The Executive Suite: Physicians and Independent Medical Exams

Almost all physicians have been asked to fill out forms excusing patients from work or school. When to comes to major issues like disability benefits or work injuries, your notes as a physician are reviewed based on very specific criteria before your patient can receive benefits.

Some physicians are also asked do independent medical examinations (IMEs). These exams are different from patient evaluations you do as a treating physician. Typically IME reports are used—along with a treating physician’s notes and records—for determining whether a patient qualifies for publicly or privately funded compensation due to a disability or injury. A typical IME report follows a specific format as requested by a client.

Find out your employer and medical malpractice carrier’s regulations

If you are interested in adding IME exams to your work, there are a few steps you need to take. It is important to know that physician IMEs are not compensated by the patient’s health insurance. They are generally paid for either by the patient’s attorney or by the patient’s disability provider. So, if you are employed and considering taking on IMEs, you need to make sure that doing this type of work at the office where you are employed is compliant with your employer’s policies. Generally, if your employer will permit them at the office, they would collect the reimbursement and you would be paid based on an RVU or bonus equivalent.

Qualifications and learning the IME process

And if you want to perform IMEs outside your work hours, you need to make sure that the work doesn't conflict with your non-compete clause and that it is covered by your medical malpractice insurance.There are a number of types of IMEs. For example, the bureau of workman’s compensation or private companies may ask a very specific set of questions and request a report based on their template.

Some requesting agencies may require that their medical examiners have certain certifications that validate competency in doing IMEs. You can check which certifications are required by your state bureau or by local companies before you proceed with any courses or certification exams.

Finding IME Referrals

If you are required to gain certification, then you can read through and learn the required information, which may include definitions, physical examination guidelines, details about report formats, and how to submit the reports. Sometimes you might be required to take a test so that you can earn a certificate validating that you completed the course.While many doctors are asked to do IMEs, some physicians seek out this type of work. If you want to find work as an independent medical examiner, there are several steps to can take. You can reach out to local companies that provide disability benefits or to attorneys who specialize in disability or work injury to let them know that you are available to provide independent medical exams. You can also indicate your availability on your practice website or list your name on a registry of independent medical examiners (usually for a cost). There are also companies that provide IMEs for disability providers and attorneys, and you could reach out to them to express your interest in collaborating.

Setting rates

Once you begin to get referrals, you can perform the exams in your own office if you have a private practice or at the site provided by an IME company. As with all contract work, setting rates can be tricky. You may not want to undervalue you’re services, but you also don’t necessarily want to price yourself out of getting referrals. As you get started, it might make sense to ask the referring company what their hourly rates are. You could request that you receive payment for a pre-specified number of hours so that you will have enough time to deliver a thorough report. And if you continue to provide this type of service, you can learn to gauge your reimbursement as you figure out how long it will take you to do the medical examination and provide the requested report.

As a physician, you undoubtedly take care of patients who suffer from disabilities or work injuries. You might consider augmenting your knowledge and clinical experience by providing documentation of functional and disability status for patients by doing independent medical examinations.