Independent Medical Examinations (IMEs) — What to Expect

At some point in a CTP claim, the insurer may ask you to attend an independent medical examination — a consultation with a doctor of their choosing, not your treating team. IMEs help the insurer form their own view of your injury, capacity, and treatment needs, and the resulting report can carry real weight in decisions about your claim.

Why the insurer arranges one

Insurers use IMEs to test or confirm the picture your treating team has documented — particularly on contested questions like whether an injury is threshold or non-threshold, whole person impairment, or ongoing work capacity. An IME doctor is engaged and paid by the insurer, which is worth keeping in mind, even though they're expected to give an independent clinical opinion.

Your rights around an IME

• You're entitled to know the purpose of the examination.
• You can usually ask to bring a support person with you.
• You generally must attend if reasonably requested, or risk your benefits being affected.
• You can usually ask for a copy of the report once it's finalised.

Preparing for the appointment

Bring a clear, honest account of your symptoms, how they've changed, and how they affect your daily life and work. It's not an appointment to exaggerate or minimise — a consistent account that matches your treating records is what supports your position, not an especially dramatic one.

What happens if the IME disagrees with your treating team

This happens more often than people expect, and it doesn't automatically mean the IME's view prevails. Your treating team cannot control what the IME doctor writes, but a consistent, well-documented clinical record over time makes it harder for a single IME to overturn the weight of your ongoing treatment evidence. If there's a genuine conflict, this is exactly the kind of dispute the Personal Injury Commission's medical assessment process exists to resolve. If you don't yet have a treating doctor who knows the CTP scheme, see doctors and allied health for CTP claims.

After the IME

Ask for a copy of the report once available, and go through it against your own medical file. If something looks wrong or inconsistent with your treating evidence, get legal advice about your options — including whether a dispute or a further assessment is worth pursuing.

Different types of IMEs you might encounter

Not every IME looks the same. Depending on what's being assessed, you might be examined by an orthopaedic surgeon (for musculoskeletal injuries), a psychiatrist or psychologist (for psychological injury or a threshold psychological injury question), or an occupational physician assessing your broader work capacity. Some assessments also involve functional capacity testing rather than just a consultation and discussion. Knowing which type you're attending helps you understand what's actually being asked, and prepare accordingly.

How many IMEs might you attend?

There's no fixed number — it depends on how many distinct medical questions are in dispute over the life of your claim. It's not unusual for someone with a longer or more complex claim to attend more than one IME over time, sometimes with different specialists for different injuries. Each request should still have a clear, explained purpose; if it doesn't, it's reasonable to ask the insurer for one.