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Medical Evaluations

What is an IME?

An IME (Independent Medical Evaluation) may be conducted to determine the cause, extent and medical treatment of a work-related or other injury where liability is an issue.  The evaluation determines whether an individual has reached maximum benefit from treatment and whether any permanent impairment remains after treatment. An IME may be conducted at the request of an employer or an insurance carrier. The IME is used to obtain an independent opinion of the clinical status of the individual. Workers’ Compensation insurance carriers, auto insurance carriers, and self-insured employers have a legal right to this request. Should the doctor/therapist performing the IME conclude that a patient’s medical condition is not related to a compensatory event, the insurer may deny the claim and refuse payment.

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What is an AME?

If you, your attorney and claims administrator do not prefer to go through the state system for creating a IME Panel you can agree on a single physician to conduct the evaluation. This doctor is called an AME (Agreed Medical Evaluator).  The AME doctor can do an IME, but does not have to as long as everyone agrees on the selection. However, if you would prefer to use an IME, the Department of Workers Compensation can provide a list of IME-qualified doctors from which to choose. An important point: You can only obtain an AME if you are represented by an attorney. Once you use an AME , you cannot use an IME afterwards.

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