Reasons to Request an Independent Medical Examination
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Lack of Improvement
- The client is concerned that the primary care provider is not providing appropriate therapeutic direction for the claimant
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Inconsistencies on File and Client’s ‘Sixth Sense’
- Clinical or surveillance information inconsistent with claimed disabilities
- ‘Gut feeling’ that something is not quite right with the claim
- Concerns of possible factitious reporting, malingering, or fraud
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Variances from the Expected Norm
- Discrepancy between vehicle damages/repair costs/velocity at impact and reported injuries
- Prolonged recovery despite various therapies
- Inconsistencies and non-organic signs on examination (Waddell’s signs)
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Assistance on Claim Management
- Is there objective justification to continue providing benefits relative to a contract/insurance policy/regulation, and if so, for how long
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Information Presented in the IME Report
- Details of the incident, seatbelt usage, loss of consciousness, other accidents, WCB claims, etc.
- Work history
- Psycho-social stressors other than the incident
- Prior disease as indicated in pre-incident medical history (GP chart notes, imaging studies, statement of benefits, etc.)
- Review of medical documentation
- Present complaints
- Abnormalities and impairments on examination
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Causality, Disability and Treatment
- Causation of impairment and disability
- Questionable passive/alternative therapies (past and present)
- Medically essential treatment plan
- Safe Return to Work plan
- Prognosis
- Support or counter an opinion put forth by the treating GP or by a specialist retained by legal counsel