Reviewed by Larry Forman, Attorney
You went to the insurance company's doctor for a short exam. A few weeks later, your PIP checks stop, or the adjuster's offer drops, because of an IME report saying you've healed, need no more treatment, or that your injury "isn't related" to the crash. It's one of the most frustrating moments in an injury claim. It's also one of the most common, and it's not the final word.
Here's how to get the report, what these reports usually say, and how to answer them under Kentucky law. For what happens before and during the exam, see our independent medical exam guide.
What an IME report usually says
An "independent medical exam" is done by a doctor the insurer chooses and pays. The report is written to answer the insurer's questions. The conclusions that cause the most trouble are:
- "Maximum medical improvement." You've gotten as good as you're going to get, so treatment should stop.
- "No further treatment needed." Therapy, injections or surgery aren't "reasonable or necessary."
- "Not causally related." Your symptoms come from something other than the crash.
- "Degenerative" or "pre-existing." The MRI shows age-related changes, so the crash didn't cause the problem.
- "Inconsistent effort" or "subjective complaints only." The doctor suggests you exaggerated.
Each of these is an opinion. Opinions can be answered with better evidence.
How to get a copy of the IME report
In a PIP claim, if the insurer had you examined, you're entitled on request to "a copy of a detailed written report of the examining physician setting out his findings including results of all tests made, diagnoses, and conclusions," along with reports of earlier exams of the same condition (KRS 304.39-270(2)). The same rule applies to exams you agreed to, unless your agreement says otherwise.
There's a trade-off. By requesting and getting that report, you waive any privilege, for the PIP claim, over the testimony of every other doctor who has examined you or will examine you for the same condition. That's often worth it, but talk to a lawyer before you ask.
If you're already in a lawsuit, Kentucky Civil Rule 35.02 gives you a similar right to the examining doctor's report, with a similar exchange of your own doctors' reports.
Read the report closely
IME reports often have weak spots. Look for:
- Records the doctor didn't review. Was the MRI read? Were your physical therapy notes included?
- A short exam. Compare the report with your own notes on when the doctor came in and left.
- Factual errors. Wrong crash date, wrong side of the body, a prior injury you never had.
- Your own words, misquoted. "Some days are better" can turn into "symptoms resolved."
- Degenerative findings with no "before" comparison. Age-related changes are common. The question is whether you had symptoms before the crash.
Write down every error with a page and line. Your lawyer and your doctor will use that list.
How to answer a bad IME report
Your treating doctor's opinion matters most. A doctor who has seen you over months usually carries more weight than one who saw you once. Ask your doctor for a letter or narrative report that responds to the IME point by point:
- Why continued treatment is reasonable and necessary
- Why the crash caused the injury, or made an old condition worse
- What the imaging shows, compared with any earlier imaging
- What future care is likely
Kentucky law also helps on pre-existing conditions. An at-fault driver takes you as they find you, so making an old condition worse is a real injury. Records from before the crash showing you were working, active and pain-free are often the strongest answer to "degenerative."
Keep treating if your doctor says you need it. Stopping because PIP stopped paying hands the insurer a gap in treatment to point to. Ask about using your health insurance in the meantime.
When PIP stops paying after an IME
PIP is your own coverage, and Kentucky sets rules for how your insurer handles it:
- Written reasons. An insurer that rejects a PIP claim must give "prompt written notice of the rejection, specifying the reason" (KRS 304.39-210(5)(a)).
- Overdue benefits carry interest. Benefits are generally overdue if not paid within 30 days after the insurer receives reasonable proof of the loss. Overdue payments carry 12% interest a year, or 18% if the delay "was without reasonable foundation" (KRS 304.39-210(1)(c), (2)).
- Attorney fees may be available. A court may award a reasonable attorney's fee if overdue benefits are recovered and the denial or delay "was without reasonable foundation" (KRS 304.39-220).
- There's a deadline. A suit for further PIP benefits generally must be filed within two years after the last payment of benefits (KRS 304.39-230(1)).
Send the insurer your treating doctor's response in writing and ask it to reconsider. Keep copies of everything. See how Kentucky PIP insurance works and our guide to insurance adjuster tactics. If the insurer's conduct goes beyond a fair dispute, read about insurance bad faith.
When the IME is used against your injury claim
In a claim against the at-fault driver, the defense may use the same report, or set up its own exam after a lawsuit is filed, to argue your case is worth less. See what affects a Kentucky injury case's value.
In a lawsuit, the defense doctor's opinions can be tested at a deposition and at trial:
- How long the exam took, and what records the doctor did and didn't review
- How often the doctor does exams for insurers or defense lawyers
- Whether the opinions match the imaging and the treating doctors' findings
- Whether the doctor considered how you were doing before the crash
A jury hears both sides and decides whom to believe. Many cases settle once the defense sees how its doctor's report will hold up.
Injuries IME reports often dispute
These are the injuries where IME reports most often say "resolved" or "degenerative":
- Whiplash and neck injuries
- Herniated discs and back injuries
- Concussions and brain injuries, where symptoms are often invisible on scans
How Forman & Associates helps
We decide with you whether to request the report, go through it line by line, work with your treating doctors on a written response, press the PIP insurer for overdue benefits, and prepare to cross-examine the defense doctor if the case goes to suit. When an insurer won't be fair, we're ready for court: Larry Forman has tried 50+ jury trials and won 95% of them. Learn more about our Louisville car accident practice.
IME report FAQ
Can I get a copy of my IME report in Kentucky?
Yes. In a PIP claim, KRS 304.39-270 says that on request the insurer must give you the examining doctor's detailed written report. Requesting it waives privilege, for the PIP claim, as to other doctors who examined the same condition, so talk to a lawyer first.
Can my PIP be cut off because of an IME?
Insurers often stop paying after an IME report says treatment is no longer needed. The insurer must give written reasons. If the denial lacks a reasonable foundation, Kentucky law provides interest on overdue benefits and may allow attorney fees.
Is the IME doctor's opinion more important than my own doctor's?
Not automatically. Your treating doctor has seen you over time. A detailed response from that doctor, backed by records and imaging, is often the strongest answer to an IME report.
What if the IME report says my injury is degenerative?
Degenerative changes are common and often cause no symptoms. If the crash made an old condition worse, that's part of your claim. Records from before the crash help show the difference.
How long do I have to sue for unpaid PIP benefits?
Generally two years after the last PIP payment (KRS 304.39-230). See our statute of limitations guide.
Talk to a Louisville car accident lawyer
If an IME report is being used to cut off your benefits or lower your claim, call Forman & Associates Accident Injury Lawyers at (502) 931-6788 or get a free case evaluation. Our office is at 1139 S. 4th St., Louisville, KY 40203. No fee unless we win.
This post is general information about Kentucky law, not legal advice. Reviewed October 2026.
