If your long-term disability insurer asks you to attend an independent medical examination in Ontario, your benefits are being closely reviewed.

An independent medical examination—also called an IME, independent medical assessment or independent medical evaluation—is arranged to give the insurance company another opinion about your condition and ability to work.

The insurer normally chooses the assessor, provides the records and questions, pays for the examination and receives the report.

The examiner must follow professional rules in Ontario, but they aren’t your treating doctor. The assessment is being completed for the insurance company’s claim process—not to provide you with medical care.

⚠️ Don’t refuse an Ontario IME without legal advice. If your LTD policy requires you to attend a reasonable assessment, refusing can put your benefits at risk.

For a complete overview of the assessment process, read our national guide to independent medical examinations and LTD claims.

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What Is an Independent Medical Examination in Ontario?

An independent medical examination is an assessment completed for a third party, such as an insurance company, rather than for your medical treatment.

In a private long-term disability claim, the insurer normally requests the IME to obtain an opinion about:

  • Your diagnosis and reported symptoms

  • Your physical, psychological or cognitive limitations

  • Whether your condition prevents you from performing your occupation

  • Whether you have followed appropriate treatment

  • Whether your condition has improved

  • Whether you can return to work safely and reliably

  • Whether you can perform another occupation after the policy’s change of definition

The assessor reviews the materials provided by the insurer, interviews or examines you and prepares a written opinion.

The insurance company can then use that report to approve, continue, deny or terminate your LTD benefits.

Private LTD IMEs Are Different From Other Ontario Assessments

The term “independent medical examination” is used in several different Ontario systems.

An assessment connected to private or workplace long-term disability insurance isn’t automatically governed by the same procedures as:

  • An insurer examination following a motor vehicle accident

  • A Workplace Safety and Insurance Board assessment

  • A court-ordered medical examination during a lawsuit

  • An assessment for a government disability program

For a private LTD claim, the wording of your insurance policy is critical.

The policy normally explains whether the insurer can require an examination, what cooperation it expects and what can happen if you refuse.

💡 Advice about an Ontario car accident IME or WSIB assessment doesn’t necessarily apply to a private long-term disability claim.

What Rules Apply to IME Doctors in Ontario?

Physicians conducting IMEs in Ontario are regulated by the College of Physicians and Surgeons of Ontario.

An Ontario physician conducting an IME must:

  • Hold an active certificate of registration

  • Work within their scope of practice and area of expertise

  • Have the knowledge, skill and judgment needed to conduct the examination

  • Disclose perceived or potential conflicts of interest

  • Understand who requested the assessment and what questions must be answered

  • Explain the nature of their role to the person being examined

  • Obtain the required consent

  • Review relevant clinical information and opinions

  • Provide a report that is fair, objective and non-partisan

  • Provide opinions that are accurate, clear and supported by evidence

The physician must not allow the identity of the party paying for the assessment or the potential outcome of the insurance claim to influence the opinion.

The Examiner Must Explain Their Role

At the beginning of the assessment, the physician should make it clear that:

  • The examination is being conducted for a third-party process

  • The physician isn’t acting as your treating doctor

  • Information from the assessment will be provided to the requesting party

  • The physician doesn’t make the final decision about your LTD benefits

Do You Have to Attend an LTD IME in Ontario?

You generally have to attend a reasonable IME when your LTD policy gives the insurance company the right to request one.

Refusing can lead the insurer to:

  • Suspend your monthly benefits

  • Deny an application that remains under review

  • Terminate benefits that were already approved

  • Argue that you failed to cooperate with the claim process

However, an insurer’s right to request an assessment isn’t unlimited.

The request should be examined closely when:

  • The assessor’s specialty doesn’t match the condition being reviewed

  • The insurer requests repeated or duplicative examinations

  • The proposed testing could aggravate your condition

  • The assessment requires medically difficult travel

  • The duration is unreasonable given your limitations

  • The insurer refuses necessary disability-related accommodations

Raise concerns in writing and obtain supporting information from your treating doctor.

Don’t simply miss the appointment or announce that you won’t attend.

Is an Ontario IME Doctor Truly Independent?

