How should I prepare for an independent medical examination in an LTD case?

Insurance companies refer to these exams as “independent,” but federal courts and commentators have long noted the structural conflict of interest: the IME physician is selected and compensated by the insurer, often through a third-party vendor that tracks physician “productivity” by claim outcomes. The Second Circuit has acknowledged this conflict as a factor weighing against deferring to the administrator’s decision under Metropolitan Life Insurance Co. v. Glenn, 554 U.S. 105 (2008) (Glenn).

To prepare effectively: compile your complete medical record and bring a summary to the appointment. Arrive on your worst average day — do not push through pain to appear functional. Answer questions accurately and completely; never exaggerate, but never minimize. Report all symptoms, including fatigue, cognitive difficulty, medication side effects, and pain radiating into secondary areas. You are entitled to bring a witness in most states.

The IME physician typically spends 30 to 60 minutes with you, then writes a report that may contradict years of treating-physician records. Under 29 CFR 2560.503-1, you are entitled to review any new evidence — including the IME report — before a final denial is issued, and to respond to it. Do not let that opportunity pass unused.

If the IME report is used to deny your claim, your 180-day appeal window begins. A detailed rebuttal from your treating physician, a counter-IME if warranted, and a legal brief attacking the methodology are your tools. Our firm handles LTD cases on contingency — no fee unless we win.