Permanent Medical Impairment Assessment—What to Expect

Learn what to expect at a PMI assessment, how to prepare, and how results may affect your benefits. Review details and next steps.

This page is for workers who have been asked to participate in a Permanent Medical Impairment Assessment (PMI exam). It explains what a PMI assessment is, what happens at the appointment, how to prepare, and how results may affect your benefits. The goal is to help you plan, feel comfortable, and understand next steps.

What a PMI assessment is

Some injuries leave a permanent loss of function even after appropriate treatment. A PMI assessment measures that lasting loss, so WCB can determine whether you’re entitled to a Permanent Impairment Benefit (PIB). The results are used in other long-term benefit decisions too.

Who examines you

An independent medical advisor completes the assessment. These physicians are trained and certified in impairment evaluation methods. They use standardized guidelines to ensure assessments are consistent. These guidelines, called American Medical Association (AMA) Guides, are used by independent medical examiners all over North America.

What happens at the assessment

  • The medical advisor reviews your claim history and asks questions about your injury and recovery.
  • The exam is designed to not be strenuous—the advisor will avoid discomfort as much as possible, whether physical or psychological.
  • If you have a physical injury, you’ll have a physical exam and discussion focused on the injury, using tests of things like range of motion, strength, and loss of sensation.
  • If you have a psychological injury, the physician will ask you questions about your current state. You won’t have to describe what caused your injury, go over traumatic events, or recount specific things that happened in the past. Your diagnosis will not be reviewed or questioned.
  • The advisor applies a standardized rating system to the information gathered during the exam to calculate your permanent impairment rating (PI%).

The medical advisor is a physician. However, they have a very specific role to make an assessment about permanent impairment only.

Things they will do:

  • Ask questions about your recovery
  • Perform tests related to a physical injury, such as taking measurements for movement and strength
  • Complete a permanent impairment report
  • Determine a PI%

Things they won’t do:

  • Send you for medical tests or treatment
  • Make recommendations about your ability to work or not work
  • Ask you to talk about past traumatic events
  • Review your prior medical or psychological diagnosis and make recommendations about it
  • Give you information about claim decisions, benefit amounts, timelines and next steps. Your case worker can help with these questions.

How long it takes

Most assessments take 20–60 minutes. Time varies based on your injury and the information needed.

Before your appointment

  • For physical injuries, wear or bring loose-fitting clothing
    • Shorts are recommended for lower-body or back assessments
    • A tank top or t-shirt for upper-body, shoulder, or neck assessments
  • Bring your medications list and any recent medical reports related to the injury
  • Tell us if you need accommodations, such as mobility assistance or an interpreter
  • A chaperone can be present if requested by you or by WCB

Can someone come with me?

Yes. A family member or support person may attend if both you and the medical advisor agree.

Getting your results

Your results become part of your claim file. Your case worker will talk to you about them, and you will receive a written decision letter explaining the outcome of your PMI assessment.

Reassessment

If your condition changes after your initial assessment — specifically, if your workplace injury results in a different or greater measurable loss of function than what was previously assessed — you may be eligible for reassessment. Any change in function must be directly related to your original workplace injury. Keep in mind that a reassessment can result in a higher or lower permanent impairment rating, depending on how your condition has changed.

Reassessments are typically considered at least 16 months since your last assessment, and require recent medical reports from your doctor describing the change in your condition.

After the assessment: what your PI% may affect

  • If you have a measurable permanent impairment, your case worker will review your eligibility for a Permanent Impairment Benefit (PIB). They will also determine how your rating relates to other long-term benefits.
  • How benefits are paid (monthly or as a lump sum). This depends on WCB policy and legislation. Learn more about permanent impairment benefits.
  • Your case worker will contact you to explain the outcome and provide any decisions in your case file.

Travel, time away from work, and expenses

  • Travel and, in some cases, overnight accommodation may be covered when WCB decides they’re necessary for your assessment.
  • Contact your case worker before you book to confirm what’s covered and any limits.
  • Keep all receipts. WCB can only reimburse approved costs.
  • Submit your expenses through WCB Online with your claim number and appointment details.
  • If you miss work to attend, ask your employer to confirm your lost wages. Wages are reimbursed at the same rate used for your temporary earnings-replacement benefit (75% or 85% net earnings).

Learn more about covered expenses

Questions?

  • For appointment details, results, or how your rating affects benefits, contact your case worker.
  • For accessibility or accommodation requests for your assessment, tell your case worker when scheduling.

Learn more about WCB’s PMI policy in the WCB Policy Manual (PDF).

Last updated: 2026-04-08
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