The physician must provide an objective opinion, but the insurer controls important parts of the assessment process.

The insurance company normally:

  • Chooses the physician or assessment company

  • Pays the assessment fee

  • Provides the medical and claim records

  • Writes the referral questions

  • Receives the final report

You don’t normally choose the examiner or help decide what information is included in the referral package.

The fact that the insurer chose and paid the physician doesn’t automatically invalidate the report. However, it makes the examiner’s instructions, assumptions, records and conclusions important to review.

An Ontario IME report should identify:

  • Who requested the opinion

  • What the physician was asked to determine

  • What medical information was reviewed

  • The facts and assumptions relied on

  • The basis for the physician’s conclusions

  • Any limitation caused by missing information

What Records Does the Ontario IME Doctor Receive?

The insurance company normally prepares the package provided to the examiner.

It can include:

  • Clinical notes and medical reports

  • Specialist consultations

  • Diagnostic test results

  • Your LTD application forms

  • Your job description

  • Statements made to the insurer

  • Surveillance reports or video

  • Social media information

  • Previous medical or functional assessments

  • Questions prepared by the insurance company

Ask the insurer for the referral letter and a list of the records sent to the examiner.

If relevant medical information is missing, identify it before the appointment and request that it be provided.

How Should You Prepare for an Ontario IME?

Confirm the Appointment Details

Ask the insurer to confirm in writing:

  • The examiner’s name and specialty

  • The purpose of the assessment

  • The date, location and expected duration

  • The type of testing involved

  • The records being sent to the examiner

  • What you must bring

  • What travel expenses will be paid

  • Whether the insurer will provide the report

Review Your Medical History

Be familiar with your major diagnoses, treatments, medications and changes in your symptoms.

Don’t guess when you don’t remember a date or detail. Say that you aren’t sure.

Understand Your Actual Job Duties

Be prepared to explain the physical, cognitive and psychological demands of your occupation.

Focus on the duties you can’t perform safely, consistently or reliably—not simply your job title.

Request Accommodations in Advance

Request necessary accommodations before the appointment, such as:

  • Rest breaks

  • A shorter assessment

  • An accessible location

  • An interpreter

  • A morning or afternoon appointment based on symptom patterns

  • Transportation or an overnight stay

Ask your treating doctor to explain why the accommodation is medically necessary.

What Should You Do During the Examination?

  • Answer honestly: Don’t exaggerate your symptoms, but don’t minimize them to appear cooperative or optimistic.

  • Explain symptom variability: Describe good days, bad days and the recovery time required after activity.

  • Ask for clarification: Don’t answer a question you don’t understand.

  • Don’t guess: Say that you don’t remember when you’re genuinely unsure.

  • Report symptoms during testing: Tell the examiner if an activity causes pain, fatigue, dizziness, panic or another significant reaction.

  • Don’t perform beyond your safe ability: You don’t need to injure yourself to prove that you tried.

The examiner can observe how you sit, stand, walk, complete paperwork and interact with clinic staff before and after the formal assessment.

Act naturally and consistently throughout the visit.

Can You Record an IME in Ontario?

Recording arrangements must be addressed with the insurer and physician before the assessment.

Under Ontario’s professional rules, audio or video recording arrangements must be mutually agreeable to everyone involved.

Don’t secretly record the examination.

The examiner can object when a recording would interfere with:

  • The reliability of psychological testing

  • Standardized assessment procedures

  • The privacy of staff or other people

  • The integrity of the examination

If the parties can’t agree, the examination can be postponed while the issue is discussed.

If recording isn’t permitted, write detailed notes immediately after the appointment.

Can You Bring an Observer or Support Person?

Ontario physicians generally must permit an observer unless they believe the person’s presence will affect the examination.

The observer can’t interfere, answer questions or participate in testing.

Request an observer in advance, especially when support is needed because of:

  • Cognitive impairment

  • Communication difficulties

  • Severe anxiety or trauma symptoms

  • Memory problems

  • Mobility or personal-care needs

For an intimate examination, the physician must give you the option of having an observer present.

