What Is an Independent Medical Exam?

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An independent medical exam (IME) is usually requested by employers or workers compensation insurance companies. The purpose of these medical examinations is to analyze and assess an injured employee who is seeking workmans compensation.

Usually, these “independent” insurance doctors tend to side with their insurance company employers. This means that they are paid large sums of money to contest the legitimacy of seriously injured workers that are seeking restitution. While this is often the case, it does not speak for all IME monitors and regulators.

Can an IME Affect Your Workers Compensation Case?

An independent medical examination is essentially a medical evaluation. The IME is done to resolve questions about the validity of your medical condition. The assessment also identifies which treatments are needed, as well as the degree of your temporary or permanent impairment.

Again, these examinations are usually requested by insurance companies or employers. Based on your findings, they determine which disability rating you should receive. This determines if you qualify for workers compensation.

In some cases, a judge or hearing officer will be assigned to your case. This is only if there are outstanding or disputed issues present. The presiding judge or officer will also evaluate the IME findings to determine if you qualify for benefits and financial restitution or assistance.

Independent medical exams are also needed to prevent fraudulent claims on all sides of the issue. With this in mind, your case can be affected in many ways, both positive and negative. This is based on what the IME shows and determines in regards to your medical injuries.

IME: Important Facts to Know

Here are some important things to keep in mind when it comes to your IME:

  • If you believe that your IME has been conducted unfairly or in a biased manner, a Queens workers compensation lawyer can build a case demonstrating the lack of fairness.
  • The independent medical exam should be performed by a physician who specializes in the field of medicine related to your injury. For example, a chiropractor may be selected to check your back injury sustained at work but should not be evaluating a burn injury.
  • The IME physician should not have been previously involved in your medical care. This means that you cannot have your primary care doctor check you out as the doctor will be selected by the employer or insurance company.
  • The IME does not create a doctor-patient relationship.

The only purpose of the IME in a workers compensation claim is to verify and validate your injury. This includes determining the cause of the mishap, as well as the extent of the disability sustained from the work-related injury.

Furthermore, if the treating doctor has not placed the worker at maximum medical improvement (MMI), the IME can be utilized to determine which further treatments the employee requires.

Are IMEs Fair Assessments?

Independent medical exams are performed to help insurers make fair decision on how to handle claims. The IME also provides the workers compensation adjuster with all pertinent and necessary information related to the case. This includes continuing medical treatment, along with discontinued medical treatment or changes in plan.

These scenarios determine whether the recipient will get permanent partial disability or total disability benefits. While some employer- and insurance company-appointed physicians may side with their referrers, most IME examinations are fair and impartial.

Sources:

https://en.wikipedia.org/wiki/Independent_medical_examination

https://www.workerscompensation.com/news_read.php?id=9279