Workers Compensation

Frequently Asked Questions

What is the difference between an IME and a second opinion?

There are two primary differences between an IME and a second opinion. First, we do not provide causation in second opinions. Proper evaluation of causation requires a different process from an evaluation where current medical condition, evaluation of treatment options and potential for assumption of care are being addressed. Secondly, in a second opinion, we meet with the patient during the visit to review findings and recommendations and, where applicable, to determine whether assumption of care is going to occur. If assumption of care occurs, we will also initiate care at that time. We do not meet with patients during an IME visit to discuss findings and/or recommendations; this is partly due to the nature of the evaluation and partly due to the fact that for IMEs we prefer to review records after we have met with the patient for the history and examination.

How do I arrange for an IME or second opinion?

You need only phone our office and our staff will guide you through the referral process. You may contact us to let us know of a referral and our staff will call you to get the process started. It has been our experience that the process is unnecessarily bogged down when we try to complete the entire process by email, so our office staff will contact you by telephone to complete the referral process.

Will you assume care of a patient who has been seen for IME?

We will assume care for patients whom we believe we can benefit by our involvement in their care and for whom care is authorized by the referrer. For any treatment we are ordering (including most diagnostics), we do require seeing the patient again before ordering so that we can present our findings and treatment recommendations and obtain consent to participate in treatment. Our office staff can assist you in ‘converting’ somebody from an IME to a patient under care.

How do I arrange for a rating on a patient who has reached MMI?

A written request to our office is all you need to get started. Request can be sent by mail, fax or email and need contain only the patient’s name, identifying information and confirmation of the request. Our office staff will then work with you to get the process started through to completion.

Does the patient need to be seen again for a rating?

A patient does not typically need to be seen again just for purposes of rating. There are situations when our physician may feel a return visit is necessary to properly complete a rating request. If the patient has not been treated by the rating physician, an in-person evaluation is almost always necessary.

Why do you require peer reviewers schedule time to speak to one of your physicians?

Patients whose case is under peer review tend to have complicated medical histories; our physician wants to be prepared to discuss the patient by reviewing key parts of the record prior to the call. More importantly, an unanticipated 15-30 minute telephone call during outpatient office hours means that every patient that day will have to wait for a non-emergent interruption. We try to avoid any non-essential interruptions during patient visits so that we can give each patient our fullest attention and care.