Independent Medical Evaluation (IME)
An Independent Medical Evaluation (IME) can be assigned in several ways:
1. An IME provider can be selected by an insurance company, or a specialty IME company, on behalf of a company administering a short-term or long-term private disability insurance policy. IMEs are performed to provide current, impartial information for case management and/or for use as evidence in hearings and other legal proceedings. The IME examines the client to document the current nature of the disability, how the disability is impairing the client, whether or not the disability still is present, and what treatment modalities may result in decreasing the disability. There are also checks made to determine if there are any indications of malingering or exaggeration. The IME can provide confirmation of the treating physician's diagnosis and plan of care, or provide suggestions for further treatment that may not have been considered by the treating doctor.
California Regulations prohibit advertising as an Independent Medical Evaluator (AME) other than stating that such services have been provided in the past. Dr. Whitehead has indeed served as an Independent Medical Evaluator (IME) in past cases. Feel free to call Dr. Whitehead for any further information on the IME process, including scheduling availabilities and timeframes.
No listing here is meant to imply that there is any official or state-sponsored appointment, title or status as IME nor that any special tactical advantage, certainty of outcome, guarantee, warranty, favorable expectation, or prediction as to case outcome should be expected, if a decision is made to assign any IME case to this evaluator.
What can be counted on will be a professional evaluation based on skilled analysis of all case information and documentation; a thorough face-to-face evaluation with the client; careful consideration of case issues in the context of ethical and clinical standards and current clinical research; and a timely, well-written, concise evaluation report which answers all of the case referral questions in clear and practical language.
2. An IME provider can be selected by a Judge in the California Workers Compensation system to determine the cause of a condition or injury, the permanent impairment caused by the injury, and/or the permanent limitations, if any, that the worker has sustained. The IME will also serve to ‘apportion’ the claim, in other words determine what portion of the work injury led to the disability, and what portions came from other sources or causation, if any.
In a Workers Compensation setting, IME reports are used to help determine an injured worker’s eligibility for workers’ compensation benefits. In psychological injuries, which are referred to as Injury to the Psyche cases in the workers’ compensation world, the determination of the injury can be complicated. This is because of the many special rules and regulations that apply to psychological stress and injury claims.
Injury to the Psyche claims can develop out of general or specific stresses encountered in the workplace. Examples include sexual harassment, hostile work environment, stress and trauma from workplace robberies, and other complex workplace situations and dynamics between workers, supervisors, and co-workers. The determinations can be very complex, and the IME must do an excellent job of analyzing and reporting what has happened, and how this has affected the worker. The IME also has to consider the special State of California rules and regulations that apply in such cases.
Injury to the Psyche claims can also arise from physical injuries that lead to chronic pain, such as a back injury, neck injury, shoulder injury, severe hernia, broken bones, machinery accidents that create physical injuries, and any other problems that lead to chronic pain. Chronic pain can sometimes lead to the development of depression, anxiety, mood instability, sleep problems, and other related problems.
Head injury and brain injury are also assessed by IME’s. These can result from blows to the head during robberies, exposure to toxic substances, vehicle accidents, machinery malfunctions, and a variety of other incidents in which brain function has been affected. Dr. Whitehead even once evaluated an injured worker who was thrown from a horse at work, landed on his head, and fell into a 3 month coma. In such cases, the effects of injuries on memory, attention, concentration, reasoning ability, and other general cognitive effects have to be evaluated thoroughly and fully reported.
It is the job of the IME to fully and fairly assess all these complex and challenging issues, and provide written and supportable opinions that help the case to move on to being finalized.