If you have been asked to attend an IME, an Independent Medical Examination, it means your claim has reached the point where the insurer wants its own medical opinion on you. In Queensland that insurer is usually WorkCover Queensland or a self-insurer if you had a workplace accident, or a CTP insurer if you had a car accident.
The appointment matters more than most people realise. The report that comes out of it will drive what your claim is worth, and in a WorkCover claim it can end your weekly payments. This guide covers what these doctors actually do, what your rights are under Queensland law, and how to give an accurate account of yourself without handing the insurer ammunition.
Queensland rules are not the same as New South Wales or Victorian rules, and a good deal of the IME advice online describes another state’s system or an American one. What follows is Queensland.
What an IME Is, and What It Is Not
An IME is a one-off assessment by a doctor who is not involved in treating you. Your own GP or treating surgeon cannot be the examiner, because the point is an opinion from outside your treatment team.
The examiner is typically asked to give an opinion on your diagnosis, the cause of the injury, whether you still need treatment, your capacity for work, and your level of permanent impairment. What they are not there to do is treat you, order your scans, or tell you what is wrong with you. Do not try to get a diagnosis or advice out of them on the day, because that is not their role and the attempt itself can end up in the report.
The purpose is verification. The examiner is checking whether the extent of your symptoms is consistent with how you say the injury happened, and whether the limitations you describe are as serious and as permanent as you claim.
Your Rights Depend on Which Queensland Claim You Are In
This is the part almost every article gets wrong for Queensland readers, and it decides whether you can push back on an appointment. There are three different situations and they carry different rules.
A WorkCover statutory claim
This is while you are receiving weekly benefits and medical expenses. Under section 135 of the Workers’ Compensation and Rehabilitation Act 2003 (Qld), the insurer may at any time require you to submit to a personal examination by a registered person, at a place reasonably convenient to you.
There is no panel of doctors at this stage. The insurer chooses the examiner. If you fail to attend without reasonable excuse, refuse to be examined, or obstruct the examination, your entitlement to compensation is suspended until you undergo it. That is the harshest consequence in the whole system, and it is why simply not going is never the answer.
The one real lever you have is the words “reasonably convenient”. An appointment that requires unreasonable travel is arguable. Raise it with the insurer in writing, and get advice rather than deciding for yourself.
A WorkCover damages claim
Once you move to a common law damages claim, the rules change in your favour. Under section 282 of the same Act, the insurer or a contributor may ask you to undergo a medical examination by a doctor you select from a panel of at least three doctors nominated in the request, at the insurer’s expense. The same applies to an assessment of cognitive, functional or vocational capacity.
If three suitably qualified doctors are not available the panel may be reduced to two. And you must comply unless it would be unreasonable or unnecessarily repetitious, which is a genuine limit on being sent to examiner after examiner.
A CTP claim after a car accident
Section 46A of the Motor Accident Insurance Act 1994 (Qld) works much the same way. Where the insurer wants a medical report and cannot get your agreement, you must undergo, at the insurer’s expense, an examination by a doctor you select from a panel of at least three nominated in the request, or an assessment of cognitive, functional or vocational capacity from a panel of at least three experts. Again the panel can drop to two if three are not available, and again you are not obliged to attend if the examination would be unreasonable or unnecessarily repetitious.
Section 46 also lets you and the insurer jointly agree on a single expert, and neither side is obliged to agree to that. Where you are offered a panel, the choice is worth taking seriously rather than picking the first name or the closest address. Your lawyer will usually know the reputations on that list.
So when an interstate article tells you that you always get a choice of three doctors, that is true in Queensland for a damages claim or a CTP claim, and not true for a WorkCover statutory claim. Read carefully which one you are in.
Common IME Doctor Tricks Used by Insurers in QLD
Insurance companies like WorkCover Queensland have been using the same IME doctors for years, and these doctors know exactly what insurers want to hear. Here are the most common tactics they use:
The “Pro-Insurer” Doctor Panel
In our experience, insurers and defendant lawyers rarely send you to neutral doctors (WorkCover Queensland being an exception which is typically more balanced). They maintain lists of doctors who consistently find in favour of the insurer’s interest. These doctors write thousands of medico-legal reports and know that more referrals come from writing insurer-friendly reports.
Surveillance Before and After Your IME
Private investigators often film you for days before your appointment. They’re looking for any activity that contradicts your claimed limitations, and even something as simple as carrying groceries can be used against you. Surveillance is one of several financial and practical risks that come with running a personal injury claim.
