Impairment Tutorial: Spinal Cord Stimulation and Intraspinal Opioids:Impairment Rating Issues
James B. Talmage
Search for other papers by James B. Talmage in
Current site
Google Scholar
Leon H. Ensalada
Search for other papers by Leon H. Ensalada in
Current site
Google Scholar
Restricted access


Evaluators must understand the complex overall process that makes up an independent medical evaluation (IME), whether the purpose of the evaluation is to assess impairment or other care issues. Part 1 of this article provides an overview of the process, and Part 2 [in this issue] reviews the pre-evaluation process in detail. The IME process comprises three phases: pre-evaluation, evaluation, and postevaluation. Pre-evaluation begins when a client requests an IME and provides the physician with medical records and other information. The following steps occur at the time of an evaluation: 1) patient is greeted; arrival time is noted; 2) identity of the examinee is verified; 3) the evaluation process is explained and written informed consent is obtained; 4) questions or inventories are completed; 5) physician reviews radiographs or diagnostic studies; 6) physician records start time and interviews examinee; 7) physician may dictate the history in the presence of the examinee; 8) physician examines examinee with staff member in attendance, documenting negative, physical, and nonphysiologic findings; 9) physician concludes evaluation, records end time, and provides a satisfaction survey to examinee; 10) examinee returns satisfaction survey before departure. Postevaluation work includes preparing the IME report, which is best done immediately after the evaluation. To perfect the IME process, examiners can assess their current approach to IMEs, identify strengths and weaknesses, and consider what can be done to improve efficiency and quality.

  • 1.

    Fanciullo GJ, Rose RJ, Lunt PG, et al.. The state of implantable pain therapies in the United States: a nationwide survey of academic teaching programs. Anesth Analg. 1999;88:13111316.

    • Search Google Scholar
    • Export Citation
  • 2.

    Talmage JB, Brigham CR. Rating pain after a musculoskeletal injury. The Guides Newsletter. July/August 1997, 45.

All Time Past Year Past 30 Days
Abstract Views 130 130 40
Full Text Views 21 21 0
PDF Downloads 0 0 0