Striving for Quality IMEs

January 24, 2018

A good independent medical examination (IME) can assist in determining injury causation and disability rating, assist in formulating a treatment protocol and gauge return to work parameters. A recent white paper, “The Quality Divide: Are You a Leader or a Laggard in Quality IME Practices?” by Genex, discusses the benefits of IMEs as well as how workers’ compensation insurers and third-party administrators can create a quality IME process.

According to the white paper’s author, Michael Valasek, vice president of IME Services, there are three factors to ensure a quality IME process. They include:

  1. Claims Staff
  2. IME Vendor
  3. IME Doctor

He indicated several key criteria that claims staff should consider, including using an IME vendor to ensure a quality physician is selected, making sure the request for an IME is timely, and outlining a clear objective with specific questions for the IME doctor to address in his or her report.

Because it can be difficult for claims staff to identify appropriate, qualified IME doctors, vendors must remain impartial and conduct background research on a broad pool of doctors. In addition, vendors can assist in rounding up the pertinent medical records the doctor will need to assist them during the IME. Valasek noted that IME vendors will also have knowledge of jurisdictional differences in the requirements related to IMEs.

Quality IME doctors will have reviewed medical records and diagnostics prior to the patient’s visit, as well as the specific questions outlined in the IME request. Lastly, IME doctors may uncover previously undiagnosed conditions.

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