When you’re pursuing a personal injury claim in Texas, you could be asked to attend an “Independent Medical Examination” (IME). Though this may sound benign, IMEs are often high-stakes interactions that are far from “independent,” neutral, or unbiased in nature.
Effectively, that means that what you do and say during an IME could impact your personal injury claim.
- What Is a Court-Ordered “Independent Medical Examination” Under Texas Law?
- Do I Have to Attend the Exam?
- How Does the Defense Get a Medical Exam Ordered?
- What Is a Defense Medical Exam (DME)?
- Who Is the Doctor Performing the Exam?
- Can I Get Medical Advice from the DME Doctor?
- How Should I Prepare for the Exam?
- Should I Bring Notes With Me?
- What About Getting to the Exam Location?
- Can I Bring Someone With Me to the Exam?
- How Long Will the Independent Medical Exam Take?
- What Should I Expect on the Day of the Exam?
- What Should I Do During an Independent Medical Exam?
- What Tests Are Done During a DME or IME?
- Should I Sign Anything at the Appointment?
- What if I Have Questions During the Exam?
- What Should I Do After the Exam?
This personal injury IME guide is designed to highlight the essentials in less than ~5 minutes.
To explore more key insights for accident and injury victims, check out How to Prepare for Your First Meeting with a Personal Injury Lawyer.
What Is a Court-Ordered “Independent Medical Examination” Under Texas Law?
IMEs, under Texas Rule of Civil Procedure 204.1, are “physical or mental” examinations that are:
- Requested by the defendant
- Conducted by a qualified physician or psychologist selected by the defense
- Ordered by the court when the defendant can demonstrate “good cause” for the independent medical exam.
Defense attorneys typically argue that they need their own doctor’s opinion to verify or challenge the plaintiff’s medical claims.
If the defense intends to request an IME, they have to do so “no later than 30 days before the end of any applicable discovery period.”
Do I Have to Attend the Exam?
You only have to show up and go through an IME if the court orders it.
If you don’t, you could be giving the defense room to argue that:
- You have something to hide about your medical condition.
- You’ve exaggerated your injuries.
- Your claim is frivolous.
On the other hand, if the defense requests an IME but the court does not grant the order, you would not have to attend this exam.
How Does the Defense Get a Medical Exam Ordered?
A defendant in a Texas personal injury case must establish the following to the court:
- Your physical or mental condition is genuinely in question.
- There is “good cause” for the exam.
- The exam is needed to prepare the defense, not simply to harass you.
If the court agrees, an order for an IME will be issued in your case.
What Is a Defense Medical Exam (DME)?
A DME is another term for an IME. Both are medical exams that are:
- Done for the benefit of the defendant
- Typically conducted by physicians who routinely work with insurance companies and defendants
- Focused on questioning your injuries and finding ways to minimize them or attribute them to another cause, rather than affirm them or back up what you’ve said.
Who Is the Doctor Performing the Exam?
The IME doctor will be a physician selected by the defendant. As such, many of these doctors are “frequent flyers” who make a living performing defense exams, rather than treating patients.
Consequently, these physicians tend to have relationships with the insurance companies that find themselves as defendants in personal injury cases, like claims involving car accidents, 18-wheeler wrecks, work injuries, and more.
That said, it’s critical to know that:
- You have a right to know the doctor’s name and background.
- Your personal injury lawyer can research the doctor’s history.
- While IME doctors may view your injuries through the lens of the defense, they cannot fabricate information or “lie.”
- The better prepared you are when you go to an IME, the better you’ll be able to navigate the process with confidence and peace of mind.
Can I Get Medical Advice from the Defense Doctor?
Instead, independent medical exams who conduct them are:
- More akin “investigations”
- Focused on gathering evidence
- Intended to help the defense, not you.
So, don’t make the mistake of thinking these doctors are part of your ‘team’ or that they’re on your side. They are not.
How Should I Prepare for the Exam?
Here’s what you can do to get ready for a defense medical exam or IME:
- Create a detailed list of your prior injuries and the medications you take.
- Be prepared to discuss your current physical, emotional, and mental trauma in detail.
- Be ready to talk about how the injury affects your daily life, including any new challenges or limitations it has presented.
You can also work closely with your personal injury attorney for additional support preparing for IMEs.
Should I Bring Notes With Me?
Yes! Bring any lists or notes you have, so you don’t forget to share important details.
If you leave anything out, like certain symptoms or specific limitations, the defense may allege that you overstated your injuries — and that your omissions were never ‘real’ issues in the first place.
What About Getting to the Exam Location?
Plan ahead, and:
- Look up the physician’s address ahead of time.
- If needed, bring someone with you to drive and/or support you through the process.
- If the office is far, let your attorney know. The defense may be required to cover travel expenses.
Can I Bring Someone With Me to the Exam?
Your attorney can help you make these arrangements if needed.
How Long Will the Exam Take?
