What to Expect at an Independent Medical Examination (IME)?
An IME is a medical examination arranged by your insurer — not your treating doctor. You’ll meet a specialist chosen by the insurer who reviews your records and assesses your condition. The exam typically lasts 30–60 minutes, and you can bring a support person. The IME report significantly influences your TPD or insurance claim outcome.
If you’ve made a Total and Permanent Disability (TPD) or income protection claim, there’s a good chance your insurer will ask you to attend an Independent Medical Examination (IME).
It can be a scary thought.
You’ve already provided your doctors’ reports in great detail. Why do they want another opinion? And what will really happen when you go to an IME?
This guide covers:
- What an IME is, and why insurers use them.
- What to expect before, during and after the exam.
- The common traps.
- Tips to help you prepare and protect your claim.
- What you can do if you disagree with the report.
What is an Independent Medical Examination (IME)?
An IME is an assessment by a doctor or specialist appointed (and paid for) by the insurer, or sometimes by the super fund trustee.
The aim is to get an “independent” opinion on your medical condition, your functional capacity, and your ability to work.
However, the word “independent” can be misleading:
- The IME doctor is not your treating doctor.
- Their job is to prepare a report for the insurer, not to treat you or advocate for you.
- Insurers often rely heavily on IME reports when making decisions.
Why Do Insurers Request an IME?
Insurers order IMEs to:
- Confirm your diagnosis and the severity of your condition.
- Assess whether your disability is permanent.
- Determine whether you could do some form of work (not necessarily your old job).
- Check you’ve followed appropriate treatments.
- Spot any inconsistencies between your treating doctors’ reports and your presentation.
In short: insurers like IMEs because they provide another opinion they can use to assess — and sometimes dispute — your claim.
Types of IMEs
Depending on your condition, you may be referred to:
- General practitioners (GPs): broad assessment.
- Psychiatrists or psychologists: for depression, anxiety, PTSD, or other psychiatric claims.
- Orthopaedic surgeons: for musculoskeletal injuries (e.g. back, knees, shoulders).
- Neurologists: for brain and nerve conditions.
- Occupational physicians: to review your functional capacity for work.
Sometimes insurers order multiple IMEs across specialties to build a more comprehensive picture — or to find contradictions.
Psychiatric & Psychological IMEs: What’s Different
If your TPD claim is based on a mental health condition such as depression, anxiety, PTSD, or burnout, you will usually be sent to a psychiatric IME rather than a physical one. These assessments work differently, so it helps to know what to expect.
| Feature | Physical IME | Psychiatric IME |
|---|---|---|
| Conducted by | GP, orthopaedic surgeon, neurologist | Consultant psychiatrist or psychologist |
| Typical length | 30–45 minutes | 60–120 minutes |
| Main method | Physical examination, movement tests | Clinical interview, mental state exam |
| Assessing | Range of movement, physical capacity | Mood, cognition, function, insight |
| Tests/scans | May review imaging or scans | No scans — opinion based on interview |
Tip: Describe your worst and average days, not just your best. Many people unintentionally understate how much they struggle because they want to appear capable.
Common Psychiatric IME Question Themes
There is no fixed script, but psychiatric IMEs tend to explore the same themes. Being aware of them helps you answer calmly and honestly:
- How your symptoms started and how they have changed over time.
- A typical day, from waking up to going to bed.
- Sleep, appetite, energy, concentration, and motivation.
- Whether you can drive, shop, cook, or manage self-care.
- Your treatment, medication, and whether it has helped.
- Whether you have thoughts of self-harm (answer honestly if asked).
What Happens Before the IME?
- Appointment notice: You’ll be notified of the time, date, and specialist. Insurers usually pay.
- File review: The IME doctor will be given your medical records, claim forms, and sometimes even surveillance footage.
- Pre-exam questionnaires: You may be asked to complete forms about symptoms, daily activities, and work history.
Tip: Always confirm the appointment and keep a record of correspondence. If the date or location is unreasonable, you can request an alternative.
What Happens During the IME?
1. Interview
The doctor will ask about:
- Medical history.
- How your condition affects daily life.
- Treatments tried.
- Work and education history.
