Disability insurance companies are usually entitled to send a patient to a doctor or rehabilitation specialist of their choice.  These are called "Independent Medical Examinations" (IMEs), however, "independent" means that the examination is paid for by the insurance company, but it does not mean that it is an unbiased examination.  This raises serious ethical issues as there is an obvious conflict to interest..

The insurance companies goal is to keep their costs to a minimum and therefore to have as few people receiving disability benefits as possible.  To this end they very often choose doctors whom they can rely on to give them a report that expresses the opinion that the patient is not disabled, even when there is overwhelming evidence that the patient is.  In addition, Dr. Arnold Voth indicated that the IME doctors are often paid ten times or more than the usual payment for a medical report.  The insurance companies will not pay these kind of fees unless it is clear that they will receive a report that benefits them.

Some doctors make a living doing IMEs for insurance companies.  Dr. BeverlyTompkins, who runs a  ME/CFS and FMS Clinic in Calgary, reported (in ME Canada's newsletter "The Messenger") that 70 of her 700 patients lost disability insurance benefits through the efforts of only three physicians in the province who work for many insurance companies. This shocking fact is one reason why the National ME/FM Action Network decided to collect information regarding patients experiences at IMEs and form an IME Registry.