An Independent Medical Examination (IME) is an attempt to confirm – or more likely, to dispute – the treating doctor’s management and care recommendations for an injured worker.
The Independent Medical Examiner is supposed to act as a neutral third-party who reviews the medical records presented by the treating doctor; conducts tests to substantiate or counter those findings; recommends future care needs and offers an opinion on what medical benefits, if any, the employee should receive in the future.
The popular theory is that Independent Medical Examinations are most often requested by the insurance carrier who disagrees with the prognosis for the injured worker’s future care. However, in the last few years, the worker’s attorney is just as likely to request an IME and for exactly the same reason: they disagree with the treating doctor.
“The IME is an invaluable tool for the injured worker’s lawyer,” said Scott Uricchio, who has been representing injured workers for 25 years at Morgan and Morgan, the largest law firm in Florida. “Workers compensation in Florida is not a level playing field. Everything is set up to favor the insurance company, especially if the only doctor my client gets to see is one the employer or insurance company has approved.
“That doctor is going to be more interested in building a relationship with the employer or insurance carrier than he is in building a relationship and actually treating my client. That’s why we use an IME in probably 50% of my cases.”
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What Happens at an IME?
The first thing you should know about an Independent Medical Examination is that you are not the IME doctor’s patient. This doctor is not there to provide medical treatment for your injury. The doctor is there to obtain contradictory information on behalf of whomever hired him/her.
It is advisable to bring a third-party witness to the examination and have that person take notes of what is being tested or asked during the exam. If permitted, videotaping the exam is the best way to make sure there is an accurate record of what was done.
That said, the IME physician has a responsibility to act in a professional manner. When you come in the examining room, the doctor should have reviewed your medical records, looked at x-rays or MRI tests, seen the medications prescribed – basically know you as well as any doctor can know a patient they are seeing for the first time.
Armed with that knowledge the IME doctor likely will begin by asking a series of questions about the accident and maybe conduct a series of tests to assess your range of motion, reflexes, pain tolerance, sensitivity and discomfort you experience from an injury.
IME doctors are looking for signs of deception, meaning exaggeration of pain or symptoms, whether that comes during the physical exam or in answering questions about the injury. It’s important to know how to deal with workers comp doctors, and to be sure you understand every question before answering. There is nothing wrong with a simple “Yes” or “No” response. If you’re not sure about the question, ask the doctor to clarify it.
There is no reason to take more x-rays or MRIs or anything beyond simple, physical tests to verify (or contradict) the results your treating physician already documented. Don’t agree to any written tests or visits to another doctor’s office for further examinations.
IMEs usually take around 30 minutes, but could be over in 10 minutes. Make a note of how much time was spent. There is only so much “history” an examining doctor can absorb from one meeting with a patient.
You may want to make notes for yourself during the exam about unusual questions the doctor asked and how you responded; the tests or procedures the doctor put you through; what topics you two discussed during the exam.
If your case goes to trial, what happens during an IME is crucial to the outcome. You could be denied benefits because of what an independent medical examiner concluded from his examination. Be prepared to dispute any conclusions.
Tips for Preparing for an IME
The most obvious recommendation for someone going to an independent medical exam is to understand that the doctor you’re seeing is not on your side. The doctor is being paid by the opposition to poke holes in your story.
With that in mind, here are some suggestions that should improve your chances of success:
- Be honest: There is no reason to exaggerate any part of your story. Answer every question as truthfully as you can.
- Be brief: Yes or no is a good answer. No need to do storytelling. The more you talk, the more doors you open to get yourself in trouble. Don’t open doors.
- Review the details of your claim: Before going to the appointment, review the account you gave of the accident. You should be well versed in telling the story. When did it happen? Where did it happen? Were there witnesses? How quickly were you treated? Again, there is no need to embellish your story. Be straightforward.
- Review the medical care you have received: Be prepared to go over the treatment you received, any medications prescribed and your body’s reaction to both.
- Understand you are being observed: You are being watched, possibly from the time you leave home until you return home. You can’t walk confidently through the parking lot and then start limping as soon as you get inside the office door. It’s best to assume your every move is being watched.
