What’s the purpose of an independent medical exam?
The goal of an independent medical examination, or IME, is to have the patient examined by a doctor who has not previously been involved in their treatment. This supposedly allows the doctor to be impartial while conducting the exam. The physician then reports their findings to the insurance carrier, which uses the information to determine whether to pay out a claim.
IMEs are typically short exams and they are different from a typical doctor visit. The goal of a medical examiner is not to treat a condition, but simply to determine whether an injury or disability is present, and whether it affects the patient’s ability to work.
Who administers the IME?
Independent medical examiners are licensed physicians. However, beyond maintaining a license, they do not need to have any special training. Many of these doctors are semiretired, occasionally performing IMEs after leaving their practice.
Some critics have raised concerns about the lack of oversight or training for IME physicians. “Basically if you haven’t murdered anyone and you have a medical license, you get certified,” one orthopedic surgeon and independent medical examiner told the New York Times in 2009.
How independent are these exams?
The physician who conducts the IME is paid by the insurance company. As you can imagine, it is If a doctor wants to keep getting paid for performing exams, he or she typically must make a report that benefits the insurer. That means IME doctors are often looking for ways to undermine a patient’s injury claim or find that there is no injury at all.
With the deck stacked against injured workers in this setting, it is critical that you protect yourself if you’ve been hurt on the job. If your employer or its insurer require you to have an IME, it is wise to speak with an attorney if you haven’t already done so.
In our next series of posts we’ll explore these issues further, including problems with the IME process and how you can best prepare if you’re required to have one of these exams.