Can an Ontario Employer Require an Employee to Attend an Independent Medical Examination?

Sometimes — but not automatically.

An independent medical examination, often called an IME, is a medical assessment performed by a doctor or specialist who is not the employee’s treating physician. In the workplace, employers may consider an IME when they need reliable medical information to assess accommodation, return-to-work restrictions, fitness for duty, or workplace safety.

However, Ontario employers do not have a free-standing right to demand an IME whenever they are skeptical of an employee’s medical note. The request must be reasonable, necessary, and connected to a legitimate workplace purpose.

The Ontario Human Rights Commission states that a request for a second opinion, specialist opinion, or IME must be necessary to provide accommodation and should not be used to refute the existence of a disability or avoid accommodation.

For employers, the practical rule is this:

An IME may be justified where the medical information is inadequate, inconsistent, unclear, unreliable, or where safety-sensitive duties require better information before the employee returns to work.

What Is an Independent Medical Examination?

An IME is a medical assessment used to answer specific workplace-related questions, such as:

  • Can the employee safely perform the essential duties of the job?

  • What are the employee’s functional restrictions?

  • What accommodations are medically required?

  • Is the proposed return-to-work plan medically appropriate?

  • Is the employee fit for duty?

  • Are the restrictions temporary, permanent, or uncertain?

  • Is there a prognosis for return to regular duties?

  • Are there safety concerns for the employee, co-workers, clients, or the public?

An IME should focus on functional ability, not curiosity about diagnosis. In most cases, the employer does not need to know the employee’s full medical history, private treatment details, or diagnosis unless that information is clearly necessary.

The OHRC’s disability policy says accommodation providers generally do not have the right to know confidential medical information such as diagnosis, symptoms, or treatment unless those details clearly relate to the accommodation sought or the needs are complex, challenging, or unclear.

Why Would an Employer Request an IME?

Employers usually consider an IME in one of four situations.

1. Return to Work After a Long Medical Absence

If an employee has been away for months or years and suddenly provides a brief note saying they can return, the employer may need more information before safely reintegrating them.

This is especially true if the return-to-work plan is gradual, conditional, unclear, or inconsistent with earlier medical information.

2. Conflicting Medical Information

An IME may be appropriate where the employee’s medical documents conflict with each other.

For example, one note may say the employee is totally disabled, while another note shortly afterward says the employee can return immediately with minimal restrictions. If the employer has objective reasons to question the reliability or sufficiency of the information, a further assessment may be reasonable.

The OHRC states that a request for more medical information may be appropriate where there is a reasonable and objective basis to view the initial information as inadequate or inaccurate.

3. Safety-Sensitive Work

An employer may have stronger grounds to request medical clarification where the employee performs safety-sensitive duties.

For example, employees who operate vehicles, machinery, heavy equipment, weapons, hazardous materials, or provide care to vulnerable people may create safety concerns if there is uncertainty about fitness for duty.

Ontario’s Occupational Health and Safety Act requires employers to take every reasonable precaution in the circumstances for the protection of workers.

4. Complex Accommodation Requests

Where an employee’s restrictions are complex, long-term, unclear, or difficult to implement, an IME may help clarify what accommodation is required and whether the employee can perform the essential duties of the role with accommodation.

Under Ontario’s Human Rights Code, employees have the right to equal treatment in employment without discrimination because of disability. The Code also recognizes the duty to accommodate disability-related needs to the point of undue hardship.

Does the Employer Have an Automatic Right to an IME?

No.

An IME should not be the employer’s first reaction to every medical note. It is usually a more intrusive step that should be reserved for situations where the employer has a genuine, objective reason to need additional independent medical information.

The OHRC specifically warns that an IME should not be used to “second-guess” an accommodation request, and that requests for medical examinations must be warranted, take into account disability-related needs, and respect privacy as much as possible.

Employers should usually start with less intrusive steps, such as:

  • Asking the employee for clarification

  • Sending functional abilities questions to the treating physician

  • Requesting updated restrictions and prognosis

  • Asking whether the employee can perform essential duties

  • Requesting information about limitations, not diagnosis

  • Holding a return-to-work meeting

  • Considering temporary modified work

If these steps do not provide enough reliable information, an IME may become more defensible.

