Independent medical examination

An independent medical examination (IME) occurs when a doctor, psychologist, or other licensed healthcare professional conducts an examination of an individual to help answer specific legal or administrative questions related to a variety of situations, e.g., a disability claim; workers' compensation case; a personal injury lawsuit (tort claim); impaired professionals program; or sexual harassment in the workplace.^{[lower-alpha 1]}

Limited doctor-patient relationship

Conducting an IME does not establish a typical doctor/therapist-patient relationship as exists when a clinician treats a patient in the hospital or at an outpatient clinic. However, the independent, objective (unbiased) nature of the examination does not absolve the doctor from all professional responsibilities. For example, in most IMEs the clinician should assess for possible psychiatric disorders and ask the individual if he or she has been thinking of hurting or killing themselves or someone else. If upon further questioning after an affirmative response it becomes apparent that the evaluee poses a significant risk of imminent harm to self or others, the examiner must take steps to prevent such harm and to facilitate referral to appropriate treatment and psychosocial support. Thus, a "limited doctor-patient relationship" exists when conducting IMEs.^[1]

Workers' compensation and long-term disability insurance

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 compensable event, the insurer may deny the claim and refuse payment.

Notes

References