Independent medical examination

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An independent medical examination (IME) occurs when a doctor/physical therapist/chiropractor who has not previously been involved in a person’s care examines an individual. There is not 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.

While called "independent" medical examinations, these examinations are conducted by doctors/therapists who have been specifically selected by the insurance carrier, where the insurance carrier stands to save substantial amounts of money if the IME doctor/therapist determines the patient to be fully recovered and/or without impairments and/or at maximum medical improvement. Insurers therefore pick very insurer-oriented physicians. Some doctors/therapists, particularly board certified specialists, in some jurisdictions earn well over one half million US dollars per year just for performing IMEs and the substantial testimony fees following from same where their opinions are favorable to the contracting insurer.

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