What is an Independent Medical Evaluation (IME)?

In Canada and the United States, IMEs are variously known as impartial medical examinations, binding medical examinations, medical tiebreaker examinations, defense medical examinations, agreed medical examinations, or neutral medical examinations.

IMEs can be used and useful in numerous ways. The independent medical examination process can be helpful in delivery of care to the injured. It can provide confirmation of the treating physician's diagnosis and plan of care. It can provide alternative treatment recommendations that may not have been considered. The IME can also weed out inappropriate claims and assist in "case closure", where appropriate coordinated services are not being provided and disabilities are unnecessarily prolonged. (See The many roles of IMEs.)

Independent medical evaluations (IMEs) are examinations performed by a healthcare professional who has no other involvement in the examinee's care, to establish current clinical status and clarify legally significant case issues - medical and other. IMEs are performed to provide current, impartial information for case management and /or for use as evidence in hearings and other legal proceedings. They are a component of all workers' compensation statutes.

Significant responsibility is assumed when performing an independent medical examination/evaluation. The examiner's impartiality must be rooted in awareness that the IME report will have financial and social impact on the examinee, the requesting client and other participants.

The IME report must reflect specific IME training (knowledge, skills and abilities), the quality of the evaluation, and address in a clear and defensible manner the questions posed.

Independent medical examinations/evaluations vary in complexity, dependent upon the case specifics and issues. Dependent upon the case and the examiner's effectiveness, the process may require hours of examiner time. Most evaluations, however, are based on a single visit by the examiner.

An IME involves the essential elements of a medical assessment, including history, examination, and review of applicable diagnostic studies.

The sole purpose of an IME is to provide information to the client who requested the evaluation. Therefore, although an IME involves a provider (examiner) and a patient (examinee), the IME is not a "doctor-patient treating relationship", and no such relationship is established. Providers involved in normal treating relationships with their patients are bound by medical practice ethics and expected to be patient advocates while providing optimal and appropriate treatment.

Examiners who render IMEs are providing a service to an insurer, employer, entity or attorney by utilizing medical knowledge and medical skills to appropriately evaluate the available medical records and examination findings, and render specific opinions for questions that have been raised.