Independent Medical Examinations (IMEs) in NSW CTP
In NSW CTP claims it’s common for insurers to request an Independent Medical Examination (IME). It can feel stressful, but understanding the purpose and how to prepare can help.
General information only — the right approach depends on your claim and injuries.
1) What an IME is (and isn’t)
An IME is an assessment by a doctor who is not your treating practitioner. The IME doctor provides an opinion for claim purposes — they are not there to treat you.
2) Why insurers request IMEs
- Diagnosis clarity
- Work capacity / restrictions
- Treatment approvals (“reasonable and necessary”)
- Threshold injury and WPI-related disputes (in some contexts)
Related: treatment refused disputes.
3) Practical preparation tips
- Be ready to describe symptoms and timeline clearly (no exaggeration, no minimising).
- Be specific about functional impact (work, driving, sleep, chores).
- Bring key recent imaging/reports if you have them (often records are already provided).
4) If the IME leads to an adverse insurer decision
If the insurer stops payments or refuses treatment after an IME, the next steps are usually driven by the decision letter and deadlines. Often you can request an internal review and escalate to the PIC if needed.
See: internal review and PIC pathways.
Frequently asked questions
- Do I have to attend the insurer IME?
- Often yes if the request is reasonable. Unreasonable non-attendance can affect statutory benefits, but the request must comply with scheme requirements.
- Can I get a copy of the IME report?
- In many cases you (or your lawyer) can request a copy of the report obtained by the insurer.
- What if the IME disagrees with my treating doctor?
- That is common. If an insurer makes an adverse decision, you can often challenge it via internal review and (if necessary) the PIC pathway depending on the dispute type.