Why insurers request an IME
Insurance companies use IMEs to:
- Look for reasons to reduce or terminate benefits
- Challenge your treating physician’s opinions
- Support a claim that you can return to work (or perform “some” work)
IME reports are often used as key evidence in denials and appeals.
What to expect at an IME
- The exam may be brief (sometimes 10–30 minutes)
- The doctor may ask about symptoms, daily activities, and work history
- Physical or cognitive testing may be limited or superficial
- The examiner may review selected records provided by the insurer
What’s said, done, or observed—even casually—can appear in the final report.
Common issues with IME reports
- Symptoms minimized or omitted
- Pain, fatigue, or cognitive issues discounted
- Short observations used to claim full-time work capacity
- Conclusions that conflict with long-term treating providers
If left unchallenged, an IME can carry significant weight in the administrative record.
Key takeaway
An IME is not a neutral second opinion—it’s a tool insurers use to justify benefit decisions. How the IME is handled, documented, and responded to can have a major impact on your LTD claim.
If you want, I can:
- Turn this into a 3-paragraph explainer with a call to action
- Write a “How to prepare for an IME” checklist
- Explain how IME reports are challenged in LTD appeals
How the Bernstein Law Firm, PLLC can help!
The Bernstein Law Firm PLLC helps long-term disability claimants by focusing on one of the most important—and often overlooked—parts of an LTD claim: the administrative record. This is the complete file the insurance company uses to decide whether benefits continue or are denied, and in most cases, it is the only evidence a court will ever review. If key medical opinions, functional limitations, or explanations are missing from the record, they usually cannot be added later.
The firm works to build a strong, complete administrative record before it closes. That includes gathering detailed physician opinions, clearly tying medical conditions to work-related limitations, and addressing issues insurers frequently exploit—such as fatigue, pain, cognitive symptoms, and good days versus bad days. When insurers rely on surveillance, paper reviews, or selective medical opinions, The Bernstein Law Firm PLLC places that evidence in proper context and submits rebuttals so misleading conclusions do not go unchallenged.
By treating the appeal as a trial on paper, The Bernstein Law Firm PLLC protects clients long before a lawsuit is ever filed. A well-developed administrative record limits the insurer’s defenses, strengthens the case for continued benefits, and significantly improves the chances of success if court review becomes necessary.
If your long-term disability benefits are under review, denied, or at risk, contact The Bernstein Law Firm PLLC to discuss how protecting your administrative record now can make all the difference later.
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Don’t give up. With aggressive and effective legal representation from our disability attorneys, you improve your chances of securing the benefits you need. Our firm has successfully recovered millions of dollars for individuals nationwide whose disability claims were denied. We understand how to navigate the complex process involved in obtaining benefits from the Social Security Administration or a private long-term disability insurer.