Independent medical examinations (IMEs) are performed by a physician or other health care provider who is not involved in the injured worker's treatment. IMEs are done at the request of the insurer to clarify medical or legal issues.
Oregon worker's comp rules allow insurers to request IMEs to obtain an unbiased opinion by a clinical specialist.
Authorization and training
To perform IMEs on injured workers, a provider must be authorized by the Oregon Workers' Compensation Division (WCD). For more information on becoming an authorized IME provider, contact WCD at 503.947.7606.
Because it's important that an IME physician understand the Oregon workers' comp rules and laws in effect at the time of the examination, they are trained on legal standards.
Purpose of IMEs
IMEs may be requested to:
- Provide a diagnosis or a treatment plan
- Provide an opinion on the cause of a worker's medical condition based on specific legal standards
- Conduct a closing evaluation; the attending physician must concur in order to close the claim.
The attending physician's role
Independent medical exams are a component of the medical or legal analysis. The attending physician is provided a copy of the IME report within 72 hours of the insurer receiving it.
The reports are sent to the attending physician for informational purposes, but in certain circumstances the AP is asked to review and comment on the opinion of the IME doctor. This is also the AP's opportunity to read the IME report and provide their own medical opinion.
IME exams can occur anytime during the process for each open period of a claim, up to three times.
IME exams can vary in complexity, depending upon the specifics of the case and the issues involved.