Somewhere in the middle of a Nevada injury case, a letter arrives setting an appointment with a doctor you have never met, chosen and paid for by the insurance company defending the case. The letter often calls it an independent medical examination. Nobody in the courthouse actually believes the word independent belongs in that phrase, and most Nevada lawyers call it what it is, a defense medical exam.
The appointment makes people anxious, and the anxiety usually comes from not knowing the rules. Can they ask me anything they want? Can I bring my spouse? Can I record it? Do I have to go at all? What happens if the doctor writes that I am fine when I am not?
Those questions have concrete answers in Nevada, and the answers come from a court rule that has been fought over hard in the last several years. Here is how the process works, what the rule actually permits, and how to walk into that room prepared rather than rattled.
What a Defense Medical Exam Actually Is
A defense medical exam is a discovery tool. When you put your physical or mental condition at issue by suing for injuries, the other side is entitled, within limits, to have a physician or other qualified examiner of their choosing evaluate that condition and write a report. The examiner is not your treating doctor. No treatment is provided, no prescriptions are written, and there is no ordinary doctor patient relationship in the way you are used to.
The examiner’s job is to form opinions the defense can use, typically on three questions. Are the injuries you claim actually present. Were they caused by this incident rather than by aging, a prior accident or a degenerative condition. Is the treatment you received reasonable, necessary and related, or was some of it excessive. Those opinions then anchor the defense position on the value of the case and are offered as testimony at trial.
None of that makes the exam illegitimate. It is a normal part of litigation, and refusing to cooperate with a properly ordered examination causes real problems. What it means is that the exam should be treated as part of the case rather than as a medical visit.
The Rule That Controls the Exam in Nevada
Nevada Rule of Civil Procedure 35 governs physical and mental examinations in state court civil cases. Under the rule as amended in 2019, the court where the action is pending may order a party whose mental or physical condition, including blood group, is in controversy to submit to an examination by a suitably licensed or certified examiner, and has the same authority as to a person in the party’s custody or legal control.
The rule contains protections that people rarely know they have. An order may be made only on motion for good cause shown and on notice to the person to be examined and to all parties. The order must specify the time, place, manner, conditions and scope of the examination, and the person or persons who will perform it. The examination must take place in an appropriate professional setting in the judicial district where the action is pending, unless the parties agree otherwise or the court orders otherwise.
Read that again, because it is the part that gets used. Scope is not open ended. If your case is about a shoulder and a neck, an examiner who starts probing psychiatric history is outside what the order authorized. Manner and conditions are also written into the order, which means many disputes are better resolved before the appointment than argued about afterward.
Who Can Be in the Room and Whether It Can Be Recorded
NRCP 35 addresses both questions directly, and the answers are more limited than most people expect.
On observers, the party against whom an examination is sought may request as a condition of the examination to have an observer present. The request must identify the observer and state that person’s relationship to the party being examined. The observer may not be the party’s attorney or anyone employed by the party or the party’s attorney. One observer is allowed, with an important exception. No observer is permitted for a neuropsychological, psychological or psychiatric examination unless the court orders otherwise for good cause shown. An observer who is allowed to attend must not interfere with, obstruct or participate in the examination.
On recording, the rule provides that on request of a party or the examiner, the court may, for good cause shown, require audio recording as a condition of the examination. Whoever requests the recording arranges and pays for it and provides a copy on written request, and the examiner and everyone present must be told before the exam begins that it is being recorded.
Good cause is a real threshold, not a formality. In 2026 the Nevada Supreme Court addressed it in Powers v. Eighth Judicial District Court, holding that “a generalized fear that the examiner might distort or inaccurately report what occurs at the examination is not sufficient to establish good cause to audio record the examination.” The same decision found that a district court erred in ordering a court certified interpreter without adequate evidence of genuine need where the examiner was already fluent in Spanish and the test was available in that language, while allowing disclosure of raw neuropsychological testing data to the plaintiff’s counsel subject to protective order restrictions.
The practical takeaway is that if there is a specific, documented reason to want a recording or an observer, that reason has to be built and presented to the court in advance. Turning up with a cousin holding a phone is not a plan.
The Statute That Tried to Change This and What the Courts Did
Nevada spent several years with two competing sets of rules on this subject, and the history explains why online advice about defense exams in Nevada is so unreliable.
Shortly after the revised NRCP 35 took effect in 2019, the Legislature passed AB 285, codified at NRS 52.380, which allowed an examinee’s attorney or staff to act as an observer, permitted an observer at neuropsychological and psychological examinations without any showing of good cause, and allowed recording without any showing of good cause. On December 30, 2021, in Lyft, Inc. v. Eighth Judicial District Court, the Nevada Supreme Court held that the statute was unconstitutional because it attempted to abrogate an existing rule of procedure the court had prescribed under its inherent authority, and that the district court manifestly abused its discretion by allowing examinations to proceed under the statute.
