What is an IME (Independent Medical Examination)?

Lawyers and insurance professionals often request Independent Medical Examinations (IMEs). In these appointments, an independent doctor assesses the overall health of the patient. Depending on the case, the IME may focus on any specific area of the patient’s health. People can receive neurological, general, cardiac, and psychological IME.

IME doctors serve as expert witnesses in many situations. Therefore, it’s essential that they are impartial to both sides of a case. Through their examination, they determine if a patient has certain health conditions that are relevant to the situation at hand.


Who Can Perform IMEs?

An independent doctor is a fully licensed medical professional who does not know the patient and has never been involved in the person’s medical care. IME doctors should be board certified in the area of medicine for which they are examining. For example, patients should not see an oncologist for a psychological IME.

Neurologists, psychiatrists, and psychologists all care for the mental health of their patients in different ways. So, some patients wonder what type of doctor they need to see for their independent medical examinations. The answer depends entirely on the case and what facts are in question.

For example, if a central question revolves around a person’s emotional or mood disorders, a psychiatrist will likely be the most appropriate doctor, although a psychologist may work for some instances. However, if the question is whether the person can retain memories, a neurologist may help more.


Why Would Someone Need an Independent Medical Examination?

Patients who seek help at their own volition and to address emotional issues do not need independent medical examinations in psychiatry. These specialized sessions exist for those times in which a person’s mental or physical state is in question. The most common reasons for independent medical examinations are workers’ compensation claims, insurance, and criminal court.

Workers’ Compensation

Insurance companies may ask for independent medical examinations for workers’ compensation claims. For example, if a first responder has PTSD and needs workers’ compensation benefits while they heal, the insurance company and employer may need an independent doctor to confirm the diagnosis first.

When a workers’ compensation firm insists on seeing an IME report, it does not necessarily mean that the organization does not believe the person who is making a claim. Instead, companies typically make this routine for all requests.

Settle Insurance Claims

Insurance companies may request claimants receive IMEs before paying out a claim. Because claims can be expensive for insurance companies, they want to ensure that no fraud is taking place.

A claimant can be the person who holds the policy, such as when someone must use disability insurance. The claimant can also be someone who files against the policyholder. For example, if someone sues you and the insurance company wants to prove that the person is a pathological liar.

Court Ordered IMEs

Lawyers may send their patients to get IMEs as well. In popular culture, and sometimes in real life, attorneys use “the insanity defense” to prove that the court should not hold their patients responsible for certain crimes.

IMEs may also be necessary for certain civil court cases. When one private party files suit against another, the court may wish to see evidence of either party’s mental fitness.


What are Psychological Independent Medical Examinations Like?

The questions that the examiner asks depend mainly on the case itself as well. Doctors do not ask leading questions that prompt specific answers. Instead, they give open-ended prompts. The following discussions allow professionals to understand each patient’s overall mental state better.

Assessments can go on for several hours at a time. One court ruled that doctors can take as long as six hours, but this is unusual. During that time, patients may also take written psychological assessments, which ask standardized questions.

What Happens During an IME?

When patients are unfamiliar with the IME process, it can feel daunting. However, a little preparation and a basic understanding of what to expect can help ease the nerves.

It’s vital for patients to know that the physicians are not here to make them look bad or judge their moral character. They are not “playing for one side” or trying to catch people in a slip of the tongue. They are merely making diagnoses. Understanding the neutrality of an IME doctor sometimes eases the fear.

Prepare Before Your Examination

The day before the test, patients should gather all medical diagnostic paperwork they can find. Patients should also write down the names and dosages of any medications they regularly take, including over-the-counter supplements. Finally, they should get plenty of sleep the night before, as being tired only makes things harder.

Right before the tests, patients should eat good-sized meals that will keep them satisfied for a few hours. They may also wish to dress in relative comfort. Professionals allow patients to take breaks during the examinations. They should come with snacks and drinks and take these breaks as needed. These sessions can be mentally taxing, so it’s perfectly reasonable to need a moment to collect oneself.

Know Your Rights

The very act of getting an IME can be stressful for anyone. However, some types of stress and discomfort are never okay. Professionals must always be respectful of a patient’s race, religion, gender, abilities, and sexual orientation.

They should never humiliate, restrain, isolate, or exploit a patient. This restriction includes asking for money in exchange for a favorable report.

Patients should never need to disrobe for longer than a medical test makes necessary. As with all medical appointments, patients in IMEs also have rights to privacy.

If any part of an IME makes you question a doctor’s ethical standards, ask questions and report to the appropriate authorities.


Who Chooses the Doctor?

Each state has different laws regarding IMEs and patient rights. Who chooses the IME doctor may also depend on the specific case and who requests the test in the first place. For example, an employer may ask for an IME to determine when an injured worker can return. In this case, the employer may provide a list of approved doctors. This list limits the patient’s ability to choose a doctor they know but also gives the worker some freedom of choice.

Georgians also have the right to request a new doctor once. This right protects the rights mentioned above. If a physician violates the patient in some way, the patient should seek the care of another provider. However, the doctor must be on the approved list.

If a patient wants to prove that his or her mental state makes them not guilty of a crime, lawyers may suggest a reputable doctor. Any time a patient needs to have an IME for any reason, it’s a good idea to contact an experienced attorney. These professionals can guide patients through the complicated legal system surrounding IMEs.

Patients can also contact a GBHP clinic for more information. We have the experience and knowledge to help patients find the care they need. We can point you in the right direction.

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Katie Butler, APRN-BC
Stress, Schizophrenia, Bipolar Disorders, and 9 more.