What is IME Evaluation?
Independent Medical Examination is a medical test to evaluate the patient’s physical, emotional, and mental state. This evaluation plays an essential role in worker’s compensation cases, personal injury litigation, and long-term disability claims. If there is an argument over a worker’s injuries, illness, or disabilities, he might need to undergo an IME. The physician must be competent enough to perform an IME and not be influenced by the patient or an interested party. Therefore an independent medical examination (IME) is done by a certified physician who has been selected by:
- The employer
- An insurance company, or
- The workman’s compensation company
In other words, this evaluation is an objective evaluation that is done by a third-party examiner, and it can be ordered by employers, insurance companies, benefits providers, or lawyers. Once the examination is complete, IME reports are sent to the group ordering the IME: employer, the insurance company, benefits providers, or the lawyer.
Why do you need an IME Evaluation?
IME test provides services to organizations or insurances facing the following:
- Workmen’s compensation. When a worker suffers an occupational injury, he/she claims compensation due to the circumstances.
- Liability injury situations. If someone is damaged on your property, you are liable for some level of compensation. This can vary from food poisoning at a restaurant or a simple slip-and-fall incident.
- IME Personal injury. Many personal injuries, such as pedestrian, cyclist accidents, or home accidents, are in this category.
- Occupational danger claims. According to OSHA laws, employers must provide a healthy and safe workplace. Possible occupational risks and injury compensation claims need to undergo IME.
- Environmental hazard claims. Events that endanger people’s health or natural environment, such as exposure to toxic waste or chemical spills.
- Nursing home negligence claims. If a person is abused or neglected in the nursing homes, or if the staff of these centers harm the residents, these centers will be held responsible.
When is the IME done?
The employer or insurance company will likely send a worker for an IME if his/her claim is complicated or serious. Some of the reasons for doing this evaluation are:
- The insurance company claims your injury is not as severe as you claim.
- The insurance company is looking for a reason to close your claim due to high or long-term costs.
- The insurance company intends to find a way to disagree with the doctor’s diagnosis.
- You claim permanent disability.
- You have an injury liability lawsuit.
Who Performs an IME?
The insurance company that applies for the IME selects the doctor to perform the assessment. Workers also have the right to ask about doctors’ impartiality. You can also apply for an IME if you disagree with your treating doctor’s opinion depending on the rules of the state you live in.
Impartiality of IME exam
Who Chooses the Doctor for an IME?
Different systems have been developed in various states to make these medical evaluations as impartial as possible. The doctor may be selected by a judge or randomly chosen from a list of eligible physicians. However, the laws are different and depend on the state you live in.
Is an IME actually independent?
Unfortunately, the doctors who perform this assessment are not truly independent because the insurance company pays the cost of this exam. If a significant portion of a physician’s income is funded by insurance companies, he or she may want to keep insurance companies satisfied and help them avoid paying long-term disability benefits.
Therefore, we recommend that you study your medical provider’s curriculum vitae (CV) before scheduling an appointment for the IME.
What can you do to ensure your IME is fair?
Before going to the scheduled IME, make sure your doctor has received all the relevant medical information and records. You can also request a witness for more assurance.
Besides, you should request a copy of the doctor’s report following the exam. It will allow you to know any inconsistencies between what occurred during the exam and the submitted report to the insurance company.
How Do You Prepare for an IME?
Before doing the evaluation, you can consider the following:
- Eat well because some exams may take hours.
- Wear comfortable clothes.
- Bring an extra T-shirt for replacement.
- Be honest and do not exaggerate in describing your injuries.
- Arrive at least 30 minutes early on the day of the test.
- Do not react positively or negatively to the length of the exam.
What happens during an IME Evaluation?
SNOHC has been conducting IME in Las Vegas for many years. This evaluation includes the following examinations:
- General Appearance Observation
The general appearance of the patient is observed by the IME examiners; how does he talk and see, how does he stand, how does he sit on the chair, and how does he walk in the room. The doctor will also observe the hygiene, dressing, weight, mental state, physical state, and activeness of the patient.
- Deceptive Signs
Any deceptive signs given by the patient triggers the observatory skills of the examiner. The intentional/unintentional exaggerating symptoms of the patient will immediately be noticed.
- Observing Injuries
The examiner looks for any wounds, scratches, lesions, internal injuries, and swollen spots. The examiner will also examine the body parts if the patients report about chronic pain.
- Objective Manifestation of the Injury
The examiner also examines the patient’s EMG nerve conduction reports, MRI reports, CT scans, and X-Ray. The amount of injury to the patient’s body is also measured.
How long does an IME take?
Most IME tests are usually done within 20 minutes. But some random tests are maybe more complicated and take longer to perform. If your claim is rejected at this stage, the case will be transferred to the court to make the final decision. If your claim is proven, you will obtain compensation; otherwise, you will not receive any benefits.
IME Exam Result
If your claim is approved, you will obtain your compensation and benefits. But, if your claim is denied, you can appeal to the insurance company. You can also get help from an attorney at this stage.
SNOHC has been performing Occupational Health Services for +15 years in Las Vegas. To know more about services performed at SNOHC, you can navigate through the menu of this website. Please contact our specialists if you need a consultation.
Frequently Asked Questions about IME exam
What happens after an IME exam?
A report will be issued after the examination. If your claim is approved, you will receive your benefits; otherwise, you can appeal.
How do I prepare for an IME exam?
- Eat well before the exam.
- Wear comfortable clothes.
- Bring an extra T-shirt for replacement.
- Be honest and do not exaggerate
What happens during an IME?
During the exam, your general appearance, any wounds, scratches, lesions, internal injuries, and your medical reports such as MRI, CT scans, and X-Ray are examined.