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.
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.
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