Independent Medical Exam (IME) Can Easily Blow Up A File
An Independent Medical Exam is one of two-edged swords in WC Risk Management. One of the most controversial and fund-leaking Risk Management techniques for Workers Compensation is the Independent Medical Exam (IME).
This list is not just for adjusters. Anyone that comes in contact with the process should keep the following list in mind. IME’s are a great tool when used properly. IME’s are also one of the riskier techniques to control WC costs. A few considerations before scheduling an IME are listed below. The most detrimental to the WC file is an IME that:
- Can backfire if :the claim is from a state that allows directed medical care.
- Is performed on a very old claim with no prior IME’s
- Is not discipline-specific
- Takes the claim on a tangent
- Starts with one of those form letters – not good
- The physician may not like the fee schedule and wants to be paid more than the CPT code allows – touchy subject
- The court has seen reports from the same physician too many times
- The treating physician is not informed an IME has been requested for a 2nd Opinion
- Does not have all the medical records included with the IME request letter
- Is rushed so heavily the IME physician is not given time to review records and do a full report
This article was going to be an all-in-one analysis. The article would have been too long if each was of the 10 was enumerated now. There will be two follow-up articles as this is a very important WC risk management consideration.
An Independent Medical Exam can be the most expensive and time-consuming risk management techniques on a Workers Compensation file. Following the above list should help in avoiding the pitfalls.
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