Independent Medical Exams (IMEs)

An IME is truly ‘Independent’ in that it is done by a doctor that has not treated the claimant at any point and is not establishing a doctor-patient relationship. No treatment is offered. The doctor doing an IME is responsible for doing 4 basic things:

  1. Verifying the reason / referral source for the IME
  2. Reviewing all medical records and paperwork related to the claim;
  3. Scheduling an appointment with the claimant to discuss their history and to perform their exam
  4. Answering questions posed by the source asking for the IME in a written detailed report.

The type of source asking for an IME is very important – the type determines which regulations, laws, or policies must be applied when the doctor is writing their final opinion report.

For example, if an employee is hurt at work and develops a physical impairment that does not resolve and it prevents them from being able to work normally, the work comp adjuster (source) will have the employee seen for an IME to determine if there is any final impairment rating that now applies to their work comp claim before it goes to a final hearing where a settlement amount is determined.

Another source might include an administrator of an employee’s long term disability insurance policy (that was part of the employee’s benefit package). The administrator will refer the claimant to an IME to determine the extent of a person’s disability before issuing any policy payout.

An attorney trying to establish the extent of ‘disability’ their client sustained from a personal injury or a lawyer / advocate helping an individual get through the steps needed to qualify for Social Security Disability income could ask for an IME. Those who have served in the military may be referred for an IME to see if they qualify for a disability rating / award on separation.

Each of the types of IME require that the examining doctor understands the regulations, laws, and policies that apply in each situation. Other sources / reasons for an IME exist but the general purposes of an IME are very similar.