Explainers
What is an independent medical examination
An IME is a one-time assessment by a doctor who has never treated you. A payer orders it when a benefit, a claim, or a legal question turns on a medical opinion. The doctor examines you and writes a report. That report is the product.
This guide covers Canada, with detail for British Columbia. It speaks to examinees first. Coordinators and referrers will also see how IMECore fits the workflow. For the breakdown by claim type, see claim types and the examinee page. To budget for a file, use the IME cost estimator.
- Average examiner time per IME across review, exam, and report
- ~6.5 hoursAverage examiner time per IME across review, exam, and reportSEAK 2024 IME fee survey
- Typical end-to-end IME turnaround in the US
- 2–6 weeksTypical end-to-end IME turnaround in the USEthos Risk, 2025
- Typical wait for the report after the exam in BC
- 4–8 weeksTypical wait for the report after the exam in BClawyerinfo.ca, BC WCAT guide
Definition
An IME answers a paid question with a medical opinion
Money depends on a medical fact. Someone neutral should state that fact clearly. That is the IME.
An independent medical examination is a single assessment by a specialist who has no treatment relationship with you. The examiner reviews your records, meets you once, and writes a report that answers the questions in the referral letter. The payer uses that report to make a decision about work capacity, causation, diagnosis, prognosis, or the need for treatment.
The word independent carries weight. The examiner does not act for you and does not act for the payer. They act for the opinion. In practice this means they must note what they reviewed, what they saw, what you reported, and where the limits of the opinion lie. A good IME reads as a chain of reasons, not as a verdict.
An IME is not care. You will not leave with a prescription or a treatment plan. If you need care, you return to your family doctor or your treating specialist. The examiner does not become part of your care team.
Coordination firms exist because this work is heavy. Someone must collect thousands of pages, build a brief the doctor can use, book the room, and return a report that answers every question without error. That middle layer is where IMECore sits for Canadian teams.
The three parts of every IME
- Records. The history that existed before the appointment: clinic notes, imaging, consults, and prior IME reports if any. The quality of this set shapes the quality of the opinion.
- Exam. One interview and one focused examination. The examiner tests function, not just pain, and records what they observe.
- Report. Written answers to the referral questions, with citations to the record, findings on exam, and the reasons for each conclusion.
Who orders one
The payer orders the IME, not the clinic
The referral comes with questions. The questions drive the choice of specialist, the records that matter, and the template for the report.
In British Columbia the usual referrers are ICBC for auto injury, WorkSafeBC for workplace injury, long-term disability insurers for duration and return-to-work decisions, and plaintiff or defence lawyers on either side of a claim. Employers also refer fitness-for-duty assessments. Each payer brings a distinct set of questions.
ICBC often asks about causation, injury severity, and the need for further treatment after a collision. WorkSafeBC often asks about work-relatedness, functional limits, and readiness to return to modified duties. Disability insurers often ask whether the person still meets the definition of disability under the policy. Lawyers on either side may ask for an addendum when a new record appears, or a rebuttal when two opinions conflict.
The coordination firm does not choose the questions. It makes sure the file answers them. That means it confirms which specialist is qualified, checks for conflict of interest, and builds a brief that contains the exact records the examiner needs. If a required report is missing, the coordinator flags it before the booking.
Common referral questions
- What is the diagnosis and is it related to the incident at issue?
- What are the current functional limits and what can the person safely do at work?
- Has the person reached maximum medical improvement and what is the prognosis?
- Is further investigation or treatment recommended, and with what urgency?
- Is the current care reasonable and necessary, and are there gaps in the record?
What makes a referral complete
A named examinee with contact details, the incident date, the specific questions to answer, and the records the examiner must review. Dates must be exact. Names must match the chart. If the referral moves as an email, keep the thread intact so the audit trail is clear.
On the day
What happens in the room
The exam is short. The preparation around it is not. Know the sequence so you can plan your time and your ride home.
- 1
Check-in and consent
You present ID. Staff confirm the referral and explain that the examiner is independent and will write a report for the referrer.
- 2
Interview
The examiner asks about the incident, your symptoms, prior health issues, work, and daily function. Answer plainly and stick to what you experience.
- 3
Focused examination
The examiner tests range of motion, strength, sensation, or cognition as the referral requires. They record what they see and measure.
- 4
Close and next steps
The examiner explains that the report goes to the referrer. You will not receive results on the day. Ask how to request a copy.
