IME Frequently Asked Questions

An IME is an evaluation by a physician who has no treatment relationship with the person examined, requested by a party such as an insurer, attorney, employer, or agency to obtain an objective opinion on disputed medical questions — diagnosis, causation, degree of impairment, or functional capacity. The result is a written report to the requesting party, not a treatment plan.

Defense and plaintiff attorneys in personal injury cases, disability insurers, third-party administrators, employers, and government agencies. The requesting party frames the questions and provides the records, but the examiner's opinions must follow the medical evidence regardless of who made the request.

The examinee gives a history of the injury or condition, followed by a comprehensive eye examination: best-corrected visual acuity, refraction, pupil testing, eye movements, intraocular pressure, slit-lamp examination of the front of the eye, and a dilated examination of the retina and optic nerve. Additional objective testing is performed as the disputed issues require.

Commonly automated visual field testing (such as Humphrey perimetry) to quantify peripheral vision, and optical coherence tomography (OCT), an objective cross-sectional scan of the retina and optic nerve that does not depend on the examinee's answers. Where claimed vision loss exceeds what the anatomy explains, consistency testing and, occasionally, electrophysiology may be added.

No. An IME creates no physician-patient treatment relationship: the examiner does not treat, prescribe, or manage care, and the report goes to the requesting party under the applicable rules. If an urgent finding is discovered during the examination, it is communicated appropriately, but ongoing care remains with the examinee's own physicians.

Typically on the order of an hour, longer when visual fields, OCT, or other testing is needed. Dilating drops blur near vision and increase light sensitivity for several hours afterward, so examinees are commonly advised to arrange transportation home.

Current glasses and all contact lenses — best-corrected vision is a central measurement and cannot be properly assessed without the examinee's actual correction — plus a list of current medications including eye drops, and anything the appointment notice specifically requests.

The examiner completes any outstanding record review and issues a written report to the requesting party addressing the questions posed — typically diagnosis, causation, objective findings, impairment, and prognosis, stated to a reasonable degree of medical probability. Depending on the forum, the examiner may later be deposed or testify about the report.

An examinee may decline any procedure, and ophthalmic IMEs rarely involve anything invasive — the closest is dilating drops, which are routine. Declining components the evaluation requires may limit the opinions the examiner can offer, and whether attendance or specific testing is compellable is a legal question for counsel.

IME is the general nationwide term for a non-treating physician's examination in civil matters. A QME evaluation is a creature of California workers' compensation: the evaluator holds a state designation under Labor Code §139.2, is selected through a statutory panel process, and must produce a report with legally required elements on statutory deadlines.