What does an Independent Medical Examination (IME) mean?

What does an Independent Medical Examination (IME) mean

If you have a workers compensation claim, at some point it is very likely that the workers compensation insurer, or your solicitor, will ask you to submit to an Independent Medical Examination, or IME.

At Bourke Legal, we see a lot of workers injured in NSW who tell us in their initial appointment, when asked the question “who is your treating specialist?”, that the specialist IME doctor they have seen, is their treating specialist. It’s a common misunderstanding that the IME doctor is a treating doctor, when they are not.

The IME doctor is not there to treat you. You are not his or her patient – there is no patient-doctor relationship between you. The doctor will report back to the insurer, or your lawyer, on the examination, and everything you say during the examination.

What is an Independent Medical Examination?

An IME is an examination by a doctor with a specialty relevant to your type of injury. If you have a psychiatric injury, you might be asked to see a Psychiatrist. If you have a back injury, you might be asked to see an Orthopaedic Surgeon or a Neurosurgeon. If you have a brain injury, you might be asked to see a Neurologist.

The doctor is provided with a brief of information by the referrer. The doctor will:

1. Review that information;

2. Interview you (which may involve asking a range of questions about your medical history, what caused your injury, how the injury affects you now, and the treatment you have received); and

3. Depending on the type of injury you have:
– administer various tests; and/or
– carry out a physical examination (if you have a physical injury).

Why might I be referred for an Independent Medical Examination?

The insurer, or your solicitor, might need an opinion on what caused your injury, the medical treatment which is reasonably necessary for your injury, your capacity for work, or the level of permanent impairment you have sustained as a result of your injury

What happens after the Independent Medical Examination?

If the IME referral was by the insurer, the doctor will provide a copy of that report (or sometimes just a part of it) to your nominated treating doctor (usually your General Practitioner). The insurer will only provide a copy of that report to you if the insurer decides to use the report to:

1. Decline liability for all, or part of, your claim; or
2. Reduce your workers compensation benefits.

If the IME referral was by your lawyer, your lawyer will review the report and explain to you what it means and how it is to be used in relation to your claim.

Who pays for the Independent Medical Examination?

The referring party pays for the cost of the report.

What about my costs of getting to and from the appointment?

If the referring party is the workers compensation insurer, the insurer will also pay for the cost of travel – whether that be flights, accommodation, mileage or meal expenses.

If the referring party is your lawyer, and you have funding from IRO for your claim, IRO will pay the cost of travel – including flights, accommodation, mileage or reasonable meal expenses. If you are an exempt worker (a police officer, firefighter or paramedic) and unable to obtain funding from IRO, your lawyer will usually pay the cost of travel, and will be reimbursed by the insurer for these costs at the successful conclusion of your claim.

What do I do if I have a problem with the examination?

If you’re not happy with anything during the examination, you should tell the doctor immediately.

If you need to undergo a physical examination, you should not be in pain during, or after the examination. If you feel your injury has been worsened by a physical examination, you should immediately report this to the doctor, the insurer, and your lawyer.

More information on your rights in relation to Independent Medical Examinations can be found here.

The information in this blog is not intended to be legal advice, and should not be taken as such. If you have any queries, contact us now on 1300 026 875 to discuss your specific circumstances.

All initial consults with our firm are free of charge. If you have an NSW workers compensation claim, you may be eligible for funding by IRO, or, if you are an exempt worker, your legal costs will be paid by the insurer upon the successful conclusion of your claim.