How Independent Medical Examinations Support Mental Health Claims in the Workplace

As we mark World Mental Health Day on October 10th, it’s worth exploring how IMEs support both employees and organizations in managing mental health claims.

Mental health has become one of the leading drivers of workplace disability claims in Canada. For employers, human resources leaders, and disability case managers, the rise in short-term disability (STD) and long-term disability (LTD) claims related to mental health presents real challenges: balancing compassion with compliance, ensuring fair adjudication, and supporting employees on their path back to work.

One of the tools that can provide clarity in this complex space is the Independent Medical Examination (IME). As we mark World Mental Health Day on October 10th, it’s worth exploring how IMEs support both employees and organizations in managing mental health claims.

Why Mental Health Matters in Canadian Workplaces

The numbers are striking:

• In any given year, 1 in 5 Canadians experience a mental health problem or illness (CAMH).
  
  
• Mental health conditions represent about 30% of disability claims in Canada and account for 70% of total disability costs (Mental Health Commission of Canada).
  
  
• The economic cost of mental illness in Canada is estimated at over $50 billion annually, with lost productivity making up a large share (CAMH).
  
  

Given these realities, it’s not surprising that mental health is now a top concern for employers and insurers. Supporting employees while making sound benefit decisions requires credible medical evidence - this is where IMEs come in.

What Is An Independent Medical Examination (IME)?

An IME is a medical assessment conducted by a health professional who is not involved in the employee’s treatment. In mental health claims, IMEs provide an objective, third-party opinion on:

• Diagnosis – is the condition accurately identified?
  
  
• Severity and limitations – how does the condition affect the employee’s ability to perform job duties?
  
  
• Causation – is the condition related to workplace factors, or other causes?
  
  
• Prognosis and treatment – what’s the expected recovery path, and what supports or accommodations are appropriate?
  
  

For disability case managers, insurers, and HR professionals, IMEs are not about replacing treatment. Rather, they add clarity, consistency, and independence to the decision-making process around STD and LTD claims.

How IMEs Add Value In Mental Health Claims

Canadian Evidence and Best Practice

Research continues to demonstrate the impact of independent evaluations in managing prolonged absence:

• A Canadian study by the Mental Health Commission of Canada found that timely, structured interventions - including medical evaluations - improve return-to-work outcomes and reduce overall disability durations.
  
  
• Across Canada, insurers report that mental health claims are the fastest-growing category of disability benefits, underlining the importance of strong, defensible medical evidence in claim decisions.
  
  

In practice, IMEs should be used not only to confirm a diagnosis but also to guide practical solutions - what an employee can do, what accommodations may help, and what timeline is realistic for recovery.

Best practices for IMEs in mental health

To ensure IMEs are effective and fair, Canadian employers and case managers should keep these principles in mind:

Choose qualified experts

• Use psychiatrists, psychologists, or occupational health professionals experienced in independent assessment.
• Ensure assessors understand Canadian employment and human rights legislation.

Focus on function, not just diagnosis

• An effective IME highlights what tasks an employee can or cannot perform, not just a list of symptoms.

• Employees should understand why the IME is being requested and how the results will be used.

• Delays in obtaining IMEs can prolong leave unnecessarily. Early assessments can identify supports that get employees back to work sooner.

• Integrate IME recommendations into return-to-work plans, accommodations, and ongoing support programs.

Addressing Common Concerns

• Employee trust – Employees may worry an IME is adversarial. Framing it as a neutral tool to clarify next steps - and ensuring respectful communication - can help.
  
  
• Cost – While IMEs have an upfront cost, they are often far less expensive than extended LTD claims or failed return-to-work attempts.
  
  
• Legal obligations – In Canada, employers must respect employee privacy and duty to accommodate under human rights law. Using IMEs fairly and transparently helps demonstrate compliance.
  
  

Why This Matters on World Mental Health Day

World Mental Health Day is a reminder that workplace mental health is not just a medical issue - it’s a human and economic one. Employers and HR leaders across Canada are striving to create supportive environments, but when employees do need to step away on STD or LTD, it’s essential to handle those claims fairly and effectively.

Independent Medical Examinations, when conducted appropriately, are a vital part of that process. They support employees by clarifying needs and capacities, and they support employers by ensuring decisions are evidence-based, defensible, and aligned with both productivity and compassion.

Mental health claims are complex, and there are no quick fixes. But IMEs provide clarity where uncertainty exists, helping bridge the gap between clinical care, workplace expectations, and fair claims management.

This World Mental Health Day, Canadian employers and disability managers have an opportunity: to use tools like IMEs not only to manage risk, but also to support recovery and dignity for employees navigating mental health challenges.

At SOMA Medical, we understand the complexity of mental health claims in Canadian workplaces. Our team of experienced psychiatrists, psychologists, and medical specialists provide independent, evidence-based assessments that give employers, insurers, and disability case managers the clarity they need to make fair and timely decisions.

With a strong track record in conducting IMEs across Canada, SOMA helps organizations navigate STD and LTD claims, reduce uncertainty, and support employees on their recovery and return-to-work journey.

This World Mental Health Day, partner with a trusted leader in independent medical assessments - because when employees thrive, workplaces thrive too.

Need help navigating a complex claim - or reviewing a recent report? Get in touch with SOMA Medical today to connect with our experts. 

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