Consent, Privacy and Access to the IME Report

An Ontario IME doctor must ensure that the required express consent has been obtained before conducting the assessment and collecting or disclosing information.

The consent process should explain:

  • The purpose and scope of the examination

  • How your information will be collected and used

  • Who will receive the report

  • What happens if consent is limited or withdrawn

Withdrawing consent can prevent the doctor from completing the report. It can also lead the insurer to allege that you failed to cooperate with your LTD claim.

Can You Get the IME Report?

Request the complete report from the insurance company in writing.

Access to records created for a third-party IME can be more complicated than access to records held by your treating doctor.

The insurer can provide the report directly to you, through your doctor or to your lawyer.

Don’t rely on the insurer’s short summary of the examiner’s conclusions. Ask for the complete report.

Who Pays IME Travel Costs in Ontario?

The insurance company arranging the IME should confirm the expenses it will cover.

Ask for written approval before paying for:

  • Mileage, taxis or public transportation

  • Parking

  • Accessible transportation

  • Hotel accommodation

  • Meals during lengthy travel

  • A medically required companion or attendant

Ontario claimants can be asked to travel from smaller communities to Toronto, Ottawa, Hamilton or another major centre where the selected specialist practises.

If travel would aggravate your condition, request a closer examiner, virtual assessment, transportation assistance or overnight accommodation.

Don’t miss the appointment without first raising the problem and proposing a reasonable alternative.

Psychological and Psychiatric IMEs in Ontario

Mental health LTD claims can involve an assessment by a psychologist, psychiatrist or both.

Psychological IME

A psychologist can conduct interviews and standardized testing to assess:

  • Depression and anxiety symptoms

  • Trauma-related symptoms

  • Memory and concentration

  • Cognitive functioning

  • Response consistency and test validity

Psychiatric IME

A psychiatrist is a medical doctor who can provide opinions about diagnosis, medication, treatment and work capacity.

Psychiatric assessments can include detailed questions about:

  • Childhood and family history

  • Traumatic experiences

  • Relationships and social activity

  • Substance use

  • Daily routines

  • Previous mental health treatment

The questions can be personal, but they must remain relevant to the assessment.

Ask about the scope, expected duration and proposed testing before attending.

IME vs. Functional Capacity and Vocational Assessments

An IME is only one type of assessment used by Ontario LTD insurers.

Functional Capacity Evaluation

A functional capacity evaluation, or FCE, measures your ability to perform physical or cognitive tasks.

It is often conducted by an occupational therapist or physiotherapist rather than a doctor.

Read our guide to functional capacity evaluations in Canada.

Vocational Assessment

A vocational assessment reviews your education, training, employment history and ability to perform different occupations.

It is commonly used when the LTD policy changes from the “own occupation” test to the “any occupation” test.

Transferable Skills Analysis

A transferable skills analysis, or TSA, identifies jobs that the insurer says use skills acquired through your education and previous work.

The vocational consultant can rely on restrictions taken from an IME, FCE or insurer file review.

Learn more about transferable skills analyses in disability claims.

➡️ An insurer can combine an IME, FCE and TSA to argue that you can return to work or perform a different occupation.

What Should You Do After the Ontario IME?

Immediately after the appointment, write down:

  • When the assessment began and ended

  • Who was present

  • The questions you were asked

  • The tests or physical movements performed

  • Any rest breaks requested or provided

  • Symptoms experienced during and after the examination

  • Any comments made by the examiner

Tell your treating doctor if the examination causes a significant physical or psychological reaction.

Ask the insurer when the report will be completed and how it will affect the ongoing review of your claim.

What if the Ontario IME Report Is Wrong?

An inaccurate or unfair IME report can be challenged.

Warning signs include:

  • The report attributes statements to you that you didn’t make

  • The examination is described inaccurately

  • Important symptoms or limitations are omitted

  • Relevant medical records weren’t reviewed

  • The doctor gives opinions outside their expertise

  • Brief activity is treated as proof that you can work full time

  • Fluctuating symptoms aren’t considered

  • The opinions of treating doctors are dismissed without a meaningful explanation

  • The conclusions aren’t supported by the assessment findings

Don’t send an angry response directly to the examiner.