The “Hidden Test” Examination Technique
The doctor may ask you to do something seemingly unrelated to your injury. For example:
- If you claim neck pain, they might ask you to remove your shoes to see if you turn your head naturally
- If you claim back issues, they’ll watch how you sit, stand, and move a chair
- If you claim limited mobility, they’ll observe you walking from the waiting room
The Downplaying Strategy
Defendant IME doctors often minimise your symptoms in their reports, focusing on what you CAN do rather than what you cannot do, or what causes you pain.
The “Exaggeration Trap”
They’ll test movements that shouldn’t hurt to catch you claiming pain where there shouldn’t be any. One false claim can invalidate your entire case.
Leading Questions and Repeated Questions
A question can be framed so that almost any answer helps the insurer. “So the pain settles down if you rest?” invites a yes that reads very differently in a report than it felt in the room. Ask for the question to be clarified if it does not fit your situation, and answer the question actually asked rather than the one implied.
Expect to be taken back over the same ground more than once. Being asked to repeat the history is a consistency check, not forgetfulness. This is exactly why a written timeline of your injury, treatment and symptoms is worth taking with you.
Blaming Something Other Than the Accident
A very common conclusion is that your symptoms come from degeneration, ageing, an old injury or something in your private life rather than the incident. Be upfront about genuine prior problems, because the insurer will have your clinical records and an omission looks far worse than the history itself. What matters is the difference between how you were before and how you are now, so describe that change clearly.
What Actually Happens at the Appointment
The examiner is briefed before you arrive. They will have a letter of instruction setting out the questions to be answered and copies of your clinical records, and they will usually have read them. Very little of what you say will be new to them, which is another reason accuracy matters more than presentation.
Most appointments follow the same shape. There is an interview covering your employment history, any previous or pre-existing conditions, how the injury happened, your symptoms now, what you can and cannot do, and what treatment you have had. Then there is a physical examination, which for a physical injury may include manipulation of the injured area. Throughout all of it you are being observed, including how you sit, stand, undress and move.
A physical examination usually runs 30 to 60 minutes. Psychiatric and psychological assessments run longer. An occupational therapy assessment may happen in your home and can take most of a day. There is no statutory time limit on how long an examiner may take.
Worth taking with you:
- Your imaging on disc or a device, not just the radiology report. The examiner has probably seen the report but rarely the actual films.
- A written timeline of the injury, your treatment and how your symptoms have changed.
- A list of your current medications and treating practitioners.
- A note of how the injury affects ordinary life, including work, housework, driving, caring for family and sleep.
- Photo identification, and your support person if you are bringing one.
Arrive early, allow time for consent forms, and tell whoever arranged the appointment as soon as possible if you cannot make it. Non-attendance fees are common, and on a statutory WorkCover claim a missed appointment has consequences well beyond a fee.
5 Tips for Protecting Your Injury Claim at an IME
1. Be Honest. Do not exaggerate your condition. If something doesn’t hurt, don’t claim that it does. You can rest assured that the examining doctor will test you to see if you are making any claims that are patently unsustainable. Usually this is done by the Doctor asking you about your symptoms, and asking you about some aspect that they know should not cause you any or little pain.
Remember that the purpose of the medical examination is to determine whether or not:
- the extent of your injuries is consistent with your claim of how it occurred; and
- the injuries are as serious as what you claim.
So, simply put, you are being tested at the Doctor’s examination and you may be asked to do something by the Doctor for an entirely different purpose than what is first apparent.
One example is if you have a neck injury and the Doctor is talking to you but moving around the room at the same time. The purpose in moving may well be to see if you turn your neck to follow them as they move.
The doctor might actually ask you to do something that has nothing to do with your injury. For example, if your claim says that you cannot turn your head, the doctor may bend your arm and be watching you to see if you turn your head to see what they’re doing.
If you claim that you cannot lift anything, or anything above a certain weight, or that you have a serious back injury, the doctor may simply ask you to move a chair or bring it to his desk to see how you cope with this task, whether or not you pick it up with both arms, or at all.
Another example may be if the doctor asks you to remove part of your attire, your shoes or top for instance. You can assume that the doctor is watching to see how you cope with doing so. If you can do so, then do so as you normally would, taking into account the effect of your injuries. Under no circumstances should you lie or exaggerate your condition as this will also become obvious to the doctor who is examining and observing you.
So just because the doctor asks you to do something and you genuinely cannot do so as a consequence of your injury, then politely decline and explain to the doctor why you have declined to do so.
Simply tell the doctor the truth. If the doctor asks you to do something and it genuinely hurts, then say so. However, if it does not hurt, say so. This will increase your credibility as certain actions or movements of your body may cause pain due to your injury and others may not. If your doctor asks you to do something knowing that there should be no pain, and there is no such pain but you claim there is, then the doctor knows you are lying and will report this in his findings.
