"Oregon" Independent Medical Examinations
Please read page and then links under "Important IME Information"
Independent medical examination (IME)
An IME is an exam scheduled by the insurer processing your claim. The insurer will choose the doctor and pay for the exam. The insurer may require you to attend up to three IMEs. Some exams may be scheduled with more than one doctor at more than one location, but only count as one of the three IMEs. This is called a panel exam. If your claim is closed and later reopened, the insurer may require you to attend up to three more IMEs.
You must attend the IME. If you cannot attend, contact the insurer immediately. If you do not attend and don’t provide a good reason, the Workers’ Compensation Division (WCD) may allow the insurer to stop paying your benefits, which may include medical, time-loss, and permanent disability. Also, unless you are receiving time-loss benefits, WCD may fine you $100 if you do not attend the exam. The insurer would take the $100 from your future benefits.
The insurer will pay some expenses for you to attend the exam, such as car mileage, child care, lodging, and some meals. The insurer must send you a form with this brochure for you to request repayment of your expenses. (emphasis added) You must complete the form and send it to the insurer. If you need payment in advance, you must ask for payment from the insurer as soon as possible. The insurer will make every effort to get the advance payment to you before the exam.
Invasive medical procedures
If the IME doctor intends to perform an invasive procedure, the doctor must explain the risks. An invasive procedure is one in which the body is entered by a needle, tube, scope, or scalpel. You have the right to refuse an invasive procedure. Refusal will not affect your right to workers’ compensation benefits.(emphasis added) The doctor must give you the form 440-3227, “Invasive Medical Procedure Authorization.” Complete the form, marking “Yes” or “No,” and give it back to the doctor. The doctor will give you a copy and send the original to the insurer.
You may have an unpaid observer attend the exam with you; doctor approval is required for psychological exams. An observer may not participate in or interfere with the exam. To have an observer, you must complete and sign the “IME Observer Form” that is attached to this brochure.(emphasis added) By signing this form, you are stating that you understand you may be asked sensitive questions during the exam in front of your observer. The doctor does not have to allow the observer to be present if this form is not completed and given to the doctor.
—Source: Oregon Workers' Compensation Division
The information above and more in a brochure here.
After returning home from your exam, be sure to complete and mail your "Worker Independent Medical Exam (IME) Survey." Oregon law requires that the insurer provide one with the appointment notice. Do not give a completed form to the IME facility.
FIRST-EVER IME REFORMS: KNOW YOUR RIGHTS
Injured Workers' Alliance led the effort to enact 2005's Senate Bill 311 in Oregon. First-ever IME oversight and reforms were enacted. The most crucial elements of SB 311 are:
- By law, workers can have an observer during exams. Bring one! Get details here;
- An expediated process now exists so workers can dispute being sent long distances to attend an exam. Call 1-800-452-0288 if you have questions;
- Workers must receive a survey about their IME experiences. It's required that you receive one with the IME appointment letter. The examiner can also provide one. If you don't receive a survey, call the number above. Mail the survey, which is a postage-paid (by the State of Oregon) self-mailer that goes to the Workers' Compensation Division, back within a few days of the exam;
- Workers can be fined $100 if they miss an exam without providing prior notice or wihtout having a good reason;
- Unlike before, there is now a process for reviewing and investigating complaints about examinations;
- Examiners found to have acted inappropriately can be barred from performing future IME's within the workers' compensation system. For this reason, It's critical you complain when mistreated.
Additional information is here.
Visit our forum section on Indepent Medical Examinations
Learn more about Senate Bill 311 which brought first-ever reforms to the IME system
Read the State IME Study and news articles about IME's
IMPORTANT IME INFORMATION
Passing the Medical Exam
Although it refers to motor vehicle accidents, conditions are the same.
Advice for Insurance Claimants
Written by Bernard Kansky, an attorney who's a founding member of The National CFIDS Foundation, Inc.
Doctors for Sale
Although written by Willamette Week in 1996, most of the examiners and IME shops are still around. Many West Coast workers will recognize one or more of the examiners mentioned.
Do you know about Worker-Requested Medical Examinations? Under certain circumstances, the Worker’s Compensation Division will choose a physician to provide an impartial exam. One example would be if your claim was denied based on one or more independent medical examinations. Learn more here.