Managing employer costs and treating employees who become injured or disabled from work with fairness and objectivity is the shared goal of claims representatives and risk managers alike. Companies administering worker compensation or disability benefits are typically third parties that contract with independent clinicians in order to obtain expert opinions that will facilitate and optimize their case management. Such independent medical (psychological) evaluations, or IMEs, are requested when an employee:
- is first injured or submits a claim in order to obtain optimal treatment;
- does not appear to be making progress in treatment and is delayed in returning
to work; - is cleared to return to work by treaters but must receive independent
authorization; - has applied for short-term or long-term disability and the company wishes to
obtain an initial or second opinion.
Clinical psychologists or neuropsychologists are frequently requested to conduct IMEs because their unique training and expertise allows them not only to diagnose mental health conditions, but to conduct and interpret psychological and/or neurocognitive testing. Such testing quantifies the nature and severity of patient complaints in an objective manner, bolstering diagnostic conclusions. Testing is also critical to alerting the clinician to potential discrepancies between claimed symptoms and objective findings or history (e.g., exaggeration, malingering, misattribution of symptoms, factitious or somatoform disorders).
Typical questions addressed by the Worker Comp or Disability IME include:
- Diagnosis
- Ruling Out Malingering
- Causation (Are claimed symptoms directly attributable to the work injury or disorder/disease; partially/fully attributable to a nonwork-related injury, personal stressor or new onset disorder/disease maintaining or prolonging symptoms; or to an exacerbation of preexisting condition?)
- Need for Treatment (Current need, type, anticipated duration)
- Appropriateness of Treatment (Has treatment relied on appropriate/empirically-based methods? What, if any, further treatment is recommended?)
- Compliance with Treatment (Has the patient contributed to the maintenance or prolongation of symptoms by failing to comply with recommended treatment?)
- Prognosis
- Restricted versus Unrestricted Return to Work, Reasonable Accommodations
We invite you to review the What We Do and What is Neuropsychology? sections to learn more about our clinicians and their particular areas of expertise, and to contact us for a consultation to determine whether an IME may be helpful to informing or resolving your case.