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Independent Medical Evaluations (IMEs)

Health First Occupational Medicine

A physician or other healthcare provider not involved in the patient's care performs independent medical evaluations (IMEs) to provide information for case management and evidence in hearings and other legal proceedings. Although the specifics vary by state, IMEs are part of all workers' compensation statutes. In some jurisdictions IMEs may be known as impartial medical examinations, agreed medical examinations, binding medical examinations, or neutral medical examinations. Both of Health First Occupational Medicine's medical directors, Stephen MacDonald, DO, MPH, and Michael MacDonald, DO, MPH are certified to perform IMEs by the American Board of Independent Medical Examiners (ABIME).

An integral component of case management, IMEs are used universally by insurers, attorneys, and others involved in managing workers' compensation, personal injury, disability, and other cases. They may be performed at several stages during the cycle of injury/illness, treatment, rehabilitation, and return to work.

These evaluations may require hours of physician time and vary in complexity, depending on the specifics of the case, the issues involved, and the effectiveness of the physician. A single visit with the examining physician is usually sufficient.

The examiner keeps the three elements of an IME in mind: independent, medical, and examination. Evaluations are to be independent, impartial, and without bias toward the client. IMEs include the essential elements of a regular medical assessment — history, examination, and review of applicable diagnostic studies.

IMEs are not done for the purpose of treating a patient's medical condition, but to provide information to the client who requested the evaluation. Since a treating physician/patient relationship is not created, it's more appropriate to refer to the subject of the evaluation as the "examinee" rather than as the "patient." The examinee waives the right to the traditional doctor/patient confidentiality, so the report includes information gathered from the examinee that may be conveyed to the client requesting the exam.

Results of the IME that are sent to the requesting authority include:

  • Overall medical history
  • History of injury or illness with summary of the treatment and recommendations
  • Updated medical evaluation
  • Recommendations regarding possible need for further diagnostic studies
  • Assessments of whether the injury is permanent or temporary, if modified duty assignments are appropriate, and if rehabilitative services may be beneficial.

For more information and IME fee schedules, please call Health First Occupational Medicine at (321) 434-8878, or e-mail