2. Describe the areas and degree of pain exactly as it is, not as the doctor suggests it should be and not as you think it should be after researching your symptoms on Google. However, if the doctor does something that causes you pain, ensure you let them know because if you don’t, the doctor will assume that your silence is acknowledgement that there is no pain.
Describe a bad day and a good day rather than only one or the other, and give concrete examples. “I can drive to Springwood but not to the Sunshine Coast without stopping” tells an examiner far more than “driving is hard”.
3. Assume that you have been watched the entire time since making your claim. Depending on the size of your claim you can safely assume that the Insurers have engaged private investigators to monitor you through video surveillance. The private investigators often use spy technology such as small cameras in the shape of a pen held in their front shirt pocket, or a hidden camera lens in their briefcase or even a newspaper they are holding.
Surveillance can occur at any point in time and can often occur around your scheduled IME appointment times. You should assume that you are being watched and filmed from the moment you depart your house, arrive to the appointment, to the moment you leave.
The Doctor conducting the Independent Medical Examination may also observe you entering the building and note in their report that you did not appear to be in any pain then and walked normally but complained of pain when you were in his presence. This leaves you exposed to the claim of exaggeration.
4. Don’t talk about your injury claim and assume that walls have ears. There is every chance a private investigator will be watching you as soon as you leave your home and follow you to your appointment. Do not discuss your claim or your injuries with anyone in the waiting rooms, or even in the lift when you arrive or leave, in case you are overheard by a private investigator who then attends court and misrepresents what you said or what you meant to say. Spy cameras exist in the form of pens, keychains, spectacles and other clever devices which can go easily undetected. Be aware that you may be recorded in public places without your knowledge.
It is also important to not discuss your injuries on social media either as the insurance company and their lawyers will most likely keep an eye out in case they can use any of your comments or photos against you.
5. Understand and expect that the doctor may have a bias against injured claimants. It is a fact that insurers tend to send injury victims to doctors, or provide you with a panel of doctors within which to choose from, who are generally recognised within the legal system as being ‘pro defendant’, or moderate, but never ‘pro plaintiff’.
Irrespective of this, you need to realise that the judges are also aware of which doctors are pro insurer, moderate or ‘pro plaintiff’, as they deal with them every second day and see hundreds of medico legal reports. Bias often shows through in the writing of these reports, so it is important if you are seeing a pro insurer doctor for an ‘independent’ medical examination that you do not overcompensate by exaggerating your symptoms, because this too will show through in the doctor’s report. Remember, it takes just one lie to throw your entire claim into jeopardy.
Psychological and Psychiatric IMEs
A psychiatric or psychological IME works differently from a physical one. There is no range of movement to measure, so almost everything turns on the interview, and the assessment usually runs one to two hours.
Expect detailed questions about your personal history well beyond the incident, including childhood, relationships, finances, alcohol and drug use, and any previous mental health treatment. This feels intrusive and it is meant to test whether something other than the incident explains your condition. Answer it honestly. Your clinical records are already in front of the examiner and a concealed history is far more damaging than the history itself.
Expect questions about a typical day, hour by hour, and about what you have stopped doing since the incident. Vague answers hurt psychiatric claims more than physical ones, so be specific about the activities, relationships and routines that have changed.
Queensland has one situation where the insurer must arrange a psychiatric examination and pay for it, including your reasonable travel. Under section 135A of the Workers’ Compensation and Rehabilitation Act 2003 (Qld), where a first responder or other eligible employee applies for compensation for post-traumatic stress disorder and has not yet been diagnosed by a psychiatrist, the insurer must arrange that examination to obtain a diagnosis.
More on how these claims are valued is set out in our guide to psychological injury claims and payouts in Queensland.
What Happens After the IME
You will not be told anything on the day. The examiner writes a report for whoever requested it, which commonly takes a few weeks, and it goes to the insurer or its lawyers first.
On a CTP claim you are entitled to see it. Section 47 of the Motor Accident Insurance Act 1994 (Qld) requires the insurer to give you copies of reports in its possession about your medical condition, within one month of receiving them, and an insurer that fails to comply without proper reason is liable for the costs that failure causes you.
On a WorkCover statutory claim, the IME report often signals that the insurer is moving to finalise. It may be used to end your weekly benefits, or to assess your degree of permanent impairment, which leads to a Notice of Assessment. That document matters enormously, because a notice of assessment is the gateway to seeking common law damages. Read why you should not let WorkCover close your claim without a Notice of Assessment before you agree to anything, and our guide to WorkCover lump sum payment amounts to see what an impairment percentage translates to.
