The pre-evaluation phase of an independent medical evaluation (IME) consists of several steps that lead to the evaluation itself. A table lists typical issues and tasks facing independent medical evaluators. The evaluation begins when the client requests an IME, and the scope of issues depends on the case's specifics and setting. The evaluating physician must understand the client's expectations and the nature of the evaluation, and specialists in the same field as the treating physician often perform the evaluation. Clients usually are responsible for obtaining medical records and other documentation. At the time of referral, the client is given the date and the time of the evaluation. Analysis of medical records is essential. Often, records provided by a client are disorganized or incomplete, and staff members can develop lists of records provided, identify missing items, and contact the client to obtain them. Staff also should notify the physician before particularly complex evaluations so the physician can allocate adequate time for a detailed review. Issues and deficiencies typically encountered in IMEs include the following: inadequate objective foundations for diagnoses and conclusions, undocumented findings, use of tests that lack validity and reliability, presence or absence of nonphysiologic and behavioral findings, and unsupported conclusions.

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