- Verify IME findings by meeting with your physician: Schedule an appointment with your own physician the same day as the IME to compare findings.
What Is in an IME Report?
Doctors performing an Independent Medical Examination follow a pretty standard template for the process that addresses issues related to the injury and severity. The evaluations usually take about 30 minutes, but can be less, depending on the extent of the injuries.
When finished, the IME doctor will fill out a report that included information about:
- The current physical and functional status of the injured worker, including observations on appearance, behavior, range of motion, etc.
- Whether the injury is typical of injuries at a similar work site
- Whether treatment for injury is appropriate and or effective
- Whether worker’s complaints/symptoms are consistent with the accident
- Observation on worker’s pain level
- Determination of severity of impairment or disability, if any is present
- Limitations worker has because of injury
- Evaluation of impairment and disability
- Whether the employee reached Maximum Medical Improvement
The IME doctor sends the report to the attorneys for the case and the Judge. If one side disagrees with the IME’s conclusions and the case proceeds, the IME can be deposed and called to testify at a trial.
The same side that paid the doctor for the medical exam will also pay him/her for their time at a deposition and/or hearing.
Do You Have to Go to an IME?
Yes, injured employees who are ordered to undergo an IME must show up, or risk losing their workers compensation benefits. Though workers compensation rules vary from state-to-state, all of them allow for a “second opinion” on the status of an injured worker. In many cases, that “second opinion” is an IME.
A survey of workers comp rules for all 50 states shows that in 23 states, you must go to the doctor or clinic designated by your employer or insurance carrier for initial treatment. In 24 states, you can be seen by a doctor of your choice, but in some cases, only for the first visit, then you must go to the one designated by your employer or insurance carrier.
In three states (New Mexico, Oregon and West Virginia), the choice varies, depending on who your employer is.
Regardless of who you see first, there is a strong possibility the opposition will want you to see a doctor of their choosing at some stage of the game. The results of the IME weigh heavily on what sort of medical benefits and indemnity (cash payouts) the employee will or will not receive.
In fact, if your injury involves multiple body parts – you suffered neck, back and knee injuries in the same accident, for example – you likely will have to go to IMEs for each one. And in many states, the laws allow for two IMEs per year for each injured body part.
Is an IME Really an “Independent” Examination?
One of the few things that both sides in workers compensation cases agree on is that an Independent Medical Examination is not “Independent.” In fact, there is some movement to take the word “independent” out altogether and change the name to “Compulsory Medical Examination” since the injured employee must attend.
The doctors conducting an IME are hired and paid for by one side. That is a built-in bias. If the IME doctor goes against the insurance company too often, they will not get a call to handle the next case. If they do side with the insurance company, they probably will cash a second check for as much as 3-4 times more than the original fee, to serve an expert witness in a trial. That makes it a lucrative freelance assignment for doctors and makes it exceptionally difficult to remain “neutral” in their role.
Exaggerating your symptoms will only make you appear dishonest and damage your credibility. Always aim to be as honest and concise as possible during your independent medical examination. Too much is at stake to do anything less.What not to say during an IME exam? ›
Exaggerating your symptoms will only make you appear dishonest and damage your credibility. Always aim to be as honest and concise as possible during your independent medical examination. Too much is at stake to do anything less.How long is the IME test? ›
The doctor will typically review your treatment records provided by your disability insurer prior to the examination. Then comes the IME – the examination itself will usually last about one hour and consists of an interview and physical examination.What is an IME interview? ›
The purpose of an Independent Medical Examination (IME) is for the insurance company to gather information about your injuries to help them determine whether to award or deny your workers' compensation benefits. There is no medical treatment prescribed and no advice given about your injuries.What to expect during a medical evaluation? ›
Typically, the patient will meet with a nurse first who will ask them about their medical history, allergies, past surgeries, immunizations, and any symptoms they might be experiencing. After that, the doctor will conduct a vital signs check, physical exam, and visual exam.What distinguishes a good IME report? ›
Don't Include Any Form of Bias in Your Report
Your IME report isn't a soapbox or venue for you to express non-medical opinions or personal feelings on the situation. Your own beliefs or lifestyle should have no bearing on your report in any way, shape, or form. You must remain impartial in every way.
