When "Independent" Medical Examinations Cause More Harm Than Good: GIDII Advocacy's Push for Reform

In the world of insurance claims and workers' compensation, Independent Medical Examinations (IMEs) are meant to provide objective assessments of injuries and conditions. However, for those with psychological injuries, these examinations can be deeply traumatic experiences that exacerbate, rather than evaluate, their conditions.

The Hidden Trauma of Psychological IMEs

The reality of psychological IMEs is rarely discussed publicly, few people actually know about them, but the evidence of their impact can be seen in the elaborate safety plans that vulnerable people must create just to attend these supposedly "neutral" evaluations.

Consider this real-world example:

A woman preparing for an upcoming IME next week has developed an extensive safety protocol involving multiple healthcare professionals, family support, and medication—all to survive what should be a straightforward assessment. Her plan includes:

• A safety check appointment with her GP before the examination

• Having her mother drive her to and from appointments

• Arranging for a support person (a trusted family friend) to take notes during the assessment

• Pre-prescribed anti-anxiety medication (Valium) to be administered after the examination

• A telehealth debriefing session with her psychologist immediately following the examination

• A follow-up appointment with her psychiatrist the very next day to address any trauma triggers

  
  

Think this is an overreaction? No. This safety plan is in place because of 4 past IME's that have been horrendous experiences. It does remind one of the safety plans case workers' help DFV victims put in place when they are unsafe due the perpetrator's escalating and alarming behaviours.

What has the world come to when a system that is meant to heal and care can't respect someone with a severe psychological injury and excuse it as a process?

The injured worker, a patient in the Workers' Compensation System's messages to the writer reveal the profound distrust and anxiety these examinations have generated: "This is due to the utter distrust I have in this system and these assessors to date... I just don't trust this guy, I will never trust any of these ppl."

The Systemic Problems GIDII Advocacy Is Addressing

GIDII Advocacy has been working with others behind the scenes pushing for reform in how IMEs are conducted for people with psychological injuries. Their work highlights several critical issues:

1. Lack of Trauma-Informed Approaches

Although health professionals perform the IME, it is the process of the IME that lacks proper trauma-informed principles. It is sterile and devoid of human care. That is not a medical appointment. That is a legal appointment which is what the intended purpose of the IME is actually for.

For example, what might seem like standard questioning to an examiner or, for a lawyer can trigger profound psychological distress in someone with PTSD, anxiety disorders, or other mental health conditions.

2. Adversarial Rather Than Medical Focus

Too often, IMEs operate from an adversarial standpoint rather than a genuine medical assessment. Claimants frequently report feeling as though the examiner's goal is to discredit their condition rather than understand it.

3. Insufficient Safeguards for Vulnerable Individuals

Current systems rarely provide adequate protections for people with psychological injuries. Simple accommodations, like recording sessions, or conducting examinations in less clinical settings are frequently denied. Telehealth settings are frequently used for speed and convenience for psychological injuries - creating a territorial barrier to interpersonal communication for the patient.

4. Medical Misogyny and Bias

A significant issue GIDII Advocacy has identified is the presence of medical misogyny in the assessment process, where women's symptoms and experiences are minimized, dismissed, or attributed to emotional overreaction rather than legitimate psychological injury.

GIDII's Proposed Solutions

GIDII Advocacy has been pushing for several meaningful reforms:

Independent Oversight

Establishing an independent body to review IME practices, handle complaints, and ensure examiners meet appropriate standards for psychological assessments.

Trauma-Informed Training Requirements

Requiring all IME providers who assess psychological injuries to complete comprehensive trauma-informed care training and demonstrate competency in this area.

Democratizing the Assessment Process

While support persons are technically allowed, GIDII Advocacy recognizes that the IME process contains fundamental power imbalances that must be addressed through:

• Meaningful implementation of breaks during assessments, not just as a formality

• Providing comprehensive, clear pre-assessment information that truly prepares claimants for what to expect

• Creating formal mechanisms for claimants to submit additional information after assessments, recognizing that psychological conditions often interfere with one's ability to communicate effectively during high-stress situations

• Allowing claimants more agency in the overall process, including input on assessment conditions

• Implementing mandatory training for examiners on medical misogyny and unconscious bias, particularly regarding women claimants

• Ensuring examiners recognize how trauma can affect memory, communication, and presentation during assessments - noting medical training does address this but the 'process' of the IME does not accommodate this in any way.

  
  

Appropriate Examiner Selection

Ensuring that psychological injuries are only assessed by professionals with relevant expertise in the specific conditions being evaluated. The fact that the system does not have enough examiners is the system's problem and the patient should not be sent to 'best fit' examiners who have no expertise in the body part or injury itself.

Moving Forward: A Call for System-Wide Change

The text messages shared by this woman preparing for her IME next week reveal something profoundly broken in our current system. When someone requires this level of professional support and medication just to endure an evaluation, we must ask ourselves if the process is serving its intended purpose.

GIDII Advocacy continues to collect testimonials like these to demonstrate to policymakers, insurance companies, and medical authorities that the current IME system for psychological injuries isn't just flawed—it's actively harmful.

True independence in medical examinations should not mean independence from compassion, understanding, or basic trauma-informed approaches. As GIDII Advocacy emphasizes, we can create systems that provide objective assessments without retraumatizing vulnerable individuals.

The reform of IMEs for psychological injuries isn't just about adding superficial accommodations—it's about fundamentally rebalancing power dynamics and ensuring that those with psychological injuries aren't further harmed by the very process meant to evaluate their conditions.

If you've experienced a traumatic IME or want to support this important work, consider sharing your story with GIDII Advocacy and joining their push for meaningful reform.

Note: The individual's identity in the referenced messages has been protected. The safety plan described represents just one example of the extensive measures people with psychological injuries must take to endure the current IME process.