The 2026 Powers decision applied the same reasoning to a later statute, stating that “to the extent NRS 629.620 encroaches on this court’s rules prescribing the handling of NRCP 35-based physical and mental examinations conducted during civil litigation, it is of no effect.” You can review the Nevada Supreme Court’s ADKT 522 amendments to the Nevada Rules of Civil Procedure for the rule text itself.
If you read an article, a forum post or a checklist telling you that Nevada law flatly gives you the right to bring your lawyer and record the exam, check the date on it. That was the statutory position for a stretch, and the courts have since said the rule controls.
What the Examiner Is Looking For
Knowing what is being measured takes most of the fear out of the appointment. A defense examiner is generally building a record on a handful of themes.
- Consistency. Does what you say today match your intake forms, your deposition, your medical records and your prior statements. Inconsistencies are the most common thing cited against a plaintiff.
- Prior history. Old injuries, prior claims, degenerative findings on imaging, and preexisting conditions that could explain current complaints.
- Objective versus subjective findings. Measurable range of motion, strength testing, reflexes and imaging correlation, weighed against what you report feeling.
- Effort and symptom validity. Whether your presentation appears exaggerated, particularly in neuropsychological testing where validity measures are built into the battery.
- Function. What you can and cannot do at home, at work and in daily life, which is why questions about hobbies and chores are not small talk.
Surveillance and social media often ride alongside the exam, because the defense wants to line up what you told the examiner against what you posted. Our article on how social media can undermine an injury claim covers that risk in detail.
How to Prepare Without Hurting Your Case
Preparation is not about performing. It is about being accurate and steady.
Review your own timeline before you go. Know the date of the incident, the mechanism of injury, when each symptom started, what treatment you have had, and what you are still doing. Read your deposition transcript if you have already been deposed. Bring a list of current medications and current treating providers.
Answer the questions asked and stop. Do not volunteer a life story, and do not speculate. If you do not remember, say you do not remember, which is a truthful answer and a safe one. If you do not understand a question, ask for it to be repeated.
Describe a normal day honestly, including the bad days and the good ones. People hurt themselves in both directions here. Minimizing to seem tough makes the report say you have recovered. Overstating gives the examiner a chance to call your presentation inconsistent with the objective findings. The accurate version is also the strongest version.
Do not do anything during the examination that increases your pain to prove a point. Tell the examiner when something hurts and stop the maneuver. Note the time you arrived, the time the doctor entered, the time the doctor left, what tests were performed and how long each took, and write it down as soon as you get to your car. Length of contact time is frequently disputed later. Keep the same discipline with adjusters generally, a subject we cover in our piece on the tactics insurance adjusters use.
Be courteous. Hostility toward the examiner reliably shows up in the report and never helps.
What Happens to the Report and How Your Lawyer Uses It
Under NRCP 35(b), unless the court or discovery commissioner orders otherwise for good cause, the party who moved for the examination must, on request by the party examined, provide a copy of the examiner’s detailed written report within 30 days of the examination or by the applicable expert disclosure deadline, whichever comes first. The report must be in writing and set out in detail the examiner’s findings, including diagnoses, conclusions and the results of any tests.
Requesting that report has a consequence worth understanding. By requesting and obtaining the examiner’s report, or by deposing the examiner, the party examined waives any privilege regarding testimony about all examinations of the same condition, in that action or any other action involving the same controversy. The rule also lets the moving party then request like reports of earlier or later examinations of the same condition, and gives the court authority to exclude an examiner’s testimony where a report is not provided.
Once the report lands, the work is cross examination material. The examiner’s history of testifying, the share of the examiner’s income derived from defense referrals, the volume of exams performed, the time actually spent with you, the records reviewed and not reviewed, and any internal contradiction in the report all become fair game. Careful contemporaneous documentation of your own treatment is what makes that possible, which is why we stress the role of medical records in an injury claim. The way an examiner characterizes ongoing symptoms also feeds directly into the argument over pain and suffering damages.
Talking to The Bourassa Law Group Before Your Exam
If a defense medical exam has been scheduled in your Nevada case, or the other side has moved for one, The Bourassa Law Group offers a free consultation to review the proposed order, the scope, the examiner and the conditions before you attend. Objections raised before the appointment are far more useful than complaints raised after the report is written.
This article is general information about Nevada law and procedure and is not legal advice. Reading it does not create an attorney client relationship, and court rules change. Speak with a licensed Nevada attorney about your own case, or see our overview of Nevada personal injury representation.
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