The IME is typically a one-time interview, physical examination, and supplemental record review performed by an impartial (ie, nontreating) physician at the request of a claimant's legal counsel or opposing defense attorney, in order to provide focused answers to a particular set of questions intended to help resolve a ...How long does it take for medical examination? ›
When asking, "What is a physical exam?" health care consumers should know its essential elements. A thorough physical examination covers head to toe and usually lasts about 30 minutes.What does IME report stand for? ›
An independent medical examination (IME) is a medical evaluation performed by a medical professional on a patient who was not previously involved in the treatment of that patient, to evaluate the patient's course of prior treatment and current condition.What is an IME in medical terms? ›
Two well-known acronyms for health plans and payers are IME, otherwise known as independent medical examination, and IMR, or independent medical review.
An independent medical examiner (IME) is a specialist with qualifications relevant to your injury. They do not replace your nominated treating doctor. They review your injury and provide independent commentary.Is an IME the same as a QME? ›
An IME is an opinion by a physician on an individual's medical condition – usually given in relation to injury or disability. On the other hand, a QME is a licensed panel physician set up by the Division of Workers' Compensation, which provides neutral medical findings used for settlement purposes.How long does it take to get an IME report back in Pennsylvania? ›
Under normal circumstances, the physician that performed the IME will have the report prepared and mailed to the insurance adjuster within two weeks. Occasionally, if additional records are requested for review, it could take slightly longer.What triggers a medical evaluation board? ›
The MEB is convened once the medical retention decision point is reached or when the Service member's physician thinks the Service member will not be able to return to duty for medical reasons.What do you wear to a medical evaluation? ›
Wear loose clothing that gives easy access to these areas. Think t-shirts, sleeveless tops or shirts with sleeves that roll up all the way.What not to do before a physical exam? ›
Avoid exercising or engaging in any physically strenuous activity the night before or the morning of your assessment. Physical activity may cause an increase in your heart rate and blood pressure.What advice should be given to a client before attending a defense medical evaluation? ›
Do not take any medication before the exam that may impact the examination. Be on time for the examination and be polite to the defense medical examiner and his or her assistants. Be open and honest and provide detailed information about your medical treatment, symptoms and restrictions.What is the difference between detailed patient examination and comprehensive patient examination? ›
Detailed – An extended examination of the affected body area(s) and other symptomatic or related organ systems. Comprehensive – A general, multisystem examination or complete examination of a single organ system.How long does it take to get an IME report back in NY? ›
The IME exam generates a report that is sent to all parties generally within 10 days. The report may or may not agree with your doctor and often will vary, especially in assessing your degree of disability.What are the 3 contributing factors that determine the level of EM service? ›
The extent of these services are major factors in defining the level of the service performed. The other three factors (Counseling, Coordination of Care, Nature of Presenting Problem) are contributing factors.
What are the three key components used to select e m codes and the four levels each component has? ›
Many E/M codes, such as those for inpatient care and home visits, include a combination of patient history, examination, and medical decision making (MDM). These factors — history, exam, and MDM (HEM) — are known as the three key components of E/M level selection.What are the components of physical assessment? ›
WHEN YOU PERFORM a physical assessment, you'll use four techniques: inspection, palpation, percussion, and auscultation. Use them in sequence—unless you're performing an abdominal assessment.What questions do they ask at a physical? ›
- How often do you exercise?
- Do you smoke, drink alcohol, or use any drugs?
- What is your diet like?
- Are you feeling any abnormal pain or discomfort?
- Where do you feel the pain or discomfort?
- How is your sleep?
- “I'm rooting for you.”
- “All the best to you today.”
- “I hope everything goes well.”
- “I'm praying for you.”
- “Best wishes!”
- “I know you'll do great at whatever you put your mind to.”
- “You were made for big things.
