What this exam is — and isn't
This is not a treatment visit. The evaluator won't prescribe anything or manage your care. Their job is to answer legal-medical questions in a written report: Is the condition work-related? Have you reached MMI? What's your impairment rating? How much is attributable to pre-existing causes (apportionment)? What work restrictions are permanent?
The name varies by state and situation:
| Term | Who picks the doctor | The short version |
|---|---|---|
| QME (California) | You pick from a state-issued panel of three | The neutral evaluator when sides disagree. |
| AME (California) | Both attorneys agree on one doctor | An evaluator both sides pre-trust — their word is close to final. |
| IME (many states) | Often the insurance company | "Independent" describes the format; prepare accordingly. |
| Designated doctor (Texas) | The state DWC | Texas's neutral, state-appointed version. |
Judges and adjusters treat the medical-legal report as the closest thing to neutral truth in the file. Settlement values move directly with its findings — the rating, the causation opinion, the apportionment percentage. That's why an hour of preparation is worth more here than anywhere else in your claim.
Before the exam
- Rebuild your timeline. Be able to tell the story in order, with dates: how the injury happened, first symptoms, first report, first treatment, how symptoms evolved. Write it down; bring the note for your own reference.
- List every provider and treatment. Doctors, PT, injections, imaging, medications — evaluators check your account against records, and forgotten treatments read as inconsistency.
- Know your "before." Prior injuries or claims involving the same body part will be in the records. Denying them is fatal to credibility; explaining them ("I hurt it in 2019, fully recovered, worked six years without restriction") is powerful.
- Track a typical week of symptoms. Not your best day, not your worst — the honest range: what you can do, what you pay for later, what you've stopped doing entirely.
- Show up. Early. Missing a medical-legal exam can suspend benefits and delays everything by months.
During the exam
- 1
Tell it straight — the whole time
Total honesty is both an ethical and strategic rule. These exams often include consistency checks — the same question asked two ways, observation of how you move in the parking lot versus the exam room. Exaggeration is the fastest way to a bad report; nothing discredits real symptoms like fake ones.
- 2
Don't minimize either
The politeness reflex — "I'm doing okay, thanks" — becomes a sentence in a report. Describe pain specifically: where, when, what triggers it, what it stops you from doing. "I can sit about 30 minutes before I have to stand" beats "it hurts when I sit."
- 3
Cover every body part and the bad days
Mention every injured area, even ones that feel minor next to the main problem — unmentioned parts effectively don't exist in the report. And describe your range honestly: if two days a week the pain keeps you home, say so; an exam on a good day otherwise records only the good day.
- 4
Answer what's asked, then stop
This is a professional evaluation, not a conversation to win. Don't volunteer theories about your employer, the insurance company, or your case. Facts and symptoms — that's the entire assignment.
After the exam
- Get the report. You (or your attorney) are entitled to a copy. Read it.
- Check the facts. Wrong dates, missed body parts, a misquoted history — factual errors can be challenged, and most states have a process for correction or supplemental reports. Timelines are short.
- Understand the big four findings: causation (work-related or not), MMI status, the impairment rating, and apportionment. These four numbers and opinions drive your settlement math.
- If the report is genuinely wrong on the medicine, options exist — deposing the evaluator, rebuttal reports, a replacement panel in some circumstances. This is squarely attorney territory; consultations are typically free.
1) No-showing. 2) Exaggerating symptoms. 3) Minimizing symptoms out of politeness. 4) Hiding prior injuries that are already in the records. 5) Arguing your case instead of describing your body. Every one of them is avoidable with an hour of preparation.
Frequently asked questions
Spend ten minutes with the glossary so nothing in the report reads like a foreign language — MMI, apportionment, impairment rating, work restrictions.