Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

IME (Independent Medical Exam)

IME - independent medical exam


Whether through fear or outside influence, the patient most often does not see the ordering of an I.M.E. as a positive action.

The patient suspects that the I.M.E. is ordered:

  1. IME as a means of disputing the validity of his/her complaints
  1. IME as a means of denying care
  1. IME as a means of encouraging them to accept modified duty
  1. IME as a means of saving insurance dollars consumed by current authorized treating providers
  1. IME as a means of forcing a settlement and limiting the settlement amount
  1. IME as a means of punishing the patient for consuming time and financial resources

The patient receives some degree of validation of these beliefs when:

  1. The clinician performing the I.M.E. has not read all of the records
  1. The independent examiner acknowledges that “I am only here to see if you can work.”
  1. The examiner denigrates the patient’s complaints, stating that they are improbable, unlikely and suspicious
  1. The clinician is impatient, brief, terse and dismissive
  1. The independent exam addresses only a portion of the range of the patient’s complaints.

An I.M.E. can produce valuable data needed to more effectively assist the patient. but is unlikely to be effective if that examination does not include time to discuss the results with the patient so that s/he understands what has been accomplished

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