Settlement discussions usually follow rather than precede the medical evidence, because until both sides have their reports, nobody can value the claim properly. An IME is therefore usually a sign the claim is progressing, not that it is about to be paid.
If the IME Report Is Wrong or Unfair
A bad report is not the end of the claim, and it is not the final word on your injuries. It is one opinion, and it is evidence that can be tested.
There are several ways to answer it. Your own solicitors can send you to an appropriately qualified specialist for a report of your own, and those reports are very often more favourable because the examiner is not working from an insurer’s brief. Factual errors in the report can be identified and corrected, and they are common, including wrong dates, a mis-stated history, symptoms attributed to the wrong body part, or an account of the incident that does not match the records. Where the report contradicts your treating doctors, that conflict is itself something a court weighs, and treating practitioners who have seen you over years carry real weight.
If the report gives you a very low or nil impairment rating, that is not necessarily fatal either. Read why an injury assessed at 0 percent by WorkCover might not matter, because the impairment percentage and the value of a damages claim are two different things.
What does not work is arguing with the examiner on the day, or writing to them yourself afterwards. All contact should go through whoever arranged the appointment, or through your lawyer.
Frequently Asked Questions About IMEs in Queensland
IME stands for Independent Medical Examination. It is a one-off assessment by a doctor who is not treating you, arranged so the insurer can get an opinion on your diagnosis, the cause of your injury, your need for treatment, your capacity for work and your level of permanent impairment. The doctor is not there to treat you and will not give you a diagnosis on the day.
It depends which claim you are in. On a WorkCover statutory claim, section 135 of the Workers’ Compensation and Rehabilitation Act 2003 lets the insurer require an examination at a place reasonably convenient to you, and if you fail to attend without reasonable excuse, refuse to be examined or obstruct the examination, your entitlement to compensation is suspended until you undergo it. On a WorkCover damages claim under section 282, or a CTP claim under section 46A of the Motor Accident Insurance Act 1994, you must comply unless the examination would be unreasonable or unnecessarily repetitious. Get advice before refusing rather than after.
Sometimes, and this is where Queensland differs from other states. On a WorkCover damages claim and on a CTP claim, the insurer must nominate a panel of at least three doctors and you choose from that panel, at the insurer’s expense. If three suitably qualified doctors are not available the panel can drop to two. On a WorkCover statutory claim there is no panel requirement, so the insurer picks the examiner. Interstate articles that promise you a choice of three are describing the law of another state.
IME doctors receive most of their work from insurance companies. While they are supposed to be independent, there is an inherent financial incentive to write reports favourable to insurers. Queensland judges see hundreds of these reports and are well aware of which examiners lean which way, which is also why exaggerating your symptoms to compensate is a serious mistake.
Most examinations for physical injuries take around 30 to 60 minutes, though this varies by injury type. Psychiatric and psychological IMEs usually run longer, often one to two hours. Assessments by occupational therapists are often conducted in the injured person’s home and can take up to a whole day. There is no fixed statutory time limit, so allow more time than you are quoted.
Yes. You have the right to bring a support person, and we strongly recommend it so long as they are not a witness to your claim. Tell whoever arranged the appointment beforehand so the examiner is expecting them. A support person is there to support you, not to advocate. They cannot answer questions on your behalf, and your lawyer should not attend.
Wear comfortable, loose, easy-to-remove clothing. The doctor may need to examine the injured area. Dress as you normally would rather than dressing to look injured, because how you present is itself being observed.
On a CTP claim, section 47 of the Motor Accident Insurance Act 1994 requires the insurer to give you copies of reports in its possession about your medical condition, within one month of receiving them. On a WorkCover claim the report forms part of your claim file and can be requested. If you have a lawyer, the report comes to them and they will go through it with you.
Seek Legal Advice
If you have been asked to attend an IME but have not yet sought legal advice, we recommend you do so urgently, and before the appointment rather than after it.
If you are receiving weekly WorkCover benefits, being sent to an IME is a typical sign that your claim is coming to an end and your benefits may be stopped depending on the outcome of the report.
If you are a victim of a car accident or slip and fall, being sent to an IME is a sign that the CTP insurer takes your claim seriously, but does not want to pay your maximum entitlements.
If you have legal advice, your solicitors are able to advise you of the specific and potential impacts any IME reports have on your claim, help you choose sensibly where you are offered a panel, and send you to alternative doctors for your own IME reports that are almost always more favourable.
Contact Roche Legal for a free consultation.