How to prepare
Take your medications as usual unless the appointment letter says otherwise. Bring your ID, your medication list, and any device you use each day. Write down the incident date, the names of your treating providers, and a short note on what you do at work. Arrive early. If you need an interpreter or a specific accommodation, confirm it before the day.
Do not rehearse or hold back. Describe what you can do, what you avoid, and why. If pain varies through the day, say so. If you have good days and bad days, describe both.
What not to do
Do not bring new scans or test results unless the referral asked for them. Do not ask the examiner for treatment or for a note for your employer. Do not record in secret. If you are unsure about a question, say that you are unsure and explain why.
If you feel the exam was too short or a concern was missed, note that in writing soon after the appointment and share it with your representative. Facts fade. A short note written the same day carries more weight than a memory from weeks later.
Timelines
How long each stage takes
The bottleneck is rarely the exam. It is the queue to book a specialist and the work to draft a clean report.
Booking
2 to 6 months in BC
Specialist availability for a BC IME often takes months to secure. Rural access and narrow specialties take longer. Source: lawyerinfo.ca, BC WCAT guide.
Exam and review
About 6.5 hours of examiner time
Review, exam, and report time combined. Record volume drives the range. Source: SEAK 2024 IME fee survey.
Report after exam
4 to 8 weeks in BC
Drafting, QA, and delivery after the appointment. Addenda move faster. Source: lawyerinfo.ca, BC WCAT guide.
End-to-end, many US files close in 2 to 6 weeks (Ethos Risk, 2025). BC specialist files often run longer because the booking queue is longer and the report window is measured in weeks, not days. IMECore cuts time in the stages it controls: intake, records, and report preparation. The examiner still controls the exam and the opinion.
If you face a fixed deadline, such as a hearing date or a benefit review, tell the coordinator at referral. They can flag the file, ask the clinic about rush options, and keep the referrer updated when dates slip.
The report
What the report contains
A sound IME report answers each referral question in order, shows its work, and states its limits. The reader should see which facts came from the records, which came from the interview, and which came from the examination. The opinion should follow from those facts.
- Header and referral questions. Who ordered it, who was examined, when and where, and the exact questions to answer. No paraphrase.
- Records reviewed. An indexed list of what the examiner received and the date range each document covers. Missing records are named as missing.
- History and interview. What you reported about the incident, your symptoms, and your function at work and at home.
- Examination findings. Objective measures: range of motion, strength, sensory testing, cognitive screens. Observed behaviour is noted with care.
- Opinion. Answer to each referral question, with the reason and the limits. Citations tie each conclusion to a source in the file.
What good looks like
The report states when an opinion is probable and when it is not. It explains what would change the opinion, such as a missing operative note. It avoids copied text. It keeps the same diagnosis from the first page to the last.
A note on fees
A standard specialist IME in BC often runs $3,000 to $6,000; a psychiatric or neurological IME often runs $4,000 to $8,000 or more (lawyerinfo.ca, BC WCAT guide). The Doctors of BC guide recommends $2,165 for a medico-legal opinion report and $1,294 for a simple factual report (2024). Review time is billed at $122 per 15 minutes. Use the cost estimator to size your file.
Limits
What an IME is not
Clear limits protect everyone. The examinee knows what to expect. The referrer knows what weight to give the report.
It is not treatment
No prescription, no referral to a surgeon, no ongoing care relationship. If the examiner sees an urgent issue, they will note it and direct you back to your treating provider or to urgent care.
The examiner is not your doctor
No doctor-patient relationship is formed. Privilege does not apply. The examiner shares the report with the referrer and keeps a copy under clinic retention rules. You may request your own copy through the referrer.
It does not replace your chart
One visit cannot see years of function. The examiner relies heavily on the records. If a key report is missing, the opinion will note that limit. Provide a full history and flag missing documents.
It does not decide the file alone
The decision maker weighs the IME with treating notes, imaging, and the facts of the claim. One report informs the decision. It does not make it by itself.
Rights
Your rights as an examinee in Canada
Canada has no single IME statute. Rights come from privacy law, from the rules of the tribunal or court that will use the report, and from the referral itself. In British Columbia, PIPEDA and BC PIPA govern how personal health information is collected and used. Public bodies such as WorkSafeBC and ICBC also face provincial public-sector privacy duties.
You have the right to know why the exam was ordered, what questions the examiner must answer, and who will receive the report. Ask for the referral letter. If the letter is not shared, ask for a short summary in writing.
