What Happens During a Work Comp Independent Medical Exam?

What Happens During a Work Comp Independent Medical Exam?

If an employer or the company’s insurance company is disputing the claim of an employee’s work-related medical condition, the employee will likely have to have an independent medical exam done ([dcl=6679]). Also called an ‘IME,’ the findings of this exam will help determine whether the employee is eligible to be granted permanent disability, for how much, and for how long. Since the exam is such a crucial aspect of the employee’s status, it is good to know what to expect beforehand. Read on to answer the question of “What happens during a work comp independent medical exam?”

IME Expectations

Generally speaking, an IME is scheduled when there is a question as to the validity of an employee’s claim to work-related injuries, illness, or the nature of medical treatment. For an IME exam, a doctor that is not your regular doctor will examine you. They will be documenting your the severity of your medical condition, any necessary treatment, and assess your ability to continue work. The insurance company can use these findings as evidence against you. If the doctor rates your disability as low and not debilitating, the insurance company can lower their offer of a disability award.

In theory, the IME doctor is supposed to be impartial, but unfortunately, that is not always the case. The insurance company often chooses the doctor to conduct the exam, and the doctor gets paid by them for performing the exam. As the IME doctors want to continue getting referrals and getting paid for them, some are likely to tailor their reports to the best interest of the insurance company.

IME Interview

Your IME exam will begin with an interview, during which the doctor will ask you a series of questions related to your condition. Questions to expect may include your medical history, your daily tasks at work, how you were injured on the job, what symptoms you are experiencing, and your ability and willingness to return to work. Be ready to answer questions about your health prior to receiving your workplace injury. The doctor will be looking for indications of an underlying condition that could have contributed to the workplace injury.

The doctor will be looking for signs that you are not telling the truth or are exaggerating the nature of your injury and inability to work. Your answers will likely be checked against your medical records to test your veracity. You may be asked the same question repeatedly to see if your answers are consistent. If the doctor suspects you are being dishonest, it will be noted in their report, and this will affect the outcome of your claim.

IME Exam

After the interview, the doctor will start the exam. Your basic health will be checked first such as blood pressure, breathing, heart and lungs. They will look in your mouth, ears, and nose. After the basic portion is done, they will switch their focus to the specific work-related injury. The doctor will ask you relevant questions and gauge the severity of the issue. Their findings will then be put into a report and sent to the insurance company, according to [dcl=6679].


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