Independent Medical Examination
How, Why, and What to Look For
Presented by:
Jeffrey E. Hickcox
The Workers’ Compensation Act provides for employer/insurer-selected independent medical examinations under O.C.G.A. § 34-9-202(a). This provision allows "physical, psychiatric and psychological examinations as well as reasonable and necessary testing, including Functional Capacity Evaluations. " Board Rule 202(a). The statute does not limit the number of times the employer/insurer may request an IME. Further, the IME is available in both compensable and denied claims. Rather, it is available "[a]fter an injury and so long as he claims compensation..."
The procedure for the employer/insurer IME is found in Board Rule 202(b). The employer must give ten days written notice of the time and place of the evaluation. Further, advance payment of travel expenses must accompany the notice of the evaluation. Failure of any portion of these requirements gives the claimant a reason to avoid the IME.
Effective July 1, 1990, claimants were given the right to a one-time IME with a physician of their own choosing. O.C.G.A. § 34-9-202(e). However, the right to an IME is limited to compensable claims and those in which income benefits have been received in the last sixty days. The examination must take place within the state or within 50 miles of the claimant’s residence. The claimant must give notice in writing in advance of the appointment to the employer or insurer; however, there is no requirement that it be a certain number of days before the evaluation. The IME may not repeat any diagnostic tests unless the costs of such tests, which exceed $250, are paid for by a party other than the employer or insurer.
An IME is often requested to obtain favorable medical evidence. It may also be used to get a second opinion about surgery, treatment options, impairment ratings, or virtually any other purpose. The physician performing the IME should be well informed about the case history and what information is being sought by the IME. Medical records should be provided well in advance of the IME so that the physician has an opportunity to review the case prior to the evaluation.
[Discussion of IME’s and medical issues attendant thereto to be led by practicing orthopedic surgeon.]
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