Clients who request an independent medical or impairment evaluation are more likely to obtain a quality report from an evaluating provider if they request the appropriate evaluator, provide needed information, and clarify the specifics of their referral. The referral should identify the information needed for the assessment, define the standards for the evaluation, and provide detailed questions to be answered. Failure to provide this information often will result in a poor outcome. The article includes a sample generic referral letter to an impairment evaluator; this example letter can be modified based on the specifics of a case. For example, a workers’ compensation case in California could include the question, What is the overall percentage of permanent disability caused by the industrial injury, and what is the percentage of permanent disability due to all other factors, including prior injuries? The generic referral letter instructs the evaluator to use the standards in the AMA Guides to the Evaluation of Permanent Impairment, (AMA Guides), Fifth Edition and refers the evaluator to Chapter 2, Philosophy, Purpose, and Appropriate Use of the AMA Guides. The article includes a sample paragraph that could be included in the generic referral letter and includes specific questions that address statutory requirements under California law, along with instructions about apportionment decisions and documentation.

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