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Independent Medical Exams (IME) – Great Article On Basics

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Independent Medical Exams (IME)

Workers Comp Independent Medical Exams (IME’s) can be a great risk management technique when used properly.  IME’s are worth the time and cost in certain circumstances.

Picture Of Medical Personnel Independent Medical Exams In Hospital
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The  final diagnosis and medical opinion by the IME physician may often agree with the current medical treatment and future treatment plan. However, knowing that the injured employee is receiving the proper medical care is of the utmost importance.

This is a great basic article on the mechanics of the IME process.   If you are not familiar with the process, I do recommend reading the articles on the first two links in this article.

One possible way to reduce the need for IME’s is to have the proper medical treatment network from the day the claim is reported until its conclusion.  Controlling the medical is one of the Five Keys to Reducing Your Workers Comp Costs.

The treatment network will usually consist of:

  • General Practitioner/Walk-in-clinic – original treating physician
  • Orthopedist/Orthopedic Surgeon
  • Pharmacy
  • Physical/Occupational Therapy
  • Dental – may not be used that often, but still need to have one in place
  • Optometrist/Ophthalmologist – may not be used that often, but still need to have one in place
  • Hospital
  • Ambulatory Surgery Centers
  • Radiological – especially MRI’s
  • This is not an exhaustive list
Physicians Independent Medical Exams Looking At Folder
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Some states require the employer to have a panel of physicians for the employee to choose from when receiving treatment for their injuries. Other states allow the employee to have the choice.  The number of states that allow employee choice has been shrinking over the last few years.

Most Third Party Administrators (TPA’s) and carriers will usually have a medical treatment network in place that will save even more on the cost of  medical treatment.

The bottom line is the treating physician may be seen by the WC Board or Industrial Commission as the only impartial witness in the claims process.

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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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