They may cross-check your answers with records for consistency.
2. Examination
- Physical conditions: tests of strength, mobility, reflexes, balance, lifting capacity.
- Psychological conditions: structured interview, questionnaires, assessment of mood, memory, concentration, and behaviour.
3. Observation
IME doctors often note how you behave before, during, and after the exam. For example:
- Did you struggle to get out of your chair?
- Did you walk differently leaving the clinic?
- Did you drive yourself?
4. Duration
Most IMEs last 30–90 minutes, depending on complexity.
What Happens After the IME?
- IME report prepared: The doctor writes a report for the insurer (not for you).
- Report sent to insurer: You may not automatically get a copy — but you can request one.
- Claim decision influenced: Insurers often give the IME more weight than treating doctors’ reports.
Understanding Your IME Report
After the examination, the doctor writes a report and sends it to the insurer, not to you. You are usually entitled to request a copy, and you should. The report often carries significant weight in the insurer’s decision, so read it carefully.
| Section of the report | What to check for |
|---|---|
| Your history | That it accurately reflects what you actually said |
| Examination findings | That observations match your real condition |
| Diagnosis | Whether it aligns with your treating doctors |
| Capacity opinion | Any claim you can work that your specialists dispute |
Warning: If the report says you can work when your own specialists disagree, that conflict is often the strongest ground to dispute the insurer’s decision.
How Insurers Use (and Misuse) IME Reports
While IMEs can provide helpful independent evidence, insurers sometimes misuse them:
- Giving the IME more weight than years of treating doctor evidence.
- Highlighting inconsistencies while ignoring supportive parts of the report.
- Ordering repeat IMEs until they get the “opinion” they want.
- Using vague IME conclusions to justify denial (“patient could do some form of work”).
This is why it’s critical to be prepared and to challenge errors if they occur.
Common Traps with IMEs
- Thinking the doctor is there to help you – They’re assessing, not treating.
- Inconsistent answers – If your answers differ from records, it damages credibility.
- Downplaying symptoms – Pride leads some to minimise their condition; insurers use this to argue recovery.
- Exaggerating symptoms – Overstatement backfires when unsupported by records.
- Body language observations – IME doctors note how you walk, sit, or interact, even outside the exam room.
- Not checking the report – IME reports often contain mistakes or unfair interpretations.
What Do IME Doctors Look For?
An IME doctor is not just recording what you say. They are trained to observe consistency between your reported symptoms and how you behave during the appointment — sometimes from the moment you arrive in the car park.
- Consistency between your described limitations and your movement, memory, and concentration on the day.
- Range of movement and effort for physical claims — how you sit, stand, walk, and remove clothing.
- Genuine effort during physical or cognitive tasks.
- Everyday function — whether daily activities line up with the severity you describe.
Tip: Be genuine. Do not exaggerate, but do not put on a brave face either. Describe your limitations exactly as they are on a normal day.
Tips to Prepare for an IME
- Be honest and consistent – Don’t minimise or exaggerate.
- Bring a support person – A family member may be allowed as a witness.
- Take your job description – Helps link your disability to your duties.
- Review your medical history – Know your treatment timeline.
- Request a copy of the report – Correct errors early.
- Seek advice before attending – Lawyers can explain what to expect and how to respond.
What Not to Say at an IME
Always be honest — but a few common mistakes can unintentionally damage a strong claim. This quick comparison shows the difference:
| Avoid saying this | Do this instead |
|---|---|
| “I’m fine” or “it’s not too bad” (out of politeness) | Describe your real limitations honestly |
| Overstating or dramatising symptoms | Give an accurate, consistent account |
| Guessing at dates or details you don’t recall | Say “I don’t remember” if that’s the truth |
| Predicting you’ll “probably get better soon” | Focus on how you are right now |
| Discussing legal strategy or blaming others | Keep answers to your health and function |
Remember: You are not there to perform or win an argument. Be honest, be consistent, and describe an average day.
Real-Life Examples
Case 1: Back Injury (Physical Condition)
Mark, a 46-year-old mechanic, had a chronic back injury. His GP and surgeon agreed he couldn’t return to physical work. The insurer sent him to an IME with an occupational physician, who reported he could do “light desk work.” With legal support and vocational evidence, Mark’s claim was eventually approved.
