IME Report Delivery: Real-Life Examples of Varied Timelines

Independent Medical Examinations (IMEs) are essential to the medico-legal process. Opinion from a Medical Expert in an IMEs assess the medical condition of an individual involved in a claim and provide expert, impartial opinion on the impact of their injuries or illness on their lives.

Several factors influence an IME report delivery timelines, and it can be one of the most significant challenges for claims managers and lawyers working to tight deadlines. 

Delivery timeframes greatly depend on:

• Case complexity
• Independent Medical Examiner availability
• Examinee availability and location
• Timely submission of medical records and relevant information
• Communication between the parties involved
• Adequate medical records, including investigations and results

We thought it would be helpful to share three real-life examples that show insights into the IME process and all the things that can influence IME report delivery turnaround times.

Example 1 – A Complex Personal Injury Case

A Personal Injury Lawyer required that an independent medical examination (IME) be performed on their client to determine the nature and severity of multiple injuries they sustained in a car accident, and what long-term impact they would have on their capacity to live and work in the future. 

The IME was promptly scheduled, and the examination was completed within two weeks. The medical expert was unable to calculate the degree of permanent impairment relating to the injuries sustained as pathology, and specialised radiological investigations were not available, and in fact, no testing had ever been performed. Red Health liaised with the lawyer and the examinee underwent the required testing at the first available time which resulted in a three week delay. The delivery of the final report took approximately five weeks.

To ensure that all of the essential information was acquired as quickly as possible, Red Health supported the lawyer and examinee with respect to identifying the type of testing required and the best approach to obtaining the referral forms which was aimed at avoiding additional costs for the examinee. Red Health maintained communication with the medical expert so that when the results were available they could do the final touches of their medico-legal report. 

Given the nature of this case, a comprehensive and accurate report was received in a reasonable timeframe, given the need to obtain further information to proceed. However, it could have been resolved quicker if a strategic review of the case had been completed by the Medico-Legal provider from the start – something that Red Health proudly offers.

Example 2 – A Swift Workers’ Compensation Claim Resolution

A organisation needed to assess an injured worker’s capacity to return to regular work duties in accordance with WHS guidelines. The appointment for the Independent Medical Examination was scheduled one week following the request. The medical brief included records from the workers treating doctors and up to date radiological investigations. The objective to the IME was focused around whether the worker could return to work and safely perform the inherent requirements of their role at pre-injury hours and if there were any limitations or restrictions in performing their duties.

Due to the uncomplicated nature of the case and the early submission of the medical brief, the independent medical examiner was able to dictate their draft report on the appointment day and the necessary quality assurance reviews were completed by the medical examiner and Red Health’s in-house QA team in a timely manner. This report was issued to the client within 6 working days.

The streamlined communication between the involved parties, including the employer, examinee, examiner and Red Health, allowed for a fast report delivery and worker’s compensation claim resolution.

Example 3 – A Permanent Disability Insurance Case

An insurance agency needed to determine the level of injury, and its long-term impact, in a disability claim. In light of the complexity of the case and the intricate nature of the claim, multiple IMEs were required, and the selection of experts was crucial. It took several weeks to identify the right medical and allied health professionals and secure bookings with them in the best order.

Recognising the need for a comprehensive assessment to be made, a range of assessment bookings were made across specialities, including neurology, psychiatry and with an occupational therapist.

After the assessments were completed, the practitioners completed their reports and received the report of the previous practitioner so they could draw upon relevant information to help them provide their opinion.  Red Health supported the quality assurance process and ensured the insurance agency was informed each step of the way until the reports were finalised and issued to the client.

In total, the entire process took approximately nine weeks to conclude.

This approach ensured a robust and holistic assessment outcome for the examinee, which, in turn, allowed the insurance agency to determine the appropriate level of funding for the examinee which considered multiple practitioners from different specialities. This approach was valued by the client as it delivered on clarity and reduced timeframes which was required given the complexity of the disabilities.

What makes an effective IME process?

• Clear communication between the examinee, referring client, examiner, and IME provider
• Taking the time to determine a planned approach, particularly with complex matters which require multiple opinions
• Understanding what medical information is required and having it available prior to the appointment 
• Securing the best suited medical expert rather than the next available appointment
• Comprehensive assessment and information gathering
• Liaising with your IME provider to seek guidance and support
• Unbiased opinion
• Prompt report completion

Make an appointment with the Red Health team today for a strategic case review, and our staff will show you the way from the beginning, saving you time, money and headaches!

Disclaimer: The timeline examples provided in this blog are intended for illustrative purposes only and should not be construed as predictive of future IME delivery timelines. Actual delivery times may vary depending on numerous factors, including case complexity, Independent Medical Examiner availability, examinee availability, timely submission of medical records and relevant information. For the most accurate and up-to-date information on your unique matter, please reach out to your Red Health case manager.