If your long-term disability insurer has told you that you need to attend an independent medical examination, often referred to as an “IME” for short, there are some things you should understand before you go.

The first is that it is not independent. The doctor is selected by the insurer, paid by the insurer, and reports to the insurer. Their job is not to treat you and not to advocate for you. Their job is to produce a report that the insurer will use to make a decision about your benefits. In most cases, that decision is whether to deny, terminate, or reduce what you are receiving.

The second is that the IME is one of the most consequential events in your claim. A negative IME report can lead directly to your benefits being cut off. A favourable one (which does happen, but less often than insurers would have you believe) can keep your benefits in place. How you prepare and how you present yourself matters.

Why Do LTD Insurers Require Independent Medical Examinations?

LTD policies almost always give the insurer the right to require medical examinations as a condition of continuing to pay benefits. The contractual language varies but generally allows the insurer to require examinations “as often as reasonably necessary” while a claim is open. If you refuse without a good reason, the insurer can suspend or terminate your benefits.

The reason insurers commission IMEs is straightforward: they want medical evidence that supports a decision they are inclined to make. Treating doctors usually support their patients’ disability claims because they know the patient and have seen the functional impact of the condition. IME doctors do not have that history. They see you for an hour or two, often once, and produce a report based on that snapshot plus a review of your file.

That snapshot is selected and framed in ways that tend to favour the insurer. This is not necessarily because IME doctors are dishonest. It is because of how the system is structured. Insurers refer repeat business to doctors whose reports are useful to them. Doctors whose reports consistently support claimants tend not to get repeat referrals. Over time, the IME ecosystem sorts itself.

The Two Types of LTD Independent Medical Examinations

There are two distinct contexts in which you may be sent for an IME.

The first type is the IME that occurs during the claim or appeal process.

This is the most common type of IME. You have applied for LTD benefits, or you are receiving them and the insurer is reassessing. The insurer requires an IME under the policy. The doctor’s report goes to the insurer’s claim adjuster, who uses it to make a benefits decision. At this stage, you are not in litigation. Your relationship with the insurer is contractual. The IME is governed by the policy terms and by general principles of good faith.

The second type of IME is the defence medical examination during litigation.

If your claim has been denied and you have started a lawsuit, the defence will usually want their own medical evidence. This is governed by Rule 7-6 of the British Columbia Supreme Court Civil Rules, which allows the court to order a medical examination if it is appropriate. The framework is different. You have more procedural protections, your lawyer is involved at every step, and the report is produced for use in litigation rather than for a benefits decision.

The strategic considerations are different at each stage but the practical experience of attending the examination is similar.

What Happens During an LTD Independent Medical Examination?

Most IMEs follow a predictable pattern.

You arrive at a clinic or office building. Your arrival is observed. How you walk from the parking lot, whether you use a cane, whether you grimace climbing stairs, how you sit in the waiting room, what you do on your phone, all of it may be noted. The IME starts before you enter the examination room.

You complete intake forms. These often ask you to describe your symptoms, your functional limitations, and your daily activities. Take this seriously. Inconsistencies between what you write here, what you have told your treating doctors, and what you say later in the examination will appear in the report.

The doctor takes a history. This is the longest part for most IMEs. The doctor will ask you about the onset of your symptoms, your treatment history, what makes things better or worse, what you can and cannot do. They are listening for inconsistencies, exaggeration, and patterns that suggest your condition is not what you claim. They are also looking for anything in your history that suggests an alternative explanation (a prior injury, a pre-existing condition, a psychological component).

The doctor performs a physical examination. This is usually shorter than you might expect. In musculoskeletal cases it includes range of motion testing, palpation, and specific provocative tests. In neurological cases it includes reflexes, strength testing, sensory testing, and sometimes cognitive screens. In psychiatric assessments there may be standardized testing. The doctor is observing your effort, your demeanour, and any inconsistencies between voluntary and involuntary movements.

The doctor may order additional testing. Functional capacity evaluations, psychometric testing, and surveillance referrals sometimes follow an initial IME.

The whole appointment usually takes one to three hours. You will not get a copy of the report at the end. You will not necessarily get one at all unless you specifically request it through the insurer or through your lawyer.

What Does an LTD Independent Medical Examination Report Include?

IME reports follow a standard structure where they lay out a claimant’s history, examination findings, review of records, opinion, and answers to specific questions the insurer has asked.

