Health Care

What is an IME?

Doctor And Patient Discussing

What is an IME?

IME stands for Independent Medical Examination. In my experience, there is rarely anything independent about the medical examinations.

If your treating doctor (the physician that the insurance company originally selected to treat you at a place relatively close to where you live and work) recommends a surgery or expensive treatment, the workers’ compensation insurance company may send the injured worker for an IME before agreeing to authorize the doctor’s recommendations.

In 2011 the law changed so that workers’ compensation insurance companies could send injured workers to as many IMEs as they wanted. As long as the injured worker was requesting benefits, the workers’ compensation carrier could request an IME. There was another big change with respect to IMEs. The workers’ compensation insurance company could have their attorney pick up the phone and call the IME physician about the injured worker’s visit – outside the worker’s presence and without a record on what was discussed.

This should sound strange. The treating doctor (that the insurance company hand selects) recommends a procedure or treatment and the insurance company disagrees with the recommendation. The insurance carrier requests an IME (with a doctor they hand select). If the first IME doctor does not change course, the insurance company considers a second IME (with a doctor they hand select). The whole time the insurance company is directly contacting the IME doctor with or without the injured worker’s consent.
There are different tactics an attorney can take to avoid insurance company doctor shopping. One strategy, for example, is to request a hearing with the Industrial Commission before the parade of IMEs gets started. Ultimately, just be cautious about just how independent those IMEs really are.