What Did the Bottiglia Case Say About IMEs?

A key Ontario case is Bottiglia v. Ottawa Catholic School Board.

In that case, the employer requested an IME as part of the accommodation and return-to-work process after receiving changing medical information. CanLII Connects summarizes the decision as confirming that Ontario’s Human Rights Code can support an employer’s request for an IME where the facts warrant it, particularly where there is conflicting medical evidence.

The important takeaway for employers is not that every IME request will be allowed.

The takeaway is narrower:

An employer may be justified in requesting an IME where there is a bona fide, objective reason to question whether the existing medical information is sufficient to assess accommodation, fitness for work, or return-to-work planning.

When Is an IME Request More Likely to Be Reasonable?

An IME request is more likely to be defensible where:

  • The employee has been absent for a significant period

  • The employee’s medical information has changed suddenly

  • The existing medical notes are vague or inconsistent

  • The treating doctor does not address the essential duties of the job

  • The return-to-work plan is unclear or medically complex

  • The role is safety-sensitive

  • There are observable concerns about the employee’s ability to work safely

  • The employer has tried less intrusive steps first

  • The employer can explain why the IME is necessary

  • The request is limited to functional restrictions and accommodation needs

  • The proposed examiner is properly qualified and neutral

  • The employee receives clear information about the purpose and scope of the exam

The stronger the documentation, the stronger the employer’s position.

When Is an IME Request Risky?

An IME request may create legal risk where the employer:

  • Requests it simply because it does not believe the employee

  • Uses it to challenge whether the employee has a disability

  • Ignores clear medical information already provided

  • Requests diagnosis when restrictions would be enough

  • Demands broad access to medical files

  • Chooses an examiner who appears biased

  • Sends the examiner inflammatory or one-sided information

  • Fails to explain the purpose of the assessment

  • Uses the IME to delay accommodation

  • Applies IME demands inconsistently

  • Penalizes the employee before completing the accommodation process

The OHRC says employers should accept accommodation requests in good faith and respect the dignity of employees.

What Medical Information Can Employers Ask For?

Employers can usually ask for information needed to understand:

  • Whether the employee has restrictions

  • What the employee can and cannot do

  • Whether restrictions are temporary or permanent

  • Expected duration of restrictions

  • Prognosis for return to work

  • Whether modified duties are medically appropriate

  • Whether the employee can perform essential duties

  • Whether workplace safety concerns exist

Employers should be cautious about asking for:

  • Diagnosis

  • Full medical history

  • Treatment notes

  • Medication lists

  • Counselling records

  • Specialist files

  • Irrelevant personal health information

Wherever possible, focus on functional limitations rather than private medical details.

The OHRC notes that medical information should be provided only to people who need to know it, and that medical information should generally be kept separately from personnel files.

Can an Employee Refuse an IME?

An employee cannot physically be forced to attend an IME.

However, refusing a reasonable and necessary IME may have employment consequences. The OHRC states that while no one can be made to attend an IME, failing to respond to reasonable requests may delay accommodation and may ultimately frustrate the accommodation process.

That said, employees may have legitimate concerns about:

  • The scope of the assessment

  • The doctor selected

  • Whether diagnosis is being requested unnecessarily

  • Privacy and confidentiality

  • What information the employer sent to the examiner

  • Who pays for the IME

  • Whether the report will be shared

  • Whether the process is being used unfairly

Employers should treat these concerns seriously. A collaborative approach is usually safer than a rigid ultimatum.

Who Pays for the IME?

Generally, if the employer is requesting the IME for workplace accommodation or fitness-for-duty purposes, the employer should pay for it.

Employers should also consider paying reasonable related costs, such as:

  • Travel expenses

  • Parking

  • Time away from work

  • Administrative costs for records or forms

This helps show that the IME is part of a legitimate accommodation process rather than a burden placed on the employee.

