Quick Definitions: Independent Medical Evaluation (IME)

An Independent Medical Evaluation, or IME, is a one-time examination that can be requested by either the Employer/Insurer or the Claimant. An IME is simply a way to obtain additional evidence, or simply some evidence to support the position of either party in the workers' compensation claim. For instance, if the Claimant's authorized treating physician (ATP) gives the opinion that the Claimant's injured back is fully healed, a Claimant may want to obtain an IME to contradict the ATP's diagnosis. This evidence can come in extremely handy at a hearing or during settlement negotiations.

I disagree with my authorized physician's diagnosis. Can I get a second opinion?

If effect, yes. Under Georgia law, a Claimant is allowed to seek a second opinion with a physician of his or her choosing (in other words, it is not limited to a care provider listed on the panel of physicians) at the expense of the Employer so long as several criteria are met. This one-time second opinion is known as an Independent Medical Evaluation (IME). Again, this is a one-time evaluation--not a change in the authorized physician. Unless you seek an official change of physicians, you will continue treating with your authorized treating physician (ATP) after the IME. 

The criteria are spelled out in O.C.G.A. 34-9-202(e):

1. The injury at issue must be an "accepted compensable injury." Basically, this means that the Employer must not be disputing that the injury is covered by workers' compensation coverage.
2. The examination is being sought within 120 days of the receipt of any income benefits (either TTD, TPD, or PPD benefits).
3. The examination must take place at a reasonable time and place, within Georgia or within 50 miles of the Claimant's residence.
4. The examination must be performed by a duly qualified physician or surgeon.
5. The Claimant must give advance notice, in writing, to the Employer of the examination.
6. The examination cannot repeat any diagnostic procedures that have already been performed on the Claimant since the injury, unless the costs of the procedures which are in excess of $250.00 are paid for by a party other than the Employer or Insurer.

An IME can be an extremely valuable tool for a Claimant when negotiating a settlement. Because a Claimant only has the ability to obtain one IME, it is imperative that great care be taken when choosing the IME physician. If you are dissatisfied with the care you are receiving from your treating physician, please contact us to discuss your options.