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What is an Independent Medical Examination (IME)?

An independent medical examination (IME), also known as independent medical evaluation, is an evaluation of an individual’s medical condition by an independent medical examiner to determine if the individual qualifies for disability benefits or workers’ compensation claims. The services of an IME are usually sought by insurance companies, employers, benefits providers, lawyers, or HR managers to determine whether to approve or decline benefits, coverage, or settlements to an individual.

Who is an Independent Medical Examiner?

An independent medical examiner is a specially trained doctor who is an expert in assessing a patient’s health and helps to resolve any kind of discrepancy or dispute arising out of a workers’ compensation case. They provide an unbiased opinion with an accurate report of the injuries and also estimate the amount of time required for the treatment and when the employee can return to work.

What are the Functions of an Independent Medical Examination (IME)?

The primary function of an independent medical examination is to evaluate a person’s medical condition and assist with worker’s compensation and disability claims. An IME helps to:

  • Assess the severity of the injuries
  • Identify the medical treatment required
  • Identify the injuries sustained during a work-related accident
  • Provide a second opinion to benefits providers, such as Worker’s Compensation to process claims.
  • Evaluate the authenticity of the claims and eliminate any false claims.

What Happens During an Independent Medical Examination (IME)?

During an IME, the independent medical examiner will review your medical history and perform a physical examination to evaluate your symptoms related to an accident, injury, or illness. They will also assess your ability to function and react both physically and mentally while performing various tasks. The examination may also involve lab tests, psychological testing, and diagnostic procedures for additional information. The independent medical examiner may also make certain recommendations or activity restrictions at work, home, or in recreation based on your ability to perform tasks during your exam.

What Happens After an Independent Medical Examination (IME)?

A medical report is drafted by your independent examiner after obtaining all the required information during your examination. The report involves conclusions and opinions, specifically in response to the disputed cases or inquires raised by the insurance provider or Worker’s Comp. A copy of this report is sent to you or your lawyer as well as the benefits provider you are seeking claims from. The report may give a detailed picture about:

  • Your current health status
  • The causes of the prevailing illnesses or conditions
  • Whether your lifestyle factors contributed to any of your current illness or condition
  • The correct method of treatment and its probability to work
  • Whether or not the symptoms, illness, or injury sustained by you are genuine in nature or being exaggerated for false claims

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