IME Cover Letter Effective Paragraph I Have Used Since the 1980s

Share on facebook
Facebook
Share on twitter
Twitter
Share on linkedin
LinkedIn

Recommended Paragraph For IME Cover Letter Paragraph – Used In 47 States

One of the most confusing parts of the IME cover letter is what information to request from the Independent Medical Exam physician.

I have seen many claims managers, supervisors, and adjusters just crank out their system’s IME Cover letter that often leads to having to call the physician’s office (sometimes not allowed) or write a follow-up letter.  Nothing makes an IME physician more frustrated than having to write another opinion letter.

pic of examination IME Cover Letter Paragraph
Wikimedia Commons – National Museum of Health and Medicine

 

One has to stop and ask themselves are there any extra items that you want the physician to cover.  One of the best ways is to use a familiar IME physician – but then again, the Workers Comp Courts do not like to see a physician repeatedly on your files.

Easy Way to Find An IME Physician

One easy way for assistance is to ask the rehabilitation nurse that is assigned to the file for recommendations.   You do have a rehab nurse assigned to the file, right?  Unless it is for a permanency rating, assigning a Field Case Manager usually saves 6 to 1 over the amount that you spent on them over the life of a file.  Check with your supervisor/manager on your company’s internal rules on assigning rehab nurses.

As an example, in a group of files I am reviewing, an adjuster resigned, and the supervisor took over on the files.  One thing they did immediately was to assign case managers to all files where the injured employee was going to be out of work for more than 30 days.

Sometimes, the rehab nurse/field case manager can assist with the letter.  Why use them to write the assist with the IME cover letter – because they are familiar with the nurses that work in the IME Dr’s. office. – my secret to you for the week. 

IME Cover Letter Paragraph

I usually use:

Please forward your opinion on (Fill In The Blank).

Please also include your opinion on the history, diagnosis, prognosis, treatment plan, length, and degree of disability, light-duty work recommendations, and any other important medical findings.   

Why would you ask these terms?

  • History – sometimes you may find out a different history of the accident or having the injured employee explain the past events in the claim can help your assessment of the claim.
  • Diagnosis – current health status
  • Prognosis- what the future looks like for the injury
  • Treatment plan – agreement or disagreement with the current treatment plan including future surgery
  • Important medical findings – this leaves open any medical info the IME physician wants you to know from the examination.

One very important matter is that you cc: the attorney is the claimant is represented.  Not cc:’ing the attorney is showing a lack of common courtesy which can affect resolving the claim later.

IME Cover Letter May Be Dictated By State

Your cover letter should follow the 3-3-3 rule that I invented, taught, and copyrighted for Workers Comp letters, phone calls, emails, etc.  Always keep the 3-3-3 rule in mind.

Check your State Laws on any requirements of an IME cover letter.  Some states have a form to send to the IME physician.   I have included the above same clause on the form.

Share on facebook
Facebook
Share on twitter
Twitter
Share on linkedin
LinkedIn

Table of Contents

Related...

James Moore

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt 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

Subscribe

Get the latest workers' comp news FREE!

Name
This field is for validation purposes and should be left unchanged.