The opinion section is what matters. Common conclusions in IME reports for LTD claims include:

• That your condition is real but not as severe as you describe
• That your condition is real but should resolve within a defined period
• That your condition is real but does not prevent you from working in some capacity
• That your symptoms have a significant psychological component, sometimes framed as “functional overlay” or “symptom magnification”
• That your condition is the result of a pre-existing problem rather than the event you attribute it to
• That you have functional limitations, but those limitations do not prevent you from performing the important duties of your own occupation or some other occupation
• That you can perform certain activities, such as sitting, standing, walking, lifting, concentrating, interacting with others, or working at a computer, for enough time to return to work
• That you are capable of returning to your own occupation, or to some other occupation, sometimes with restrictions, accommodations, modified duties, or a gradual return-to-work plan

Insurers use these conclusions to deny initial claims, terminate ongoing benefits, or move you from “own occupation” to “any occupation” coverage (a common transition point in LTD policies that often results in termination).

How Should You Prepare for an LTD Independent Medical Examination in BC?

The most common mistake claimants make is over-preparation in the wrong direction. They try to anticipate questions, rehearse answers, and present a particular version of themselves. This usually backfires.

The right preparation is straightforward:

• Be honest: Do not exaggerate your symptoms. Do not minimize them. Describe your condition the same way you have described it to your treating doctors. Inconsistencies are the most damaging thing in an IME report.
• Be consistent: Review what you have told your treating doctors and what you have said in your claim forms before the appointment. Your story should match your medical records. If your records contain errors, address them with your lawyer in advance, not by changing your story at the IME.
• Do not perform: Do not exaggerate a limp. Do not pretend you cannot do things you can do. IME doctors are trained to spot this and will document it. Equally, do not push through pain to appear functional. Show up as you actually are.
• Be brief: Answer the questions asked. Do not volunteer extensive narratives. Do not explain your theory of why you are disabled. Do not argue with the doctor. Yes, no, and “I am not sure” are usually sufficient.
• Eat, hydrate, and arrive rested: IMEs are mentally exhausting. Treat them like you would any other significant medical appointment.
• Bring identification, your medication list, and any aids you normally use: If you use a cane or a brace, use it. Do not leave it in the car to appear better than you are. Do not bring it if you do not normally use it.

What Should You Do After an LTD Independent Medical Examination?

Write down everything you can remember about the examination as soon as possible. Times, questions, tests, what was said. Send these notes to your lawyer.

Request the IME report through your lawyer or your insurer. When you receive it, review it carefully against your notes. Inaccuracies are common. These can range from minor errors to significant mischaracterizations of what you said or how you presented.

If the report is unfavourable, your lawyer will assess whether the report has methodological flaws, whether it is inconsistent with your treating doctors’ opinions, whether the IME doctor has a documented bias pattern, and whether you should commission your own expert opinion to counter it.

Do not respond to the insurer about the IME report yourself. All communication should go through your lawyer.

What If Your LTD Benefits Are Denied or Terminated After an IME?

If your insurer relies on the IME report to deny or terminate your benefits, you have options. The internal appeal process under the policy is one. Litigation in BC Supreme Court is another. In most LTD cases, internal appeals to the same insurer that denied you are of limited value, and the real remedy is a lawsuit.

A lawsuit changes the dynamics significantly. Your lawyer can commission your own medical experts. The insurer’s IME doctor can be cross-examined at trial. Courts in BC have been increasingly willing to scrutinize IME reports critically, particularly where the IME doctor’s history of repeat work for insurers suggests bias, where the report is inconsistent with the claimant’s treating doctors, or where the methodology is flawed.

Insurers often settle disability claims once litigation is underway and credible counter-evidence is available. The IME report that looked devastating at the claim stage often loses much of its weight when subjected to litigation scrutiny.

Speak With a BC LTD Insurance Denial Lawyer About an IME

The IME process is one of the most demoralizing parts of an LTD claim. Claimants often describe feeling judged, doubted, and reduced to a set of suspicious behaviours. That experience is real. It is also, to some extent, designed. The IME serves the insurer’s interests, and those interests are not aligned with yours.

Knowing what the IME is, how it works, and what your rights are will not make the experience pleasant. But it will reduce the chance that the IME ends your claim unfairly. Combined with proper legal representation before, during, and after, it can mean the difference between a denied claim and a successful one.

If you have been told you need to attend an IME, or if your benefits have been denied based on one, contact the experienced insurance denial lawyers at Taylor & Blair LLP today. These cases are technical, the timelines matter, and the strategic decisions you make in the first weeks shape the rest of your claim.  Contact us now for a free consultation.