There’s no standard or single answer here because the length of the exam depends on the nature of your injuries, the physician, and other factors.
That said, it’s helpful to understand that IMEs can be:
- Shorter: It’s not unheard of for some independent medical exams to take ~5 to 10 minutes.
- Longer: In many cases, defense medical exams last several hours. Some, particularly psychological evaluations, may take all day or even more than one day.
What Should I Expect on the Day of the Exam?
On the day of your independent medical exam, you can expect a structured, formal evaluation conducted by a doctor chosen by the insurance company or defense.
Once you arrive at the doctor’s office, here’s what you can expect:
1. Check-In
You’ll need to show your ID when checking in. You may also be asked to fill out a short medical history or symptom questionnaire.
2. Observation before you enter the exam room
Be aware that you could be observed from the moment you arrive, including in the:
- Parking lot
- Waiting area
- Hallways and other areas of the building
These observations are intended to uncover:
- Any discrepancies in how you behave, move, and act when you’re not being formally examined.
- Potential ‘evidence’ that your injuries are not as severe as you have alleged.
3. A brief Interview
Once you’re in an exam room, the IME doctor will likely start by asking questions about:
- Your injury
- Your symptoms
- Your treatment history
- How the condition affects your daily life.
Answer honestly, and be aware that the IME doctor will likely review your prior medical records before your exam. With that, any inconsistencies between your records and your statements can be more apparent.
4. A physical exam
The doctor will perform a physical exam, focusing on your injury. This may include:
- Movement tests
- Strength measurements
- Reflex checks
- Behavioral observations.
5. No treatment
IME doctors do not treat you. Their sole job is to assess your condition and report back to the insurance company or court.
So, don’t expect care or guidance on treatment(s) as part of this exam.
6. Personal or invasive questions
Some IME doctors will ask pointed, probing questions about:
- Prior injuries
- Unrelated medical history
- Activities not pertaining to the event or incident that caused the injury.
Remaining calm and answering respectfully—and briefly—are generally in your best interests.
No matter what’s asked, however, don’t forget that you can decline to answer questions that you feel are unrelated, irrelevant, or overly invasive.
7. No immediate feedback
Don’t expect the IME doctor to share their opinion with you during or at the end of the appointment. Instead, they’ll submit a report, which your attorney can review with you later.
What Should I Do During an Independent Medical Exam?
- Stay calm.
- Be thorough, honest, and consistent.
- Be polite and cooperative with everyone, including office staff.
- Stick to the facts of your current condition.
- Watch the time—how long the doctor spends with you matters, especially if the report claims a “thorough examination” after only five minutes of interaction.
- Wear comfortable clothing appropriate for a physical exam.
- Bring a notepad and pen to jot down anything important or noteworthy.
Do NOT:
- Lie, embellish, or exaggerate anything, especially when it comes to your symptoms.
- Overshare or say more than necessary.
- Discuss your accident with the IME doctor.
- Deny pre-existing injuries that have already been documented.
- Answer any questions you think are unrelated or overly invasive.
- Make the mistake of thinking the doctor is on your side.
What Tests Are Done During a DME or IME?
Medical tests administered during a defense or independent medical exam depend on the nature of the injuries, the physician’s decisions, and other factors. Commonly, however, IME tests include (and may not be limited to):
- Range of motion tests: These tests measure how far you can move a joint or limb and are often used for back, neck, shoulder, and knee injuries.
- Strength testing: These exams assess muscle strength and may involve pushing or pulling against resistance.
- Reflex testing: These tests evaluate nervous system response, especially for spine or nerve-related injuries.
- Sensory testing: These exams typically involve light touch, pinpricks, or vibrations to evaluate lost sensation in specific parts of the body.
- Gait and mobility observation: This entails observing how you walk, sit, stand, and get on/off the exam table, looking for signs of pain, imbalance, or restriction.
- Orthopedic or neurologic exams: These specialized tests may involve joint stability assessments, posture checks, or coordination testing.
Rare, highly invasive tests may be challenged by your attorney before you undergo them.
Should I Sign Anything at the Appointment?
No. Do not sign waivers, consents, or forms without speaking to your attorney first.
If pressured, politely decline and call your lawyer.
What If I Have Questions During the Exam?
You have the right to pause the exam and consult your attorney.
Your health and legal rights are your top priority, and there’s no reason you can’t get answers and trusted counsel during your IME.
What Should I Do After the Exam?
After you leave the doctor’s office:
- Write down everything you remember.
- Note how long the exam took, what was said, and any unusual behavior by the doctor.
- Call your attorney to share details about your IME.
Your account of what happened may be critical to challenging a biased report later.
Independent Medical Exams & Personal Injury Cases: Final Thoughts
A defense medical exam can be a pivotal event in any Texas personal injury case. With the right preparation and legal support, you can protect your rights and ensure your injuries are fairly presented.
If you have questions about your case or a defense medical exam in Houston or across Texas, don’t hesitate to contact an experienced personal injury attorney for more information.