If an injured employee at your company has been instructed to have an Independent Medical Examination, or IME, you may both have questions about what’s involved. We’re often asked about “The IME process,” so let’s take a closer look.
What is an IME?
The first thing to know is that IME’s are usually a good thing for everyone involved. In Washington State, they are ordered by L&I claim managers when there is a question about the recovery of an injured worker, in areas such as:
- Treatment plan
- Contended conditions
- Impairment rating
- Necessity of surgery
The IME allows the injured employee to be seen by one or more examiners who are board-certified or otherwise qualified under the Washington Administrative Code. The examiners are all coordinated in a single visit, which saves time, travel, and hassle for the employee. Meanwhile, L&I, your company, and your Retro group, get the assurance of an evaluation by an impartial medical professional. This second medical opinion often saves significant time and expense.
How does an IME work?
The L&I claim manager will provide the examiner(s) with claim documents, a brief summary of the reason for the IME, and any specific questions to be addressed. If you’re an Approach client, we’ll review these questions to ensure they address all relevant concerns, along with Return-to-Work issues, if necessary.
Once the IME visit is complete, each examiner must then provide a report that meets the following requirements, per the L&I Medical Examiners Handbook:
- Document the review of the claim documents provided by the department or the self-insurer;
- Document the worker’s history and the clinical findings;
- Answer all the written questions posed…or include a description of what would be needed to address the questions
- Include objective conclusions and recommendations supported by underlying rationale that links the medical history and clinical findings;
Most of all, it must contain “objective, sound and sufficient medical information.” The examiner is not allowed to offer treatment for any conditions identified, providing extra assurance of their impartiality — they have no interest in recommending additional treatment.
How do IMEs affect employers?
The IME doesn’t require any special action on your part as an employer. If you are an Approach client, your Approach Retro Coordinator will keep you updated as the examination is being scheduled and once the results are in. If you are told that your injured employee will have an IME, consider it a “win” in the claims process. After all, you’ll soon have a report from one or more providers who have seen your employee and been an extra pair of eyes on the claim. At least, you’ll have some answers and at best, potentially big savings on claims costs and your L&I account!