What Is an IME Contradiction in Workers' Comp?

An IME contradiction is any place where the independent medical examiner's findings do not line up with the rest of the medical record: the treating physician's notes, the imaging, the claimant's reported history, or the examiner's own earlier opinion.

Four shapes it usually takes

• Findings conflict: the IME records full range of motion where the treating notes from the same month record restriction.
• History conflicts: the mechanism of injury described to the examiner differs from the one in the intake record.
• Causation conflicts: the examiner attributes the condition to a pre-existing degenerative process the treating record never mentions.
• Internal conflicts: the examiner’s narrative and their own impairment rating do not agree.

Why they are missed

Not because anyone is careless. A contradiction is a relationship between two documents, and it is only visible to someone holding both at once. When the IME arrives eight months after the treating notes, in a different batch, filed under a different heading, the two are never on the same desk on the same afternoon.

Finding them is a comparison problem

The work is to put every physician opinion on the same axis: this examiner said this about causation on this date, that one said that. Once the opinions sit side by side, the conflicts are obvious. Getting them side by side is the part that takes a person a day and should not.

What to do with one

A contradiction is not an argument on its own. It is a lead. The value is in whether it holds up: is the conflict real, is it material to the disputed issue, and can you point to both pages. That judgment is the attorney's, and it is not delegable. Surfacing candidates is not the same as deciding which ones matter.