Best Practices for Employers Requesting an IME

Before requesting an IME, employers should:

1. Identify the Workplace Issue

Be clear about the issue the IME is meant to answer. For example:

  • Is the employee fit to return?

  • Are the restrictions clear?

  • Is the proposed accommodation medically supported?

  • Can the employee perform essential duties safely?

2. Review the Existing Medical Information

Document what has already been received and why it is insufficient.

3. Try Less Intrusive Steps First

Ask for clarification from the employee or treating physician before moving directly to an IME, unless safety concerns justify faster action.

4. Use a Neutral, Qualified Examiner

The examiner should have relevant expertise and should not appear pre-selected to reach a preferred result.

5. Limit the Questions

Ask only questions connected to workplace function, restrictions, accommodation, safety, and prognosis.

6. Protect Privacy

Limit circulation of medical information to HR, occupational health, decision-makers, or legal counsel who need it.

7. Avoid Influencing the Examiner

Do not send inflammatory commentary, speculation, or irrelevant workplace grievances to the doctor.

8. Communicate Clearly With the Employee

Explain:

  • Why the IME is being requested

  • Who will conduct it

  • What questions will be asked

  • What information will be shared

  • Who will receive the report

  • How the information will be used

9. Keep Accommodation Moving

Do not use the IME process as a reason to ignore interim accommodations that can reasonably be provided.

10. Get Legal Advice Before Escalating

If the employee refuses, objects, or raises privacy or human rights concerns, get legal advice before suspending, disciplining, or terminating employment.

Vanguard Law’s Workplace Counsel+™ service helps Ontario employers with accommodation, leaves, attendance and medical documentation, return-to-work planning, discipline, and termination strategy.

Practical IME Request Language for Employers

Employers should avoid aggressive or accusatory wording. A better approach is:

“We have reviewed the medical information provided. At this stage, we do not have enough information to determine whether you can safely perform the essential duties of your position or what accommodations may be required. We are requesting an independent medical examination for the limited purpose of obtaining functional information about your restrictions, accommodation needs, prognosis, and fitness for work. The assessment is not intended to challenge the existence of a disability or obtain unnecessary private medical information.”

This type of language helps show that the employer’s purpose is accommodation, not disbelief.

Speak With an Ontario Employment Lawyer Before Requesting an IME

IME requests can be useful — but they are also legally sensitive.

A poorly handled IME request can lead to allegations of discrimination, privacy breaches, bad-faith accommodation, reprisal, constructive dismissal, or wrongful dismissal.

Before requiring an employee to attend an IME, Ontario employers should get legal advice on whether the request is justified, how to frame it, what questions to ask, and how to respond if the employee refuses.

Vanguard Law advises Ontario employers on medical accommodation, return-to-work planning, employee medical information, workplace policies, and termination risk.

Contact Vanguard Law today for practical advice before requesting an independent medical examination.

FAQ Section

Can an employer require an independent medical examination in Ontario?

Sometimes. An employer may be justified in requesting an IME where it is necessary to assess accommodation, return-to-work restrictions, fitness for duty, or workplace safety. The request must be reasonable and based on objective concerns.

Does an employer have an automatic right to an IME?

No. Ontario employers do not have an automatic right to demand an IME. The request should be necessary, proportionate, and connected to a legitimate accommodation or safety issue.

Can an employee refuse an IME?

An employee cannot be physically forced to attend an IME. However, refusing a reasonable request may delay accommodation and could affect the employer’s obligations if the refusal prevents the employer from obtaining necessary information.

Can an employer ask for an employee’s diagnosis?

Usually, employers should focus on restrictions, limitations, prognosis, and accommodation needs. Diagnosis should only be requested where it is clearly necessary, such as where the accommodation needs are complex, unclear, or directly connected to safety.

Who pays for an independent medical examination?

If the employer requests the IME for workplace purposes, the employer should generally pay for the assessment and reasonable related costs.

What should an employer do before requesting an IME?

The employer should review the existing medical information, identify why it is insufficient, consider less intrusive steps, define the workplace questions to be answered, choose a qualified neutral examiner, and protect the employee’s privacy.

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