When NOT to Request an Independent Medical Examination (IME)

MYTH: To get a slow claim “moving,” the best thing to do is request an IME (Independent Medical Evaluation).

REALITY: If a claim is “stalled,” it’s quite common for the adjuster to request an IME to get the status of the injury/recovery. In some cases this may be effective and warranted, but sometimes that makes it worse. It makes is worse in these 3 circumstances:

1 – when the timing is not right,
2- when inadequate medical records are included with the IME packet,
3- or, when inadequate medical questions are asked of the doctor who is performing the IME.

You might want to consider a Functional Capacity Evaluation instead. Or, you might want to get a brief surveillance to “see” what capability (or lack of) the claimant has. Before a claim is sent for an IME, have your Medical Advisor review the claim.

Robert Elliott, Senior Vice President, Amaxx Risks Solutions, Inc. is an attorney who has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, health care, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality. Contact him at: Robert_Elliott@reduceyourworkerscomp.com or 860-553-6604

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Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs.