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What is An Independent Medical Exam (IME)?

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Independent Medical Exam Extremely Important to Work Comp

The Independent Medical Exam is one of the best after-the-fact risk management and loss reduction strategies available to claim departments.  term of the day. The term mean when an insurer requests an examination of a claimant by a doctor other than the attending physician.   

Picture of Doctor Doing Independent Medical Exam Of Patient
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The previous classic definition leaves out one area.  The injured employee may request an Independent Medical Exam also, but then the confusion starts once again as it that appointment an IME or is it a second opinion.   Regardless, claims adjuster, risk managers, etc. forget that the employee can request an IME anytime during their treatment.

The State Workers Comp Boards rubber stamp those requests from employees.  Has anyone ever seen the situation where the state rejects an employee-requested IME?   I have not seen one unless the injured employee has already requested one or several.

Often IMEs are a tool used by the defense in a claim dispute. In this case, the purpose is to diminish the severity of a medical claim. .IMEs can also be used to defeat medical claims.

One of the great debates begins with the phrase “Is a second opinion on a surgery an Independent Medical Exam”?

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James J Moore - Workers Comp Expert

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Management Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications

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