NSW Workers Compensation: What is an Independent Medical Examination (“IME”)

An Independent Medical Examination (“IME”) is a medical assessment conducted by an appropriately qualified and experienced medical practitioner to help resolve an issue in injury or claims management.  

The insurer may arrange an IME to determine: 

• diagnosis of an injury reported by the worker 

• the contribution of work incidents, duties and/or practices to the injury 

• whether the need for treatment results from the worker’s injury and is reasonably necessary 

• recommendations and/or need for treatment 

• capacity for pre-injury duties and hours 

• the likelihood of and timeframe for recovery 

• capacity for other work/duties (descriptions of such duties are to be provided to the independent medical examiner) 

• what past and/or ongoing incapacity results from the injury 

• physical capabilities and any activities that must be avoided 

• Assessment of your level of permanent impairment or whole person impairment  

Your lawyer may arrange an IME to: 

• Assess your level of permanent impairment or whole person impairment for the purpose of making a lump sum compensation claim 

• Obtain a medical opinion to challenge the insurer’s dispute notice (could be to address the injury, work capacity and/or proposed treatment) 

It is important that you understand the IME is not to replace your treating GP or specialist for ongoing treatment, but more so of a “one-off” assessment (though in some circumstances, subsequent examinations may be required) to for a medical opinion on a specific topic.  

What happens at the IME?

As a general summary, the doctor will ask the injured worker about the following: 

• their medical and work history 

• what caused the injury or condition

• how the injury affects them 

• treatment received and proposed 

• action taken in their recovery so far 

For physical injuries or conditions, the assessment may include a physical examination. For a psychological injury or condition, the doctor may conduct psychological testing. 

If you are currently taking any medications, it may be a good idea that you bring them with you so the doctor can take an accurate history of the type of medication and the dosage.  

If you have undertaken any radiology scans such as x-rays, ultrasounds, and MRIs, you should bring the films with you in addition to any paper reports as some doctors do prefer to review the films themselves.  

After the IME, the doctor will then write a report to the referrer (whether it is for the insurer, or for your lawyer), responding to the questions the referrer asked. The doctor could recommend further investigations or a subsequent assessment if required.  

The insurer is required to provide you with a copy of the report if they are relying on it to dispute your claim (or an aspect of your claim) and/or reduce the amount of weekly benefits. 

You should be aware that pursuant to Section 119 of the Workplace Injury Management and Workers Compensation Act 1998, if you refuse to attend or obstruct the IME, the insurer has the discretion to suspend your weekly benefits until you have undergone the IME.   

If you are ever in doubt as to the necessity or reasonableness of an IME arranged by the insurer, you should contact Littles Lawyers so we can provide you with legal advice.  

The NSW Workers Compensation Scheme is a complex system and therefore we highly recommend you seek legal advice. The Head of our NSW team, Jessica Cheung is an Accredited Specialist in Personal Injury Law specializing in workplace injuries. If you believe you have sustained a work-related injury and would like professional legal, reach out to Jessica and her team for a confidential discussion at no costs to you.   

Like? Share it with your friends.

Contact the Author

Topics

More Articles