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What is an Independent Medical Examination?

An independent medical examination (IME) is an examination by a healthcare professional that is requested in a workers’ compensation case.  An independent medical examination is requested by

an insurance company providing workers’ compensation benefits to an injured employee. If the company is self-insured, then the employer can also request the injured worker undergo an independent medical examination (IME).

Independent Medical Examinations and Workers’ Compensation

Independent medical examinations are requested by insurers or employers in order to verify that an injured worker is being truthful about his symptoms and the extent of his impairments caused by an on-the-job injury.  Workers’ compensation benefits pay out disability income and cover the cost of medical bills for someone who got hurt while performing work tasks. An IME ensures that a worker is getting what he deserves, but not taking advantage of the system by exaggerating his injuries or impairments.

An independent medical examination must be requested in writing by the insurer or employer. The request must be a reasonable one and employers or insurers cannot be excessive in the number or frequency of requested independent medical examinations. The injured worker must be provided with information about who the provider is that will be performing the IME and when the exam is scheduled. There must also be information about what the worker needs to do if the appointment time must be changed.

The independent medical examination can be conducted by any licensed medical professional of the insurance company’s choosing. This can include primary care physicians, specialists, dentists, podiatrists, chiropractors, eye doctors and others who can confirm or deny a workers’ claims about his impairments. In some cases, if a worker is claiming that he has suffered a loss of income because he is unable to work or his earning potential has been reduced, an insurer or employer can also request that the worker meet with a vocational expert.

A worker who is asked to undergo an independent medical examination cannot decline to submit to the exam in most cases, as refusing to undergo the exam could result in a suspension or denial of benefits. Workers who believe that the insurer/employer is being unreasonable or that the requests for an IME have become overly burdensome should consult with an experienced attorney to learn what their legal rights are.  Workers who are asked to undergo an IME may bring their own doctor with them to the examination (at their own expense).  Workers may also wish to speak with an attorney prior to undergoing the IME so they can get advice about what they should and shouldn’t do in order to avoid jeopardizing their workers’ comp claim.

Based on the outcome of an independent medical examination, an insurer or employer can grant or continue workers’ comp benefits or could take steps to curtail benefits. Workers whose benefits are adversely affected by the results of an independent medical exam should also strongly consider speaking with a lawyer as soon as possible.