Question 1

Are IMEs confidential?

Accepted Answer

This is one of the most important things to understand before you walk into an IME. The short answer is: not in the way you might expect.

In a typical therapy or evaluation relationship, confidentiality protects you. What you share stays between you and your clinician, with narrow legal exceptions. An IME works differently. Because the evaluation is requested by a third party — an insurance company, an attorney, a court — the results belong to them, not to you. The report goes to whoever commissioned it, and its contents may be shared with lawyers, adjusters, employers, or a judge depending on the context.

That doesn't mean the process is adversarial or that you should be guarded to the point of being unhelpful. It simply means you deserve to walk in with clear eyes. You're not there in a treatment context — you're there to be evaluated. Everything you say and do during the evaluation can be included in the report. A good evaluator will explain this to you at the outset. If they don't, it's reasonable to ask.

Question 2

Can an IME be used in court?

Accepted Answer

Yes — and this is actually one of the primary reasons IMEs exist. When psychological or neuropsychological questions become relevant to legal proceedings, courts rely on qualified experts to provide objective, evidence-based opinions. An IME can be entered into the court record, and the psychologist who conducted it may be called to testify as an expert witness.

This happens across a range of legal contexts: personal injury cases where emotional or cognitive damages are claimed, workers' compensation disputes, disability hearings, custody evaluations, competency determinations, and criminal proceedings, among others. The evaluator's role in these settings is not to advocate for a particular outcome, but to provide their honest clinical opinion based on the data — and then to defend that opinion under cross-examination if necessary. It's a distinct skill set, and it's one reason IMEs should always be conducted by psychologists with specific training and experience in forensic evaluation.

Question 3

What should I expect during an IME?

Accepted Answer

Walking into an IME can feel intimidating, especially if you're not sure what to expect. Here's a plain-language breakdown of how the process typically unfolds.

Before the evaluation, the examiner will likely review records you've provided or that the requesting party has collected — medical records, prior evaluations, treatment notes, employment records, or legal documents relevant to the referral question. You won't always know exactly what they've seen, but thorough record review is a standard and appropriate part of the process.

On the day of the evaluation, you'll begin with a clinical interview. The psychologist will ask about your background — your developmental, educational, medical, psychiatric, and social history — and then focus more specifically on the issues relevant to the referral question. This might include questions about the incident or condition in question, your current functioning, symptoms you're experiencing, and how your daily life has been affected.

After the interview, you'll complete standardized tests. Depending on the referral question, these might assess cognitive functioning, memory, attention, emotional state, or personality testing.

The evaluation can range from 2–3 hours for focused questions to a full day for complex cases. Afterward, you typically won't receive feedback directly — the report goes to whoever requested the evaluation. You may be able to obtain a copy through your attorney or by formal request, depending on the jurisdiction.

Question 4

How is an IME different from therapy?

Accepted Answer

This distinction matters enormously, and it's worth being clear about it — both for your own peace of mind and so you can engage appropriately with each context.

Therapy is a relationship built on trust, confidentiality, and your wellbeing as the central goal. Your therapist is in your corner. They use what you share to help you heal, grow, or cope — and what happens in that room stays there (with limited legal exceptions). The relationship unfolds over time, and the work is collaborative.

An IME is an evaluation, not a relationship. The psychologist conducting it is not your treater, your advocate, or your ally — and that's not a criticism of them. It's the nature of the role. Their job is to be objective, to answer a specific referral question honestly and accurately, and to report their findings to a third party. A single session, no ongoing relationship, no treatment goal.

A few practical implications: things you might say openly in therapy — because your therapist is working with you — may be interpreted differently in an IME context, where the evaluator is making independent judgments about consistency and credibility. That's not a reason to be dishonest during an IME; in fact, transparency and consistency serve you far better than strategic answers. But it is a reason to be thoughtful, clear, and ideally well-prepared — ideally with guidance from your attorney if one is involved.

The cleanest version of the distinction: therapy is for you. An IME is about you.

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Frequently asked questions

Are IMEs confidential?

Can an IME be used in court?

What should I expect during an IME?

How is an IME different from therapy?