Independent medical examinations: Facts and fallacies

Background: Independent Medical Examinations (IMEs) have protected the rights of workers in the United States since the first laws protecting employees were established in the early 1900s. There have been many social advancements and a great collective struggle over the last 100 years that have ultimately lead to justice for the injured or disabled worker. Objective: We describe the origins of the IME as well as the evolution of both medical and social processes that have provided the legal framework for the correct practice of IMEs. This article will summarize the current medical principles, legal process, and social controversy embodying the modern IME. Discussion: Medical professionals must adhere to the same principles of impartial and ethical conduct that they uphold in general patient care when dealing with IMEs. Although previously controversial, it is now clear following successful litigation of many physician examiners that at least a 'limited doctor-patient relationship' is created during an IME. Limitations: The limitations of this manuscript include a paucity of the literature, lack of IME updates, and certain conflicts with guidelines by various organizations. Conclusion: IMEs represent a valuable mechanism for determining alleged impairment and/or disability. In the current economic environment of declining reimbursement to physicians, IMEs exist outside the scope of traditional payment methods and offer competitive compensation.