An independent medical examination (IME) occurs when a psychologist/ neuropsychologist who has not previously been involved in a person’s care examines an individual. There is no doctor/therapist-patient relationship.
IMEs may be conducted to determine the cause, extent and medical treatment of a work-related or other injury where liability is at issue; whether an individual has reached maximum benefit from treatment; and whether any permanent impairment remains after treatment. An IME may be conducted at the behest of an employer or an insurance carrier to obtain an independent opinion of the clinical status of the individual. Workers' compensation insurance carriers, auto insurance carriers, and self-insured employers have a legal right to this request. Should the doctor/therapist performing the IME conclude that a patient’s medical condition is not related to a compensatable event, the insurer may deny the claim and refuse payment.
Every state has different laws when it comes to Worker's Compensation and No-Fault claims and every insurance company works differently. In a Massachusetts, No-Fault claim the insurance companies may require a report to be dictated by the doctor within 24 hours of the IME and sent to all parties of interest. In New York State, the Worker's Compensation Board allows the doctor 10 business days from the date of the IME to dictate the report and have it sent to all parties. Most often, there is an IME Vendor/Company involved in which they schedule the exams, send out appointment letters, follow up with the doctors, proofread the reports for any errors or missed information, and finally, send out the reports to all parties. The insurance company just makes the request to a preferred IME vendor, and the vendor takes care of the rest.