An independent medical evaluation is an examination by a doctor the insurer picks and pays. In a New Brunswick personal injury lawsuit your own insurer can order one to review Section B benefits, and the defendant’s insurer can order one in the tort claim. The doctor does not treat you. Their report goes to the insurer and determines what it pays. This page explains who orders the exam, how to prepare, what happens on the day, and how a bad report is challenged.
The Independent Medical Evaluation Gives the Insurer an Opinion It Will Act On
Insurers use the exam to get an outside opinion on the severity and cause of your injuries. The question they want answered is whether your pain is related to the collision and how much it limits you.
The adjuster uses the report to decide whether your treatment continues and what the claim is worth. A negative report delays compensation and cuts off funding. Preparation is not optional.
The Report Decides Work Capacity and Future Treatment
The report comments on your ability to return to work. If the doctor says you can, the insurer refuses to pay future lost wages. It comments on your need for future care. If the doctor says you no longer need physiotherapy, the insurer stops paying for it.
The Report Affects Both General and Special Damages
Damages divide into general damages, for pain and suffering, and special damages, for out-of-pocket costs and lost wages. The report bears on both. A lawyer’s job is to test the report against the treating records before the insurer relies on it.
Your Own Insurer Can Order an Exam to Review Section B Benefits
Anyone injured in a motor vehicle collision in New Brunswick is entitled to Section B benefits from their own auto policy, regardless of fault. They cover medical treatment and part of lost income.
Your own insurer may order an exam to verify that treatment is still needed. Refusing to attend lets the insurer suspend benefits, and with them the physiotherapy and income replacement you are relying on. Attend, and get advice first, because what you say in the exam is evidence in the tort claim as well.
The Insurer Is Looking for Maximum Medical Recovery
The insurer wants to know whether you have reached maximum medical recovery, the point where further treatment will not improve your condition. Once it can say you have, it closes the Section B file.
If benefits after a New Brunswick car accident are cut off, a lawyer can intervene.
The Defendant’s Insurer Orders a Defence Medical in the Tort Claim
A tort claim is the lawsuit against the at-fault driver. Their insurer defends it and has the right to investigate the damages you claim. During discovery the defence will almost always demand its own examination, usually called a defence medical.
The New Brunswick Court of King’s Bench rules allow it so both sides have access to medical evidence before trial. In practice the defence has the report, the plaintiff has the treating records, and the trial is a contest between them.
The Defence Picks and Pays the Doctor
The defence chooses the doctor and pays the fee for the exam and the report. Many of these doctors do hundreds of insurer examinations a year and depend on that income. Plaintiff lawyers read their reports for that reason, and the doctor’s history of findings in other cases is a proper subject for cross-examination.
The specialty matches the injury. Orthopaedic surgeons assess fractures. Psychiatrists assess post-traumatic stress and other mental injuries.
Preparation for Your Independent Medical Evaluation Means Knowing Your Own File
Treat the appointment like a court hearing. Everything you say and do is recorded.
Ask your lawyer for a preparation meeting. They will know the doctor’s background and usual approach.
Review your own history before you go. You need the timeline of your care in your head so nothing you say contradicts the file.
A Timeline of Your Care Prevents Contradictions
Build a timeline: the date of the collision, the first medical visit, every hospital visit, specialist appointment and therapy session since.
The doctor has read your whole file before you arrive. They know what treatment you have had and what medication you take. Their questions test whether your answers match the records. If the file says you saw a chiropractor for neck pain two years before the collision and you say you never had neck trouble, that answer will be the first line of the report.
If your answers contradict the file, the report calls you an “unreliable historian.” That label follows you to the judge. Accuracy is the only defence.
Precise Pain Language and a Journal Give Usable Answers
“In pain” is not a description. Use the words that mean something clinically: burning, stabbing, throbbing, aching, radiating. Say which part of the body and when it is worst.
Keep a daily pain journal for the weeks before the exam. Note the time of day, what you were doing, and the pain on a scale you use the same way each time. It records how symptoms vary and gives you exact answers when the doctor asks about a typical day.
Specific Limitations Are Measurable, Vague Ones Are Dismissed
Say what you can no longer do. Common examples after a serious collision:
- Lifting young children or heavy groceries.
- Sitting at a desk or standing at work for long periods.
- Sharp pain while driving or riding in a vehicle.
- Waking at night from muscle spasms.
- Not being able to take part in previous hobbies or sports.
Specific examples are measurable. Vague complaints are dismissed.
Observation Begins Before You Reach the Examination Room
The observation starts before you meet the doctor. Dress in loose clothing; you may need to move around or change into a gown. Arrive fifteen minutes early. A late arrival goes in the report.
Exam Day Is a Common Day for Surveillance
Insurers use private investigators, and surveillance from public places is lawful in New Brunswick. Exam day is a common day to be filmed.
They want footage of you walking from the house to the car without the cane or brace you were prescribed. Follow your doctor’s restrictions everywhere. A claimant with severe leg pain filmed jogging to the clinic door has a damaged claim.
Clinic Staff Report What They See in the Waiting Room
Clinic staff observe you. The receptionist may note how long you sit comfortably and how easily you stand when called.
If you are claiming a serious neck injury, do not sit with your head down over a phone. Sit properly, stay quiet, be polite.
The Interview Covers the Collision, the Pain and Your History
The doctor takes a verbal history. Usual questions:
- How fast were the vehicles travelling?
- Which movements increase the pain?
- Are you working, and on modified duties?
- What prescription and over-the-counter medication do you take?
- Have you had similar complaints in the past decade?
Answer clearly and briefly. Do not volunteer what was not asked.
The Physical Examination Measures Reflexes, Motion and Strength
A short, targeted exam of the injured parts follows. Expect reflex tests, range of motion measurements in the neck, back and limbs, palpation of muscle groups for tenderness or spasm, a walk across the room to observe gait, and grip strength and nerve response in the hands.
If a test causes sharp pain, say so at once. Do not push through it. The doctor needs to know where your limits are.
Exaggerating, Downplaying and Guessing Are the Three Traps
The doctor is assessing credibility as much as the body. Any sign of exaggeration goes in the report.
Injuries from motorcycle collisions are often visible. Chronic pain and nerve damage are not, and they need to be described honestly and precisely to be recorded.
Exaggeration Is Detected by Design
Doctors test for it. The worst mistake. Doctors are trained to detect symptom magnification and use specific tests for it. One example: a reflex test that should not hurt the lower back. Complain of back pain during it and the inconsistency is recorded.
Do not perform pain you are not feeling. Defence counsel uses those notes to call you a fraud.
Downplaying Pain Is Recorded as No Pain
The opposite mistake is as costly. Say you are “fine” while your back throbs and the report says you are pain-free. The insurer uses that line to cut compensation. Say exactly how the collision has reduced what you can do.
A Guess Becomes a Contradiction
If you do not know the answer, say so. Do not estimate speeds, distances or medical terms. A wrong guess becomes a contradiction later. “I do not remember” and “I am not certain” are acceptable answers, and the doctor has to move on.
The Report Goes to the Insurer and Then to Your Lawyer
The doctor writes a formal report and sends it to the insurer that ordered it. It summarises the interview and the tests and gives an opinion on prognosis. Drafting usually takes several weeks.
The insurer must forward a copy to your lawyer, who will meet you to go through it.
Treatment Continues While You Wait
Keep attending every treatment and therapy session. Do not change your medical routine because the exam is over. Continued treatment is evidence the injury is ongoing.
After one of New Brunswick’s common trip and fall accidents, the treatment record is the counter to a negative defence report.
Factual Errors in the Report Are Grounds to Challenge It
Defence reports often contain factual errors: wrong job duties, a symptom you described left out. Read it with a pen. Mark every sentence that is wrong and give your lawyer a list.
An opinion built on wrong facts can be challenged, and those errors carry weight in settlement negotiations. An adjuster who knows the report misstates your job or omits a documented symptom knows a judge will discount it.
The Firm Challenges the Report and Retains Its Own Expert
Two answers exist to a bad report: attack it, and outweigh it. All personal injury claims are on a contingency fee: no upfront cost, and no fee if there is no recovery.
The firm acts on car collisions and on long-term disability claims, and it knows how to neutralise a biased report.
The Doctor Can Be Examined Under Oath on Bias
Where a defence report is unfair, your lawyer sets out its legal and factual flaws so the insurer cannot use it to force a low settlement. During discovery the doctor can be questioned under oath, including on how much of their income comes from defence work. Adjusters know which opinions will not survive a judge, and offers improve.
A Treating Specialist’s Report Outweighs a Brief Defence Evaluation
The other answer is your own expert. Your lawyer arranges an assessment by an independent specialist. Personal injury lawyers in Moncton work with specialists across Atlantic Canada.
When a judge has two conflicting reports, a thorough report from a treating specialist usually outweighs a brief defence evaluation.
FAQ
What Is an Independent Medical Evaluation in a Personal Injury Lawsuit?
An independent medical evaluation is a medical examination an insurer orders during an injury claim. The doctor assesses injuries, limitations and future care needs, and the insurer relies on the report to set the compensation offered.
Can I Refuse to Attend This Medical Evaluation?
Not without consequences. Refusing your own insurer’s exam can suspend Section B benefits. Refusing a defence exam in a tort claim can get the lawsuit dismissed.
Who Pays for the Independent Medical Examination?
The insurer that orders it pays the doctor’s fee and the cost of the report. You pay nothing for the appointment.
Can I Bring a Family Member to the Appointment?
It depends on the clinic and the doctor. Some allow a silent observer during the interview. Many exclude anyone else from the physical examination.
What If the Independent Medical Evaluation Report Is False?
Tell your lawyer immediately. They document the errors, challenge the findings, and may retain a specialist to give a second opinion.