What to Expect at Your Orthopedic Independent Medical Examination (IME)

If you've been injured at work or in an accident, you may be asked to attend an Independent Medical Examination (IME) with an orthopedic surgeon. While this can feel intimidating, understanding what to expect can help you feel more prepared and confident. As a board-certified orthopedic surgeon with over 13 years of experience conducting IMEs, I want to help you understand the process and your role in it.

What Is an Independent Medical Examination?

An Independent Medical Examination is a medical evaluation requested by an insurance company, employer, or attorney to get an objective medical opinion about your injury or condition. The key word here is "independent"—the examining physician is not your treating doctor and does not have a doctor-patient relationship with you.

The IME doctor's role is to:

• Review your medical records and imaging studies

• Conduct a physical examination

• Provide an objective medical opinion about your condition

• Answer specific questions posed by the requesting party

Important: The IME doctor will not be treating you or prescribing medications. The examination is for evaluation purposes only.

Why Was an IME Ordered?

IMEs are typically ordered for several reasons:

• Second Opinion: The insurance company or employer wants an independent opinion about your diagnosis or treatment recommendations

• Causation Determination: To determine if your injury is work-related or resulted from an accident

• Maximum Medical Improvement (MMI): To assess if you've reached maximum recovery from your injury

• Impairment Rating: To determine the extent of permanent disability, if any

• Return-to-Work Assessment: To evaluate your ability to return to work and any necessary restrictions

Before the Examination

How to Prepare

Preparation is key to a successful IME. Here's what you should do:

• Know Your Medical History: Review the dates of your injury, surgeries, treatments, and medical appointments. Be prepared to describe your injury mechanism accurately.

• Bring Documentation: If you have copies of medical records, imaging reports, or a list of medications, bring them along. While the examiner will have records from the requesting party, having your own can be helpful.

• List Your Symptoms: Write down your current symptoms, what makes them better or worse, and how they affect your daily activities and work.

• Be Honest and Consistent: The most important thing you can do is be truthful and consistent in describing your symptoms and limitations.

• Arrive on Time: Plan to arrive 10-15 minutes early. Bring a photo ID and your insurance information if requested.

What to Expect During the Examination

Medical History Review

The examination typically begins with a detailed discussion of your injury and medical history. I will ask you about:

• How the injury occurred (mechanism of injury)

• Your symptoms immediately after the injury

• How your symptoms have changed over time

• Previous injuries or pre-existing conditions

• All treatments you've received (physical therapy, injections, surgery)

• Current medications

• Your work duties and how the injury affects your ability to work

• Your daily activities and recreational interests

Physical Examination

After reviewing your history, I will conduct a physical examination of the affected area. This may include:

• Visual inspection: Looking for swelling, scars, deformity, or muscle atrophy

• Range of motion testing: Measuring how much you can move the affected joint

• Strength testing: Evaluating muscle strength in the affected area

• Special tests: Specific orthopedic maneuvers to assess ligaments, tendons, and joints

• Neurological examination: Testing sensation, reflexes, and nerve function if relevant

• Gait assessment: Watching how you walk if you have a lower extremity injury

The examination is typically straightforward and should not cause significant pain, though some tests may cause temporary discomfort. The entire process usually takes 30-60 minutes.

Important Things to Remember

• Be honest about your pain and limitations: Don't exaggerate your symptoms, but don't downplay them either. Describe your actual experience.

• Give consistent information: Make sure what you tell the IME doctor matches what you've told your treating physicians and what's in your medical records.

• Remember you're being evaluated: The doctor will observe how you move, sit, stand, and walk throughout the visit—not just during the formal examination.

• Be aware of surveillance: In some cases, insurance companies may conduct video surveillance before or after your IME. Don't do activities that contradict your reported limitations.

• Stay calm and cooperative: While you may feel frustrated about having to undergo another examination, being hostile or uncooperative can negatively affect the evaluation.

• Ask questions: If you don't understand something, it's okay to ask for clarification.

• Know your rights: You have the right to have the examination conducted respectfully and professionally. If you feel uncomfortable with any aspect of the exam, you can speak up.

What Happens After the IME?

After your examination, I will review all of your medical records, imaging studies, and my examination findings. I will then prepare a detailed written report that typically includes:

• Summary of your medical history

• My physical examination findings

• Review of medical records and imaging

• My medical opinions on diagnosis, causation, treatment, and prognosis

• Answers to specific questions posed by the requesting party

• Impairment rating if requested (and if you've reached maximum medical improvement)

Timeline for the Report

Most IME reports are completed within 14 days of the examination. The report goes first to the party who requested the IME (the insurance company, employer, or attorney). Under most circumstances, you or your attorney have the right to receive a copy of the report as well.

How the IME Report May Affect Your Case

The IME report can influence several aspects of your workers' compensation claim or personal injury case:

• Whether your injury is deemed work-related or caused by the accident in question

• What treatment is considered medically necessary

• When you're able to return to work and with what restrictions

• The extent of any permanent impairment or disability

• The value of your claim or case

If the IME opinion differs from your treating physician's opinion, this doesn't automatically mean the insurance company's position will prevail. Your attorney can challenge the IME findings, and ultimately a judge or jury may need to decide between conflicting medical opinions.

Common Questions About IMEs

Can I bring someone with me to the IME?

Generally, yes. You can bring a family member or friend to accompany you, though they typically won't be in the examination room during the physical exam. Check with the requesting party or your attorney beforehand to confirm.

Can I record the examination?

This varies by state law and the specific circumstances of your case. Some states allow it, while others don't. Your attorney can advise you on your rights in this regard.

What if I disagree with the IME findings?

You have the right to challenge the IME report. Your attorney can request a second IME from a different physician, present evidence from your treating physicians, or cross-examine the IME doctor if the case goes to a hearing or trial.

Do I have to attend the IME?

In most workers' compensation and personal injury cases, you are required to attend the IME. Refusing to attend can result in suspension of your benefits or harm your legal case. If you have concerns about the IME, discuss them with your attorney first.

My Approach to IMEs

As an orthopedic surgeon who has performed over 13 years of Independent Medical Examinations, I approach each evaluation with objectivity, thoroughness, and respect. My goal is to provide an honest, evidence-based medical opinion that helps all parties understand the true nature and extent of your orthopedic condition.

I understand that being evaluated by an unfamiliar physician can feel stressful, especially when you're already dealing with an injury and its impact on your life. I strive to make the process as comfortable and straightforward as possible while maintaining the medical objectivity necessary for an independent evaluation.

With 25+ years of clinical experience as a board-certified orthopedic surgeon and sports medicine specialist, I bring current medical knowledge and extensive surgical experience to every evaluation. I review cases thoroughly, stay up-to-date with current orthopedic literature, and provide opinions based on sound medical principles.

Contact Information

If you have questions about an upcoming IME or need expert orthopedic evaluation services, please don't hesitate to reach out:

Dr. Daniel Romanelli, MD

Board Certified Orthopedic Surgeon

Certificate of Added Qualification in Sports Medicine

Bilingual: English / Spanish

📞 (575) 652-3528

📧 trisha@romanellimd.com

🌐 www.romanellimd.com

📍 Serving New Mexico, Texas, and Arizona

Whether you're an injured worker preparing for an examination or an attorney seeking qualified orthopedic expert witness services, we're here to help. Contact us today for a confidential consultation.