In Case You Missed It! Top 3 takeaways of the Case Resolution Series

Claims Takeaway: 3 Crucial Factors to Keep in Mind When Ordering an IME 

1. Timeliness. When there’s an opinion in question, a request for an IME should be made as promptly as possible to clarify issues early on. For example, perhaps an adjuster is unsure about the cause of the injured employee’s pain. There have been situations where a claimant received workers’ comp benefits for years, but causation was never officially confirmed. If this step was taken, the claim might not have been accepted in the first place. Once a case has started down a certain path, it’s difficult to make a significant change in direction. So, if an adjuster suspects treatment is deviating from normal guidelines, he or she should request an IME before the plan proceeds too far to be able to make changes. 

2. Clear Objective. To obtain a useful IME result, it’s also imperative to provide the examining physician with a clear objective and any specific questions that should be addressed in the final report. This allows IME physicians to understand what they’re being asked to evaluate. Is the exam to determine if further care is needed, the level, if any, of permanent disability or another concern? At the same time, it’s also important to limit these inquiries so the IME physician can focus on evaluating just a few items during the examination. 

3. Comprehensive Background. Remember the IME physician should receive all relevant background, as outlined above, including a complete medical record, diagnostic test results, job descriptions and claimant statements—all well in advance of the exam. 

When On Point returns: Trust trumps everything!  How Trusted Expertise impacts Forward-Thinking Claims Management.  An IME offers the clarity needed when opinions diverge—because what comes next could change the entire course of a claim. 

If you are ready to explore further, download the entire IME eBook here: Emperion eBook. 

If now is the time to request an exam, visit our online referral form.