What is an Independent Medical Examination?
An independent medical examination is conducted when an individual has been injured or has become ill, and an entity supporting or adjudicating the illness or injury requires third-party documentation to confirm the extent of their impairment and disability, and by extension, the eligibility or need for benefits. Those benefits may include current, past and future wage loss, current, past and future treatment, among other things. But what is an IME, exactly?
An independent medical evaluation (also referred to as an independent medical examination or IME) is an medical interview and examination, requested by a third party, to be done by an non-treating healthcare professional (examiner) who has no pre-existing relationship with the examinee, and who is therefore independent.
Many people undergo IMEs, requested by an insurance company, a benefit provider, an HR manager, an occupational health nurse or physician, or a lawyer representing either the examinee or one of the above noted referral sources, as part of the process of a litigated matter.
The IME report is used by the referring agency, or in the case of litigation, the trier of fact — a judge, a jury, or an arbiter, tasked with making factual findings based on the evidence in a trial or other court proceeding — to confirm necessary benefit levels, supports and financial awards to the individual. In cases of employment matters, the report can provide steps for a safe return to work for employers, unions and occupational health and safety professionals to follow when the time is appropriate to do so.
Who Organizes an IME?
An IME agency such as Integra, will organize and manage the independent medical examination process from start to finish. The client (for instance, an insurer) will contact the IME agency to manage the IME coordination for an individual examinee. The IME agency is responsible for finding objective, highly-qualified, independent and suitably trained healthcare professionals located within the examinee’s geographical location.
The IME agency will assist with confirming the appointment details, coordinating necessary ancillary services (such as translation and transportation services), organizing and collating the medical brief from the referral agency, and facilitating the assessment. Post-examination, the IME agency is responsible for assisting the healthcare professional in providing an appropriate IME report and securely providing that report to the referring client.
What Can You Expect From an IME?
IMEs can only be conducted by a healthcare professional who has the appropriate credentials, training and experience, to provide an opinion. Generally, the IME agency has a process of credentialing to determine the suitability of healthcare professionals for such work. The healthcare professional will review your medical, social, recreational and occupational (work) history in the report.
The purpose of the independent medical examination is for the healthcare professional to assess your medical circumstances related to your accident, injury, or illness. They will evaluate your current medical symptoms, past and current treatment, and may provide opinions on one or more of the following:
- Diagnosis
- Prognosis
- Causation
- Work capacity
- Future treatment and support needs
- Impairment and disability