What is an Independent Medical Examination?

An independent medical examination (IME) is a clinical assessment performed by a medical professional, also called an independent medical evaluator. These healthcare experts have no previous connection to the patient or claimant being assessed. Choosing these professionals helps to reduce bias and is usually requested by an insurance company to analyze and confirm the extent of an injury or illness. IMEs could also be requested from lawyers, employers, or case managers.
 

IMEs are common in worker's compensation claims. For example, if you have injured your back at work, you will need to file a worker's compensation claim to cover medical expenses and lost earnings. Before any payments are made, the insurance company responsible for covering this cost may want to verify your injuries. Assessing the situation with a third-party medical expert not only protects insurance companies from potential fraud but also ensures they are paying for the necessary treatment for the worker to fully recover. 

Top Common Questions During an IME

Preparing for an IME can be nerve-wracking since your compensation lies in the hands of a professional you've never met before. Nevertheless, being honest and straightforward will help you through the process.

Below, you can find some common questions that an independent medical evaluator may ask during an IME. These questions can vary depending on your medical history, the type of claim being processed, and the overall reason for the IME.

Questions about your medical history: 

The IME will inquire about your overall medical history to gain a comprehensive understanding of your overall health. This will aid them in determining any pre-existing conditions and if they have contributed to the injury at hand. 

• Do you have any previous injuries? This could include other work-related injuries.
• Do you have any permanent disabilities, and if so, to what extent?

Injury:

The IME will ask about the injury itself and the conditions in which it occurred. These answers will help them in determining the extent of the injury and the overall health concern.

• How did you injure yourself?
• What are your symptoms?
• Have these symptoms changed over time?

Pain and Functioning:

Next the IME will most likely ask about the pain and functioning that has occurred due to the injury. It’s important to answer these questions honestly to help the IME determine the full extent of your injury.

• Can you rate your pain on a scale from 1 to 100?
• Are there specific activities that worsen your pain or symptoms?
• Are there activities you can no longer perform?

Treatment:

The IME will inquire about treatment options you may be receiving to gain an understanding of what therapies may be in place already. 

• What treatments have you received for your condition?
• Have you been treated for this condition before?
• Are you currently taking any medication?

Lifestyle and Daily Activities:

Lastly, the IME will ask about your activities of daily living and if the current injury has impeded your ability to perform activities or impede your quality of life. 

• Can you describe a typical day for you since your injury/illness?
• Are there any activities you are unable to perform due to your condition?
• Do you require assistance with personal care or household tasks?

Next Steps

Ultimately, it's important to remember not to downplay your injury or illness, but also not to exaggerate it. State the facts and be as transparent as you can. After your IME, the independent medical evaluator will create a detailed report and submit it to the insurance company (or whoever requested it). Consider asking for a copy of your IME report for your records. Keeping it in your records could come in handy later, especially if you and your healthcare team need to challenge any points in it with your own detailed response.