Instead:

  1. Get the complete report

  2. Compare it with your notes from the appointment

  3. List every factual error and important omission

  4. Ask your treating doctor or specialist to review the conclusions

  5. Get legal advice before responding to the insurer

If your benefits are denied or terminated, read what to do after a long-term disability denial in Ontario.

⚠️ A negative IME report doesn’t prove that you can work. It is one opinion that must be compared with your medical evidence, functional limitations and actual job requirements.

Can You Complain About an Ontario IME Doctor?

A complaint to the CPSO can be considered when an Ontario physician’s conduct raises a genuine professional concern.

Examples can include allegations that the doctor:

  • Acted outside their scope of practice

  • Failed to explain the nature of the examination

  • Included irrelevant or inappropriate comments

  • Misrepresented what occurred during the assessment

  • Failed to disclose a conflict

  • Produced an opinion that wasn’t fair, objective or evidence-based

A regulatory complaint and an LTD dispute are separate processes.

Complaining about the examiner doesn’t automatically reverse the insurer’s decision or protect a deadline for starting a legal claim.

When Should You Contact an Ontario LTD Lawyer?

Speak with a lawyer before the examination when:

  • The insurer is reviewing whether to continue your benefits

  • The IME is scheduled near the two-year change of definition

  • The assessor’s specialty doesn’t match your condition

  • Your doctor believes the assessment could harm you

  • The insurer refuses reasonable accommodations

  • You have been sent to repeated assessments

  • Travel or testing requirements are unreasonable

Get advice immediately after the assessment when:

  • The report contains serious errors

  • The insurer pressures you to return to work

  • Your payments are suspended

  • Your LTD claim is denied

  • Benefits that were already approved are terminated

An Ontario long-term disability lawyer can review the policy, referral letter, IME report and medical evidence and determine the strongest way to protect your benefits.

Frequently Asked Questions About Ontario IMEs

Is an Independent Medical Assessment the Same as an IME?

Yes. Independent medical assessment, independent medical evaluation and independent medical examination are commonly used to describe insurer-requested assessments.

Can an Ontario LTD Insurer Force Me to Attend?

Your insurer can require a reasonable examination when the LTD policy gives it that right. Refusing can jeopardize your benefits.

Does the IME Doctor Have to Be Licensed in Ontario?

A physician conducting the IME in Ontario must hold the appropriate active registration and work within their scope of practice and expertise.

Can I Bring Someone With Me?

You can request an observer or support person. The physician generally permits one unless their presence will likely affect the examination.

Can I Record the IME?

Recording arrangements must be mutually agreed upon. Make the request in writing before the appointment and don’t secretly record the assessment.

Can the IME Doctor Treat Me?

The examiner isn’t your treating doctor. Their role is to assess you and provide an opinion for the third-party process.

Can I Get a Copy of the Report?

Request the complete report from the insurer in writing. It can be provided directly, through your treating doctor or through your lawyer.

Can the Insurer Request More Than One IME?

The insurer can request different assessments when additional expertise is reasonably required. Repeated, irrelevant or duplicative examinations should be questioned.

What if I’m Too Sick to Travel?

Explain the issue in writing, obtain support from your doctor and request a closer location, virtual assessment or another reasonable accommodation. Don’t simply miss the appointment.

What Happens if the IME Says I Can Return to Work?

The insurer can use the report to pressure you to return, deny your claim or terminate benefits. The report can be challenged with factual corrections, medical evidence and legal action.

Get Help With an Independent Medical Examination in Ontario

An IME can become a turning point in your long-term disability claim.

Don’t treat it as a routine doctor’s appointment or wait until the insurer uses the report to cut off your income.

Samfiru Tumarkin LLP represents people with denied, delayed and terminated long-term disability claims throughout Ontario.

Our disability lawyers can review the assessment request, address unreasonable conditions, help you prepare and challenge an inaccurate report.

Contact us for a free consultation if you have been asked to attend an IME or your benefits were denied after one.

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Asked to Attend an IME in Ontario?

The insurer can use the assessment to deny or terminate your LTD benefits. Get advice before the examination takes place.

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