What is an IME?
An IME, or Independent Medical Examination, is a way to create an independent, objective medical record for an individual. They are often requested by attorneys or insurance companies involved in cases related to a patient’s health or mental health. IMEs can center on anything from a person’s neurological or cardiac health to their general or psychological well-being.
The doctor who conducts the IME may then serve as an expert witness in court. This means that their objectivity as a third party must be maintained during and after the diagnostic process.
Who Conducts an IME?
IMEs are conducted by independent doctors who have never known or treated the patient before. These doctors should be board certified in the medical specialty in question to ensure their expertise on a medical topic. In other words, a podiatrist cannot conduct a psychological or cardiac IME.
In the world of mental health, an IME may be done by a neurologist, a psychiatrist, or a psychologist, depending on the details of the case. If a patient’s mood disorder is the focus of a case, then a psychiatrist might conduct the IME. If a person’s faulty memory is in question, then a neurologist may be required.
Why Would Someone Need an Independent Medical Examination?
IMEs are not done on patients seeking out help for themselves. They are typically conducted as a result of a criminal case, a worker’s comp claim, or an insurance claim in which the patient’s health and mental wellness are at the heart of the issue.
When a worker files a worker’s compensation claim, the insurance company sometimes requests an IME to confirm the claimed diagnosis. As an example, a person with a high-stress job may file a claim for benefits as they recover from PTSD; in this scenario, the insurance company would want an IME to confirm that PTSD is, in fact, the correct diagnosis for that patient.
An IME for worker’s comp is par for the course. It does not imply disbelief, necessarily, on the part of the insurance company, but rather demonstrates that they are doing their due diligence.
IMEs for insurance companies work much in the same way. An insurance company requests an IME to make sure that a claimant is indeed suffering from the health issue listed in an insurance claim. In some cases, the IME may be for someone suing the insurance company’s client; in this scenario, the insurance company may want to demonstrate that the claimant is delusional or plagued by pathological lying.
IMEs Ordered by the Court
Sometimes, criminal attorneys want their clients to get a psychological IME to prove that they were not in their right mind when committing a crime. In other civil cases, attorneys or the court may request an IME to prove that parties involved in a case are mentally fit.
What Happens in a Psychological IME?
In a psychological IME, the doctor works to put together an accurate picture of the patient’s overall mental health. This begins with the doctor asking open-ended questions that ideally lead to an ongoing discussion with the patient. These assessments can take some time, running for several hours. Patients may also need to respond to scales or questionnaires and take psychological assessments.
Patients who have never been through an IME may feel nervous going in. Knowing what happens in a session can help the patient approach the situation as calmly as possible.
What patients need to remember above all else is that the doctor conducting the IME is an objective third party. They do not have an agenda, and they are not trying to “get” anyone. Realizing that an IME doctor is neutral can make the process far less stressful for the patient.
Preparing for an IME
Before an IME, patients should gather any and all paperwork they have related to their medical condition, along with a list of any prescription medications they are on. This should include OTC medications, such as analgesics.
As much as possible, the patient should rest and relax the night before. A full night’s sleep will put them in good stead for the long process of an IME. Patients should wear clothing and shoes that they will be comfortable in for the duration of the day. They should also bring food and drinks that they can enjoy during regularly scheduled breaks.
Know Your Rights
It is important to know your rights, too, when having an IME. No health professional can be disrespectful of your race, gender, religion, sexual orientation or abilities. The doctor conducting your IME is also not allowed to shame you, restrain you, or isolate you. Above all, a doctor should not ask for a bribe as payment for an IME that is favorable to you.
An IME is also a medical procedure, so you have a right to privacy under HIPAA regulations.
If you have concerns about the ethics of a doctor conducting your IME, report your concerns to appropriate authorities.
Who Will Choose my IME Doctor?
This depends on the laws of your state. It can also depend on the type of case in which you are involved. If the company you work for needs an IME to determine whether or not you can go back to work in a worker’s comp case, your employer will generate a list of IME doctors approved of by their insurance company.
In some states, you will have the right to request a new doctor one time during the process. This is set up to protect your rights as listed above. If a doctor violates your rights, you can request a new one, but it may need to be from the original approved list.
In criminal cases, your attorney may suggest the doctor. Any patient involved in a case with an IME should consult with their attorney.
You can also reach out to us for guidance in this matter. Our mental health professionals have experience with IMEs and can help guide you through this complicated process.