What is an independent medical exam (IME) for workers comp?

Understanding the Difference Between Your Regular Doctor and a Doctor Providing an Independent Medical Examination

Queensland WorkCover Indepedent Medical Exam Doctor

The Role of Your Regular Doctor

After suffering a workplace injury or illness, it is vitally important to seek medical attention as soon as possible.  If your injury or illness is serious or life-threatening, you should go to your closest hospital emergency department immediately.  The staff at the emergency department will assess your condition, provide treatment as needed, and will forward the necessary information to your regular General Practitioner (GP) for follow-up care and treatment.  If your injury or illness is minor and doesn't warrant a visit to the emergency department, make an appointment with your regular GP as soon as possible.

The primary role of your GP will be to manage your condition in the short term and provide treatment options for your long-term care and rehabilitation.  Your GP will work with you to facilitate your return to work and will refer you to medical specialists if needed.

You have a full doctor-patient relationship with your regular doctor.  You are not required to allow your employer or your employer's representative to attend your doctor's appointments with you, nor are you required to sign an authority requesting your doctor to release documents to your employer.

Your doctor will be required to complete a Work Capacity Certificate to provide their opinion on your ability to work.

Your employer is not permitted to specify which doctor you attend.  They are, however, permitted to ask for you to gain a second opinion from another doctor if they choose, but you still retain the right to choose which doctor will provide the second opinion.

The Role of Your Independent Medical Examination Doctor

As part of the claim assessment process, WorkCover may require that you participate in an independent medical examination (IME).

An IME doctor is entirely separate to your regular doctor, medical specialists, and even the doctor giving a second opinion.  IME doctors are engaged on behalf of WorkCover, and their role greatly differs from the role of your regular doctor.  While your regular doctor is concerned with treating your condition and facilitating your return to work, an IME doctor's only role is to provide additional information or to clarify specific aspects of your condition and to report back to WorkCover.

The IME doctor is not a substitute for your regular doctor. An IME doctor is hired on behalf of WorkCover, and you do not have the benefits of the same doctor-patient relationship. Nothing you say to the IME doctor will remain confidential. In fact, the idea of the appointment is for the IME doctor to gather information about you that WorkCover will use to undermine your case.

WorkCover's aim is to prove that you do not have an illness or injury or, if you do, that it was not caused by your working activities.  WorkCover uses IMEs as a means of gathering the information that they need to refute your claim.

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Who Can Be an IME Doctor?

Not all doctors and specialists can provide independent medical examinations.  WorkCover maintains a panel of doctors and specialists who operate in a range of medical fields.  Although WorkCover correctly maintains that the IME doctors who serve on their panel are independent and are not employed by WorkCover, IME doctors do submit tenders to be included in the panel. IME doctors may not be employed by WorkCover, but they still take their instructions directly from WorkCover and are paid for doing so.

WorkCover maintain a current list of the medical practitioners that make up their IME panel.  Some medical specialities - such as orthopaedics and psychiatry - have several doctors making up the panel, while other medical areas - like rheumatology and cardiology - currently have only one doctor on the panel.  This means that, depending on the type of medical practitioner necessary for your condition, there may be only one person authorised by WorkCover to perform the IME.

Who Engages an IME Doctor, and Who Pays for the Appointment?

IME doctors are engaged on behalf of WorkCover, and it is WorkCover who organises and pays for the appointment.

This is important to understand. The IME doctor is not being paid to treat you or to help manage your condition.  They are instructed solely to gather information, and their instructions - and payment - come directly from WorkCover.  From WorkCover and the IME doctor's point of view, the aim is to terminate WorkCover's obligation to pay your ongoing medical costs, and to cast doubt on your condition and your inability to return to work.

With WorkCover being responsible for instructing and paying the IME doctor, you do not generally get a choice as to the specific IME doctor who will handle your appointment. Even if there are several doctors on the WorkCover panel for the medical speciality relevant to your circumstances, WorkCover will not generally let you choose your IME doctor.  Instead, you may simply be given a short list of dates and times to choose from.

An IME Doctor Is Not Truly 'Independent'

While the "I" in IME stands for "independent," an IME doctor is not truly unbiased and independent. IME doctors are instructed by WorkCover to perform a specific duty - to assist WorkCover in denying ongoing claims for medical benefits, and to write reports that are largely unfavourable to the injured party.

After all, IME doctors are paid for their work, and they know that if they wish to be chosen to perform IMEs in the future, they need to provide the types of written reports that WorkCover wants.

It is not economically viable for WorkCover to continue to pay an IME doctor who tends to side with the injured party.  For IME doctors to maintain their position on the panel and to be selected to perform future IMEs, they need to undermine the injured party's case as much as possible.

How an IME Doctor May Undermine Your Case

If WorkCover requests that you attend an IME, you are required to comply.  Failure to cooperate with the process will inevitably lead to a discontinuation of medical benefits and potentially your overall claim being denied. 

It is important to be aware of the ways in which an IME doctor may try to undermine your case.  Based on our experiences with countless clients who have attended IMEs, here are some common IME tactics:

  • Denying the existence of your illness or injury;
  • Denying that your condition was caused by your work or in the workplace;
  • Identifying a loophole or exclusion under which WorkCover is not liable for your medical costs;
  • Suggesting that your condition was caused by circumstances in which WorkCover is not liable;
  • Suggesting that you are lying or exaggerating about the severity of your condition;
  • Denying that any further treatment is needed, such as psychology, surgery, or pain management;
  • Criticising or undermining the medical care you have received to date;
  • Suggesting that there are inconsistencies in your version of events or in your medical history;
  • Suggesting that you are malingering or being uncooperative;
  • Denying that your condition - or the severity of it - is sufficient to cause you not to be able to return to work.

Now that you understand the basics of an independent medical examination, read on for our tips on what to do, what not to do, and what to expect at your IME appointment.

Strict time limits apply - seek legal advice ASAP - In most circumstances, the time limit to start a workers compensation claim is 3 years from the date of incident. Some processes need to be started much sooner. Seek expert legal advice ASAP. Call us on 1800 266 801 or start a live chat.

Last update on:
May 29, 2018
Disclaimer: This information is designed for general information in relation to Queensland compensation law. It does not constitute legal advice. We strongly recommend you seek legal advice in regards to your specific situation. For expert advice call 1800 266 801 or chat via live chat to arrange free initial advice with our Principal lawyer, Greg Smith.


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