnoses, symptoms, and prior treatments.
- Bring a list of current symptoms. Include how the injury affects your ability to work and function daily.
- Be consistent and truthful. Don’t exaggerate or downplay your limitations — IME providers are trained to look for discrepancies.
- Bring an observer. A friend or family member can document what occurs during the exam.
- Consider recording the exam. Washington law allows you to audio or video record IMEs — but you must notify the provider at least seven days in advance and get their consent. If they decline, the exam will be rescheduled with a provider who allows recording.
After the IME
- Once your exam is complete, be proactive:
- Request a copy of the IME report. You are entitled to receive this once it’s filed with L&I or your employer.
- Compare it with your doctor’s opinion. If it contains discrepancies or errors, ask your attending physician to submit a formal rebuttal.
- Watch for changes to your claim. Monitor your mail for any denial letters, claim closures, or changes in benefit eligibility.
- Keep detailed records. Save all communications related to your claim, including emails, letters, and reports.
Challenging a Negative IME Report
If you receive a decision based on an IME that you disagree with, such as claim closure or denial of treatment, you have the right to protest or appeal. In Washington state:
- You have 60 days to protest most L&I decisions
- You have 15 days to protest vocational determinations
Your protest should include a written explanation of why the decision is incorrect, along with supporting medical documentation. In complex cases, many workers choose to consult with a workers’ compensation attorney for assistance.
When to Seek Help
Not all L&I claims require legal support, but IME-related disputes are one of the most common reasons injured workers reach out to an attorney. A legal representative can help you:
- Dispute a biased or inaccurate IME report
- File a timely and thorough appeal
- Obtain a second opinion from a credible provider
- Reopen a claim that was closed prematurely
- Secure the full range of benefits you’re entitled to
Attorneys with experience in Washington L&I cases — like those at Emery | Reddy — understand the tactics insurers use and can advocate for your rights throughout the process.
Fight for Your Rights
Independent Medical Examinations may seem routine, but their impact on your workers’ compensation claim can be significant. Whether you’re facing a treatment denial, a premature claim closure, or a low impairment rating, knowing how to navigate an IME can make the difference between lost benefits and a successful outcome.
If you’re uncertain about what to do after an IME, don’t wait. Talk to a trusted L&I lawyer to better understand your rights and next steps.