There are two main kinds of physicals for women: the well woman exam and the standard physical. The basic physical can be as brief or as thorough as your doctor deems necessary, based upon your individual health needs. It includes a routine check of vitals like blood pressure, heart rate, respiration, and temperature.What not to say at an independent medical exam Australia? ›
Be 100% Honest – Don't Exaggerate Your Injuries
Concealing prior injuries or exaggerating current ones will only hurt your case because once the truth is found, your credibility on how injured you are will be damaged.
IME Transcription stands for Independent Medical Evolution transcription. It is a comprehensive review of the medical report of a patient performed by a doctor not earlier involved in the patient's care.What is the process of retraining an employee to return to the workforce called? ›
What is the process of retraining an employee to return to the workforce called? Vocational Rehabilitation.Who are the largest IME providers? ›
QTC is the nation's largest provider of medical, disability, and occupational health examinations. We employ and partner with licensed board-certified physicians from all related specialties to ensure coverage for our customers nationwide.What does IMR mean medical? ›
Infant mortality rate (between birth and 11 months per 1000 live births) Infant mortality rate (per 1000 live births) Short name: Infant mortality rate (IMR)
Qualified medical evaluators (QMEs) are qualified physicians who are certified by the Division of Workers' Compensation - Medical Unit to examine injured workers to evaluate disability and write medical-legal reports. The reports are used to determine an injured worker's eligibility for workers' compensation benefits.What is the IME sector? ›
Overview. Industrial and Manufacturing Engineers (IME's) draw on knowledge from the physical, information, and human sciences and apply engineering methods to design, implement, operate, and improve systems that deliver high quality products and services.What is IME in forensic psychology? ›
An Independent Medical Exam (IME) is when a psychologist who has not previously been involved in a person's care examines an individual. There is not a therapist-patient relationship.What is the two doctor rule? ›
If an injury victim gets a second opinion, that second opinion starts the new chain, or counts as the second doctor.What happens when a QME gives a disability? ›
A QME's determination that an injured worker has suffered some degree of permanent functional limitations as a result of the work injury, triggers the entitlement to receive permanent disability benefits. The QME will write a report and determine whether or not MMI status has been reached.Does a QME determine your disability rating? ›
The QME report is used to determine a disability rating. The rating will range from 0% disability (no functional impairment) up to 100% disability (permanently and totally disabled).What is the deadline for IME in California? ›
We are all familiar with the mandate that a defense medical examination report, the so-called “IME”, must be produced upon written request by the patient's attorney. California law requires production 30 days after the demand (or 30 days after the examination, if demanded prior thereto).How long does it take to get a settlement check in PA? ›
Pennsylvania Law Gives 20 Days for Your Settlement Funds to be Released. Pennsylvania law limits the time a defendant or insurance company can take to deliver your settlement funds after receiving the executed release form. Per Pa. R.C.P.How long does an insurance company have to pay a medical claim in PA? ›
An insurance company has 15 days to settle a claim in Pennsylvania if you're making the claim to your own insurance company. If you're making the claim to another insurance company, they have 30 days to investigate and settle the claim. The insurance company has 10 days to acknowledge that you reported the accident.Is a med board 100% disability? ›
Disability ratings are calculated at 10% increments from 0% to 100%, although not all medical conditions are rated at every 10% increment from 0% to 100%. The final calculation of the disability rating determines the percentage of base pay to be awarded to a member.
The board exams
The board exams to become a certified medical doctor are universally regarded as one of the most difficult parts of medical school. The first exam, the USMLE Step 1, is one of the hardest. Luckily, your knowledge of basic medical science will be about as good as it's ever going to be at this point.
- Get a good night sleep. ...
- Drink lots of water. ...
- Avoid exercise. ...
- Avoid salty and fatty foods. ...
- Fast. ...
- Do not drink coffee or smoke. ...
- Schedule your appointment in the morning. ...
- Prepare a checklist.
