A letter arrives with a date, an address and the name of a doctor you have never heard of. Nobody has explained why. The word independent sits in the title and somehow makes it feel worse rather than better.
An independent medical examination is not treatment. It is evidence. One assessor sees you once on behalf of an insurer, an employer, a board or a lawyer, then writes a report about you that you will not see unless you ask for it. Expect 30 minutes to two hours in the room, plus 20 to 30 minutes of paperwork before you are called.
They will not prescribe anything, they will not refer you anywhere, and in most cases you will never see them again. That does not make them your enemy. It does mean this appointment works differently from every other medical appointment you have ever had, and understanding how it works is most of what you need.
What is an independent medical examination?
An independent medical examination is an assessment arranged by someone other than your treating team. Usually that is an insurer, an employer, a workers' compensation board or a lawyer.
You will see it called several things. IME is the common short form. In Ontario auto insurance it is often called an insurer's examination or a section 44 assessment. In a workers' compensation file it may be called a medical assessment or a specialist referral.
The assessor is usually a physician, though it can be a physiotherapist, an occupational therapist, a psychologist or a chiropractor depending on what is being assessed. They are asked to give an opinion on some combination of diagnosis, what caused the injury, whether your treatment is reasonable and necessary, what you can and cannot do at work, and how much impairment remains.
Who pays for an independent medical examination?
Whoever arranged it. You should not be billed and you should not be asked for your health card as payment.
Travel costs are often reimbursable, including mileage, parking and sometimes public transit or a taxi where the distance or your injury makes driving unreasonable. Ask before the appointment and keep every receipt, including the parking stub.
Do you have to attend an independent medical examination?
If benefits are involved, in most cases yes. Not attending without a good reason can lead to your benefits being suspended or stopped, and that is a hard position to recover from.
If the date genuinely does not work, if the location is unreasonably far, if you need an interpreter, or if you need accessibility accommodation, ask in writing for a change as early as you can. Put the request in writing even if you also phone. A documented request that was refused is very different from a missed appointment nobody can explain.
What happens at an independent medical examination?
The shape of the appointment is fairly consistent.
Arrival and identification. You check in and are usually asked for photo identification. Arrive early. Being late is noted.
A questionnaire in the waiting room. Often several pages covering your symptoms, your daily activities, your work history and your treatment so far. This form becomes part of the report, so take your time with it and answer it as carefully as you would answer the doctor. If you run out of room, say so rather than compressing something important into a margin.
The history interview. The assessor asks you to describe the injury and what has happened since. This is usually the longest part.
The physical examination. Range of motion, strength, reflexes, palpation and sometimes functional tasks such as walking, bending or lifting.
The end. The assessor will not usually tell you what they concluded. That is normal and is not a bad sign. The report goes to whoever requested it.
One thing worth knowing plainly. Assessors observe you from the moment you arrive, including how you get out of your car, how you sit in the waiting room and how you put your coat back on. Some files also involve surveillance. The right response to this is not to perform. It is to be exactly as you are, on the day you are having, and to say plainly when the day you are having is better or worse than usual.
How long does an independent medical examination take?
A straightforward physical assessment often runs 30 minutes to an hour. A more complex one, or one involving several body areas, can take two hours or more. A psychological assessment usually runs longer and may involve written testing across half a day.
Add 20 to 30 minutes for the waiting room paperwork, and expect to wait past your appointment time.
What should you say at an independent medical examination?
The truth, completely, on both sides of it.
Two mistakes cost people their credibility. The first is exaggerating, which is rarer than people assume and easy for an experienced assessor to spot. The second is minimizing, which is far more common and does more damage. Many of us answer "how are you" with "not too bad" out of pure habit. In this room, "not too bad" becomes a sentence in a report.
Describe a typical week rather than your best hour. If today is a good day, say so, and say what a bad day looks like. If you can lift the kettle once but not fill it twice, say both halves.
Answer in terms of function wherever you can. "I stopped taking the stairs at work in March" carries more weight than "my knee is bad." Say when something started, not only that it exists.
You can ask for a break. You can decline a movement that you believe will injure you further, though you should explain why rather than refusing flatly. You can say you do not know.
Can you bring someone to an independent medical examination?
You can bring someone to the building and to the waiting room without question. Whether they can sit in the examination itself varies, and some assessors will object.
Ask in writing beforehand rather than arriving with a companion and negotiating at the desk. If you need an interpreter, request one formally rather than bringing a family member to translate, because an informal interpreter can become a reason to question the record later.
What should you do after an independent medical examination?
Write it down the same day, before the details blur. Record:
- The date, the time you arrived, the time you were seen and the time you left
- The assessor's name and profession
- Roughly how long the interview lasted and how long the physical examination lasted
- What you were asked and how you answered, especially anything you feel was misunderstood
- What movements or tests you were asked to perform, and which ones caused pain
- Anything unusual, including a companion being refused, a request for a break being declined or a test you were unable to complete
Then ask for a copy of the report. In most cases you are entitled to one, and reading it is the only way to know what was written about you.
If the report is wrong, you are not stuck with it. You can respond in writing, you can ask your own treating providers to comment on it, and you can obtain your own assessment. What makes any of that possible is a contemporaneous account written by you on the day, rather than a memory reconstructed months later against a document that sounds official.
The Medical Appointment Tracker, Free Starter Edition gives you a structured page to complete in the car afterwards. The Comprehensive Edition holds the full run of appointments across a claim.
Read next
- What happens at a physiotherapy appointment
- How to document injuries after a car accident
- Common mistakes injured workers make during a WSIB claim
Last verified August 2026. This article is general information for people in Canada and is not medical or legal advice.