Independent Medical Exams, Impairment Ratings and Your Kentucky Injury Claim
What a Kentucky independent medical exam (IME) is, when you must attend, your rights, and how impairment ratings, treatment gaps and old injuries matter.
Reviewed by Larry Forman, Attorney
At some point in many injury claims, the insurance company wants its own doctor to look at you. It’s usually called an independent medical exam, or IME, though the doctor is chosen and paid by the insurer or the defense. What that doctor writes, along with any impairment rating and what your records show about gaps in treatment and old injuries, can shape the value of your case.
This guide explains when Kentucky law requires you to attend an IME, what your rights are, and how insurers use impairment ratings, treatment gaps and pre-existing conditions.
What an independent medical exam is
An independent medical exam is a one-time evaluation by a doctor who isn’t treating you. The doctor reviews your records, asks about the crash and your symptoms, examines you and writes a report. The report usually answers the insurer’s questions: Is the injury related to the crash? Is more treatment needed? Have you reached maximum improvement? Is there a permanent injury?
The doctor doesn’t treat you, and there’s no doctor-patient relationship in the usual sense. Assume everything you say and do, from the waiting room to the parking lot, may appear in the report.
When you have to attend in Kentucky
There are two main situations.
PIP (no-fault) claims
Your own PIP insurer pays medical bills and lost wages after a Kentucky crash. See how Kentucky PIP insurance works. If your condition matters to the benefits, the PIP insurer “may petition the circuit court” for an order requiring an exam. The court may order one “for good cause shown,” and the order must set the time, place, manner, conditions, scope and the physician (KRS 304.39-270).
You’re entitled, on request, to a copy of the doctor’s detailed report. Requesting it has a trade-off: it waives privilege for the PIP claim as to other doctors who have examined the same condition. Your policy’s terms may also matter, so read any exam request with a lawyer.
Lawsuits (defense medical exams)
Once a lawsuit is filed, the defense can ask the court to order an exam when your physical or mental condition is “in controversy.” The order “may be made only on motion for good cause shown” and must specify “the time, place, manner, conditions, and scope of the examination” and who will do it (Kentucky Civil Rule 35.01). When you claim a lasting injury, good cause is usually easy to show. See our Kentucky injury lawsuit timeline for where this fits.
Under CR 35.02, you can request the doctor’s detailed written report of findings, tests, diagnoses and conclusions. Once you do, the defense can request your doctors’ reports of the same condition.
Your rights at the exam
Limits on scope. The order sets what the exam can cover. A shoulder exam isn’t an invitation to a full psychological workup.
Recording or an observer. The Kentucky Supreme Court has upheld a trial court order allowing a defense exam to be videotaped (Metropolitan Property & Casualty Ins. Co. v. Overstreet, 103 S.W.3d 31 (Ky. 2003)). It’s up to the judge. Ask before the exam, not at the door.
The report. You can get a copy of the report. It often conflicts with your treating doctors, and that conflict is something a jury can weigh.
Bias. Some doctors do many exams for insurers. Their history can be explored through the doctor’s testimony at deposition or trial.
How to prepare
Be on time and bring ID. Note when the doctor came in and when they left.
Be honest and specific. Describe your symptoms on bad days and good days. Don’t exaggerate, and don’t minimize.
Don’t guess. If you don’t remember a date, say so.
Know your history. Expect questions about earlier injuries. Leaving one out hurts credibility far more than the old injury itself.
Don’t push past pain to be polite. If a movement hurts, say so and stop.
Write it down afterward. Record what was asked, what tests were done and how long the exam took.
Impairment ratings
An impairment rating is a percentage a doctor assigns to describe permanent loss of function, usually after you’ve reached “maximum medical improvement.” Doctors often use the American Medical Association’s Guides to the Evaluation of Permanent Impairment.
Workers’ compensation. Kentucky’s workers’ comp law requires ratings under the AMA Guides, fifth edition (KRS 342.0011).
Personal injury cases. No Kentucky statute requires an impairment rating to recover in a car crash or other injury case. A rating can still be powerful evidence of a permanent injury.
Ratings matter in car crash cases because of Kentucky’s no-fault rules. To recover pain-and-suffering damages, an injured person generally needs more than $1,000 in medical expenses or an injury like a fracture, “permanent injury within reasonable medical probability,” permanent loss of bodily function, permanent disfigurement or death (KRS 304.39-060). A treating doctor’s opinion on permanency, with or without a formal rating, can support that.
Expect disagreement. A defense doctor may give a lower rating or none. A percentage isn’t a dollar figure. Juries weigh how the injury actually affects your work, family and daily life. See our guide to Kentucky personal injury case value.
Gaps in treatment
Insurers look closely at gaps: weeks or months without treatment after a crash, or a long delay before the first visit. Their argument is that you weren’t really hurt, or that something else caused the problem. Common, legitimate reasons for gaps include:
Waiting for an appointment, insurance approval or a referral
Being unable to take time off work or find child care
Not being able to afford co-pays
Trying home exercises because a doctor told you to wait and see
Tell your doctor about every symptom at each visit, follow the treatment plan where you can, and when there’s a gap, make sure the reason is in the records. See how to request your medical records.
Pre-existing conditions
An old injury or a degenerative condition doesn’t bar a claim. The Kentucky Supreme Court has recognized that “the tortfeasor takes the claimant as he finds him” and gets no credit against damages for “preexisting physical conditions which make the claimant more susceptible to injury, or to greater injury” (Wemyss v. Coleman, 729 S.W.2d 174 (Ky. 1987)).
What you can recover is the harm the crash caused, including making an old condition worse. The question is usually how much worse. Records from before the crash, showing how you were actually doing, are often the strongest evidence. Hiding an old injury is the most common way people hurt their own case.
How Forman & Associates handles IMEs and medical disputes
We prepare clients for defense exams, ask the court for appropriate limits, review the report against the treating records and question the examining doctor when it matters. We work with treating physicians to document permanency, explain gaps and separate new injuries from old ones. Larry Forman has tried 50+ jury trials and won 95% of them. Learn more about Larry Forman, see our case results (past results don’t guarantee a similar outcome), or visit our main car crash page.
Independent medical exam FAQs
Do I have to go to an independent medical exam?
Often yes, eventually. In a PIP claim, the insurer can ask a court to order one for good cause. In a lawsuit, the defense can get a court-ordered exam when your condition is in dispute. Talk to a lawyer before you schedule one.
Is an IME doctor really independent?
The doctor is chosen and paid by the insurer or defense. That doesn’t mean the report is wrong, but it’s not your treating doctor’s opinion.
Can I record my IME or bring someone with me?
Sometimes. In a lawsuit, the judge can allow it. The Kentucky Supreme Court has upheld an order allowing a defense exam to be videotaped. Ask in advance.
What is an impairment rating?
A percentage describing permanent loss of function, often using the AMA Guides. It’s required in Kentucky workers’ comp, but not in car crash or other injury cases.
Will a gap in treatment ruin my claim?
Not necessarily. Insurers will raise it, so the reason for the gap should be documented.
Can I recover if I had a back problem before the crash?
Yes, for the harm the crash caused, including making your condition worse. Be upfront about your history.
