What is an Independent Medical Examination (IME)?
An Independent Medical Examination (IME) is performed by a physician or psychologist in the context of a legal or administrative process. The abbreviation for an independent medical examination or exam is IME.
1) IME is an examination by a physician or psychologist who is not or has not been involved in the treatment of the patient.
2) IME is perfomed usually at the request of an insurance company, plaintiff’s attorney, or defense attorney.
3) IME does not establish a typical doctor -patient relationship . This is why the report usually uses the term “claimant” rather than “patient”
As an orthopaedic surgeon, I am often asked to perform an IME in worker’s compensation and disability cases as well as in auto accident cases . The examination begins with discussion of the injury with particular emphasis on the mechanism of injury, that is , an understanding of what happened at the time of injury. Oftentimes it can be difficult for a claimant to remember the exact details , especially if the injury was several years ago , but we do our best.
We usually have medical records to review . We review what is provided by the person who has requested the examination. It is not unusual for us not to have the most up-to-date treatment notes , so claimants may want to bring those records with them and we will add them to the file.
As an orthopaedic surgeon, I am trained to review x-rays, CT scans and MRIs. Although the report of these studies is helpful ( and usually all we get ), it is preferable to see the actual films, which are usually on a CD. The IME requester usually DOES NOT send the CD with the medical record
A physical examination of the appropriate body part of parts is performed . In most cases we are asked to restrict our examination to specific body parts. If you believe other body parts were involved in the injury you should bring it to the examiners attention , but it may not necessarily be included the report.
In most cases we are asked to answer specific questions . We are asked to confirm the appropriate diagnosis and determine whether that diagnosis is directly related to the injury. This is what we call “causal relationship.” We are usually asked to determine if the treatment received and documented in the record that we have reviewed was related to the injury. We are asked if the claimant requires any further treatment for the injury and if so , what that treatment should be.
If treatment has concluded or no further treatment is determined to be appropriate, then the claimant is at MAXIMUM MEDICAL IMPROVEMENT (MMI).
A determination of the claimant’s work status and ability to work in their regular job or a modified job is often part of the IME examiner’s tasks.
The description provided is not meant to be inclusive of all parts of an IME or typical of all IMEs. It is provided to give an overview of the general processes performed in most orthopaedic IMEs.