Case 2: PTSD (Mental Health Condition)
Samantha, a nurse, developed PTSD. Her IME psychiatrist suggested she could return to a “low-stress” admin role. With additional psychiatric evidence from her treating doctors showing she couldn’t tolerate any workplace environment, the IME was successfully challenged and her claim approved.
Case 3: Neurological Disorder
David, diagnosed with multiple sclerosis, attended a neurologist IME. The report highlighted inconsistencies in walking ability. His lawyer obtained further functional assessments that confirmed his limitations. The insurer eventually accepted the claim.
Lesson: IME reports are powerful but not always final. Strong counter-evidence can prevail.
How to Challenge an IME Report
If an IME report is used to reject or reduce your claim, it is not the final word. A negative or flawed report can be disputed, and it happens often. Follow these steps:
- Request the full report and read it closely for errors or unfair assumptions.
- Gather counter-evidence from your treating GP and specialists, who know your history far better than a one-off examiner.
- Point to inconsistencies between the IME and your documented medical records.
- Ask for a second IME or an independent review where appropriate.
- Escalate to AFCA (the Australian Financial Complaints Authority) or the courts if the insurer will not reconsider.
Key point: When an IME doctor disagrees with your treating doctors, that is not automatically decisive. A well-evidenced response from the doctors who have treated you over time can carry more weight, especially with AFCA.
If you disagree with an IME:
- Request a copy of the report – You are entitled to see it.
- Check for errors – Inaccurate details, missing context, or contradictions.
- Get clarifications from treating doctors – Ask them to respond to the IME’s findings.
- Submit additional evidence – Functional capacity evaluations, updated specialist reports.
- Escalate if necessary – Through internal review, AFCA, or legal proceedings.
FAQs
Do I have to attend an IME?
Usually yes. Refusing may give insurers grounds to reject your claim.
Do I get to choose my IME doctor?
No. The insurer chooses, but you can request a different time/location.
Can an insurer request multiple IMEs?
Yes, and there’s no strict limit — but repeated requests can be challenged as unreasonable.
Will I automatically get a copy of the IME report?
Not always. You must request it.
What if I disagree with the IME report?
You can provide counter-evidence, request corrections, or escalate through AFCA/court.
Can the insurer record the exam?
Some do. You can request a copy. You may also ask to record (with permission).
Are IME doctors biased?
They are meant to be impartial, but as they’re paid by insurers, their reports often lean conservative. This is why strong treating doctor evidence is essential.
What happens at a psychiatric IME in Australia?
A psychiatric IME is conducted by a consultant psychiatrist and usually runs 60–120 minutes. It involves a detailed clinical interview and mental state examination rather than physical tests, focusing on your history, symptoms, treatment, and how your condition affects daily function and work capacity.
What questions are asked at a psychiatric IME?
Expect questions about your symptoms, treatment history, daily routine, relationships, sleep, mood, and your ability to work. The examiner is assessing consistency and functional impact — answer honestly and describe your worst days as well as your average ones.
Can I challenge a psychiatric IME report?
Yes. If an IME report is inaccurate or unfair, you can respond with evidence from your treating psychiatrist, request the insurer reconsider, and escalate an unfair decision to AFCA.
An Independent Medical Examination (IME) can be one of the most stressful stages of a TPD or income protection claim. While they’re labelled “independent,” in practice these doctors are paid and chosen by insurers, and their reports often carry significant weight.
The key is preparation: be honest, consistent, and organised. Know that the IME doctor is assessing you, not treating you. Don’t minimise or exaggerate. Bring supporting evidence where possible, and always request a copy of the report.
If the IME is unfavourable, remember: it’s not the end of the road. With strong medical evidence from your own doctors — and legal support — many IME-based denials can be successfully overturned.
At TPD Claims Lawyers, we help Australians prepare for IMEs, challenge inaccurate reports, and fight unfair denials. If you’ve been called to an IME, or if your claim has been delayed because of one, contact us today for a no-obligation chat.
Last updated: 8 July 2026