It is not usually painful, but it may be uncomfortable. The doctor will ask the person to take off their pants and underwear before giving them a gown or cloth to wrap around themselves.Is a medical evaluation the same as a physical? ›
Both company physicals and annual exams check the overall health of an individual. The difference lies in the depth of the assessment. Company medical exams are designed to see if an employee can perform job-specific tasks. The exams are not meant to be in-depth.Do you wear a bra under a hospital gown? ›
You usually don't need to wear a bra during surgery because you'll have the hospital gown and a surgical drape over your chest. You may want to invest in a bra that's easy to put on and remove if you're getting arm or shoulder surgery.Is it OK to drink water before a physical exam? ›
Most of the time, there's nothing special you need to do to prepare for your yearly physical. If you're having blood work done, be sure to fast and drink only water for a specified period of time before your appointment. Prepare a list of prescription and over-the-counter medications and supplements you take regularly.Do you keep your clothes on during a physical? ›
Do you have to take your clothes off for a physical? You will need to take your clothes off for a complete annual physical exam. Your healthcare providers will give you a paper or cloth gown to wrap around yourself.How do you tell your doctor you're not ready to go back to work? ›
- Make sure they are aware of your symptoms. ...
- Don't exaggerate your symptoms. ...
- Make clear what your job entails. ...
- Discuss with them what you should do if you have the same pain when working.
- Let them know the pain you have when doing similar activities away from work. ...
- Make clear your concerns.
After you leave the IME physician's office, the doctor will write a report, which can take anywhere from a few days to a few weeks. Based on the opinions formed by the doctor and expressed in the report, the insurance company may initiate action to terminate or modify your workers' compensation benefits.What can you do if a patient is physically uncomfortable in a required exam position? ›
What can you do if a patient is physically uncomfortable in a required exam position? use a small pillow to support part of the body. Which position is not commonly used during a basic medical exam? Which position must be used by patients with cardiac and respiratory problems?
No federal law prohibits employers from asking employees why they are out sick. They are free to ask questions such as when you expect to return to work. They may also require you to furnish proof of your illness, such as a note from a physician.Can my doctor recommend that I quit my job? ›
The law is on your side, but only if you are willing to work within it. A doctor's medical recommendation is good cause to quit, but only if we have first given the employer the opportunity to correct, remove, or accommodate the medical reason in some way.Can a doctor say you can't work? ›
Doctor's notes need to include specific functional work restrictions. Having a note from your doctor—often referred to as a medical source statement—that details your physical and mental restrictions can help you get disability benefits.What questions would you recommend the defense attorney ask? ›
What are the specific charges against me? What are the possible penalties if I am convicted of the charges? What are the weaknesses in the prosecution's case against me? What are the likely defenses that can be used in my case?What are the things I should have done before the final defense? ›
- Learn about the structure. ...
- Outline the parts you'll present. ...
- Attend another defense. ...
- Talk to colleagues who've successfully defended. ...
- Anticipate possible questions. ...
- Practice, Practice, Practice. ...
- Dress the part.
- Risks: What are the risks or problems associated with treatment? Be sure you understand the side effects and potential for complications. ...
- Benefits: What are the potential benefits? ...
- Evidence: How much evidence (research or experience) exists?
An independent medical examination is a medical or psychiatric evaluation to determine the current status of an employee's medical condition or to determine whether the condition is related to employment.How to deal effectively with anxiety during an examination session? ›
To help you stay calm and confident right before and during the test, perform relaxation techniques, such as deep breathing, relaxing your muscles one at a time, or closing your eyes and imagining a positive outcome. Don't forget to eat and drink. Your brain needs fuel to function.What are at least four techniques used during the physical examination? ›
WHEN YOU PERFORM a physical assessment, you'll use four techniques: inspection, palpation, percussion, and auscultation.How do you deal with nerves before an exam? ›
- Hand Massage Can Help You Relax.
- Let Out Some Deep Sighs.
- Lessen the Weight of Study with Flotation Therapy.
- Practice Muscle Relaxation.
- Listen to Calming Music.
- Exercise to Reduce Anxiety and Settle Nerves.
- Pray and/or Meditate to Calm Nerves.
- Keep Perspective.