You can expect the examiner to work from an accurate record, to keep the exam within the referral scope, and to produce a report that shows its sources. You can ask for a correction if a fact is wrong, such as a misdated surgery or a medication error.
IMECore keeps a complete access log for every case. That log supports audits and proves who handled the file. It does not change your legal rights, but it makes the handling of your information checkable. For questions about how IMECore handles personal information, see the privacy page.
What to ask before the appointment
- Who ordered the exam and under what authority?
- Which specialist will I see and what is their specialty?
- How long is the appointment and where is it held?
- Can I bring a support person, an interpreter, or a device I use daily?
- How do I obtain a copy of the report and how are my records stored?
Claim types
How an IME differs by claim type
The questions change, so the specialist, the records, and the deadline change too.
Auto and accident benefits
Causation and the need for further care sit at the centre. Imaging and emergency records carry extra weight. Timelines track the benefits schedule.
Workers compensation
Work-relatedness and return-to-work planning drive the referral. Functional testing and workplace demands matter more than in other files.
Long-term disability
The policy definition of disability controls the questions. Duration and the prospect of modified duties receive close attention.
Med-legal and litigation
The report must meet the instructing lawyer template and survive disclosure. Consistency between the history and the opinion is tested early.
File review, no exam
No appointment. The opinion rests on the paper record alone. This route is faster but cannot answer every clinical question.
Addendum or rebuttal
A new record or a second opinion triggers a focused addendum. The scope is narrow, the timeline is short, and the question is precise.
FAQ
Common questions about IMEs
Do I have to attend an IME?
In most claim types you do. Your insurer, your employer plan, or a tribunal can require it as a condition of the claim. If you refuse without a valid reason, the payer may pause or deny benefits. Ask the referrer what rule applies to your file, and keep a copy of the request letter.
Is the IME doctor my doctor?
No. The examiner is independent. They do not treat you, they do not take over your care, and they do not prescribe. Their role is to examine you once and write an opinion for the party that ordered the assessment.
How long does an IME take on the day?
Most appointments run 30 to 90 minutes. That includes the interview, a focused physical or cognitive examination, and a chance to ask questions. File reviews have no appointment at all; the doctor works from the records alone.
How long until I get the report?
In British Columbia the report often takes 4 to 8 weeks after the exam (lawyerinfo.ca, BC WCAT guide). In the United States, end-to-end turnaround is often 2 to 6 weeks (Ethos Risk, 2025). Complex cases and high record volumes add time.
Can I bring someone with me?
Ask before the day. Many clinics allow a support person to wait nearby, but few allow that person in the examination room. If you need an interpreter or an accommodation for disability, tell the coordinator early so it is booked. Bring photo ID and a list of current medications.
Can I record the examination?
Rules differ by province and by clinic. Some allow audio recording with advance consent, some do not. Do not record without permission. If you want a record, ask in writing before the appointment and confirm what the clinic will allow.
What should I bring to an IME?
Bring ID, your medication list, any assistive device you use, and glasses or hearing aids if you rely on them. Do not bring new imaging or tests unless the referral asked for them. Be ready to describe your injury, your treatment so far, and what you can and cannot do at work and at home.
Does the IME decide my claim?
No. The report is one piece of evidence. The insurer, employer, tribunal, or court weighs it alongside your treating records, the referral questions, and other facts. A single IME cannot approve or deny a claim on its own.
Will the examiner ask about things unrelated to my injury?
They may review past health history that relates to function, causation, or recovery. Tell the truth about prior injuries or conditions. The report should show what the examiner relied on and why.
How do I get a copy of the IME report?
The report goes to the party that ordered it first. You can then request a copy from that party. In litigation, the other side often receives it through disclosure. Keep your own file of dates, letters, and travel receipts.
What if I disagree with the report?
Read the report closely. Note where you think a fact or date is wrong. Share that note with your lawyer, your union representative, or your case manager. You can ask for a correction of a factual error, or you can seek a second opinion through the process that applies to your claim type.
Who pays for an IME in Canada?
The party that orders it pays. For ICBC or WorkSafeBC claims, the public body pays. For disability or litigation files, the insurer or the law firm pays. Examinees do not pay the examiner fee. Travel costs are often reimbursed; keep receipts.
Run the numbers or see the workflow
Use the free cost estimator to size a file, or see how IMECore keeps the referral, the records, and the report on one case.