Fundamental Principles of Independent Medical Examination
Steven Feinberg
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Christopher R. Brigham
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Abstract

An independent medical evaluation (IME) is a specialized examination or evaluation best performed by a physician who has special training and experience in assessing issues unique to an IME. IMEs must be independent, and opinions should be consistent and impartial and based on evidence-based medicine. An IME includes the essential elements of a medical assessment, including a history, a physical examination (usually), and review of records and studies, followed by clinical impressions or diagnoses, and then by recommendations. The medical assessment may include other practitioners, eg, psychologists and chiropractors. Depending on the referral request, the IME typically discusses disability (the definition depends on the local jurisdiction) based on deficits in the person's activities of daily living. In the IME, the evaluator may be asked to consider claims issues that include causation, apportionment, impairment, work ability, appropriateness, and costs of medical care and/or future needs. The physician who performs the examination does not provide care to the individual and provides medical opinions about issues associated with the case. Impartiality, objectivity, and an understanding of medicolegal issues are required of the evaluator. IME reports are not confidential and likely will be read by many stakeholders in a claim. Accordingly, nonmedical personnel should find it easy to read and understand the IME.

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    Brigham CR, Direnfeld LK, Feinberg S, Kertay L, Talmage JB. Independent medical evaluation best practices. Guides Newsletter. September/October 2017.

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