Upcoming IME exam for EDD disability - are they trying to terminate my benefits early?
Just got a letter scheduling me for an Independent Medical Examination (IME) next week for my ongoing CA disability claim. I've been on SDI for about 3 months due to a serious back injury (herniated discs L4/L5) from a workplace accident. My regular doctor says I need at least 4-5 more months of physical therapy and limited activity before returning to my construction job. I'm super nervous about this IME appointment. My coworker went through one last year and said the doctor spent like 15 minutes with him, barely examined him, and then his benefits were cut off two weeks later. I really NEED these benefits to continue - I've got rent and medical bills piling up. But I also want to get better and return to work when I'm actually healed! Has anyone gone through an IME for California SDI recently? What questions do they ask? Should I bring additional medical records? Do they really just try to find any excuse to terminate benefits? Any advice would be appreciated because I'm seriously stressing out about this.
16 comments
Elijah Brown
I had an IME about 6 months ago for my SDI claim (shoulder surgery). Here's what to expect: - It's usually a short appointment (20-30 minutes) - They'll review your medical records - Ask about your symptoms and limitations - Do a basic physical examination - May ask about your job duties specifically My best advice: be honest but don't minimize your symptoms. Describe your worst days not your best days. Bring copies of recent MRIs or other imaging if you have them. Also bring a list of all medications and treatments you've tried. The IME doctor works for EDD, not you, so they're looking to verify you still qualify for benefits. Don't exaggerate (they can tell), but make sure they understand your full limitations. Don't panic though - not everyone gets cut off. I passed my IME and continued receiving benefits until I returned to work.
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Zoe Walker
•Thank you for all this info! Did they ask you to perform physical movements during the exam? My back pain varies a lot day-to-day, and I'm worried I might be having a 'good day' during the IME which won't show how bad it really gets. Also, should I have my doctor write a letter explaining why I need more time off?
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Maria Gonzalez
they r DEFINITELY trying to cut u off!!!! my cousin had same thing happen nd the doctor spent like 5 min with him and boom benefits GONE!!! these IME docs r paid to find nothing wrong, thats how the system works. EDD just wants to stop paying u. bring EVERYTHING u can - all ur medical files, pics of ur injury if u have them, videos of ur bad days. dont let them rush u!!!
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Natalie Chen
•This kind of fearmongering doesn't help. Yes, IMEs can result in benefit termination, but that's not always the case. Many legitimately disabled people pass their IMEs without issue. It's just a standard verification process EDD uses, especially for claims extending beyond initial estimates.
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Santiago Martinez
I've helped several clients through the IME process for California SDI. A few important points to understand: 1. IMEs are standard for longer disability claims (usually 3+ months) - it doesn't mean EDD suspects fraud 2. Preparation matters - bring a current medication list, treatment timeline, and copies of recent medical documentation 3. The exam typically focuses on your specific medical condition and functional limitations 4. Be prepared to describe how your condition affects daily activities and work duties specifically 5. If possible, bring a simple journal documenting symptom severity over 1-2 weeks I've seen many clients continue benefits after IMEs. The key is documentation and clearly explaining your functional limitations related to your job requirements. Your doctor should also be prepared to respond if the IME doctor requests additional information afterward. Be honest about your condition - don't exaggerate or minimize. And if you get an adverse decision, remember you have appeal rights.
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Zoe Walker
•The journal idea is brilliant - I hadn't thought of that. I'll start one today. My job requires heavy lifting (50+ lbs) and climbing ladders frequently. Should I specifically mention these requirements during the exam? And what's the typical timeline between the IME and their decision?
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Samantha Johnson
I went through an IME last month and it was WAY less scary than I expected! Doctor was actually pretty nice. Asked about my symptoms, did some basic range of motion tests, and reviewed my file. Got a letter 10 days later saying my benefits would continue. Just be honest and you'll be fine!
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Maria Gonzalez
•ur lucky then!!! most people i kno got cut off after IME!!! depends which doctor u get i guess
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Nick Kravitz
I'm going through something similar right now with my disability claim. I've had multiple IMEs over the years (chronic condition), and they're usually looking for a few key things: 1. Is your condition still medically supported? 2. Are your symptoms consistent with your diagnosis? 3. Do your limitations match your job requirements? 4. Are you following treatment recommendations? Something that's helped me: Before the appointment, write down EXACTLY how your condition limits your ability to perform specific job functions. Be very concrete. For construction with a back injury, explain precisely why you can't lift/bend/climb/etc. without risking further injury. One thing to know - if they suddenly cut off your benefits after the IME, you can and should appeal immediately. The appeal success rate is surprisingly high if you have good medical documentation. Don't give up if you get bad news. Honestly though, getting through to EDD during the appeal process can be absolute nightmare. Last time I had to appeal, I couldn't get through on the phone for WEEKS. I finally used this service called Claimyr (claimyr.com) that got me connected to an EDD agent in about 15 minutes instead of spending days redialing. They have a video showing how it works: https://youtu.be/1X-mEsLtbmQ?si=1hcSq3KFtCr4oAmd Good luck with the IME! Try not to stress too much before it happens.
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Zoe Walker
•Thanks for the concrete tips - I'll definitely prepare that job functions list. And good to know about the appeal process and that Claimyr service. I've already experienced how impossible it is to reach EDD by phone when I had questions about my initial claim. It's ridiculous how understaffed they are.
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Hannah White
my back injury took 18 months to fully recover and i had 2 IMEs during that time. passed the first but failed the second eventhough i wasnt better yet!! doctor said i could do "modified work" when my real doctor said i couldnt work at all. my company didnt have light duty so i was just out of luck. the whole system is rigged...just prepare for the worst
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Santiago Martinez
•This highlights an important point. The IME may determine you can perform "modified work" rather than your regular job duties. If your employer can't accommodate those restrictions, you may still be eligible for benefits under California law. Make sure you understand the specific work restrictions your doctor has given you and whether your employer can actually accommodate those limitations. This can be crucial during both the IME and any potential appeals.
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Natalie Chen
From my experience as someone who deals with the CA disability system regularly: IMEs serve a legitimate purpose - they help verify that benefits are going to those who truly need them. Yes, some IME doctors are more restrictive than others, but most are professional and thorough. A few practical tips: 1. Dress comfortably but appropriately 2. Answer questions directly without volunteering unnecessary information 3. If you don't understand a question, ask for clarification 4. If a movement causes pain, say so immediately - don't push through 5. Bring a list of all doctors, treatments, and medications After the IME, request a copy of the report for your records. This is especially important if you need to appeal later. The decision usually takes 10-14 days, and benefits typically continue during this evaluation period.
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Michael Green
•ive had ppl tell me to exaggerate symptoms for these appointments but thats actually the worst thing you can do! i did my IME totally honest and still got approved for benifits. they can usually tell when someone is faking.
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Zoe Walker
Thanks everyone for all the helpful advice! I feel much better prepared now. I've started documenting my daily pain levels and limitations, gathered all my medical records, and made a list of how my condition prevents me from doing specific job tasks. I'll update after my appointment to let you all know how it went. Fingers crossed they understand I genuinely want to return to work, just not before I'm medically ready to do so safely.
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Elijah Brown
•Good luck! Remember to get a good night's sleep before the appointment and try to manage your anxiety - stress can make pain worse and you want the doctor to see your typical condition. Let us know how it goes.
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