Independent medical examination
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An independent medical examination occurs when a doctor, psychologist, or other licensed healthcare professional conducts an examination of an individual to help answer specific legal or administrative questions related to a variety of situations, e.g., a disability claim; workers' compensation case; a personal injury lawsuit (tort claim); impaired professionals program; or sexual harassment in the workplace.[a]
Limited doctor-patient relationship
Conducting an independent medical examination does not establish a typical doctor/therapist-patient relationship as exists when a clinician treats a patient in the hospital or at an outpatient clinic. However, the independent, objective (unbiased) nature of the examination does not absolve the doctor from all professional responsibilities. For example, in most independent medical examinations, the clinician should assess for possible psychiatric disorders and ask the individual if he or she has been thinking of hurting or killing themselves or someone else. If upon further questioning after an affirmative response it becomes apparent that the person poses a significant risk of imminent harm to self or others, the examiner must take steps to prevent such harm and to facilitate referral to appropriate treatment and psychosocial support. Thus, a "limited doctor-patient relationship" exists when conducting independent medical examinations.
Workers' compensation and long-term disability insurance
Independent medical examinations may be conducted to determine the cause, extent and medical treatment of a work-related or other injury where liability is at issue; whether an individual has reached maximum benefit from treatment; and whether any permanent impairment remains after treatment. An independent medical examination may be conducted at the behest of an employer or an insurance carrier to obtain an independent opinion of the clinical status of the individual. Workers' compensation insurance carriers, auto insurance carriers, and self-insured employers have a legal right to this request. Should the doctor/therapist performing the independent medical examination conclude that a patient's medical condition is not related to a compensable event, the insurer may deny the claim and refuse payment.
- The preceding is not an exhaustive list of situations where healthcare professionals might be asked to conduct an independent medical examination.
- Ky, P.; Hameed, H.; Christo, P. J. (2009). "Independent Medical Examinations: Facts and fallacies". Pain Physician. 12 (5): 811–8. PMID 19787008.