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Medical Examinations in the Legal Arena

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Independence is not the only issue.

The dramatic increase in personal injury claims presents serious challenges for insurers and the legal profession alike.  A crucial tool in the progression and settlement of a personal injury claim is the Independent Medical Assessment (IME).

The multiplicity of competing agendas are contributing to the evolution of the way IME’s are commissioned and the markets expectations on performance, quality and cost.

At one time there was little control over the quality or cost of the report or indeed the time in which the assessment could be performed and the provision of a written report.

Lack of self-regulation in the provision of IME’s has led to ever increasing legislation to regulate the provision of IME’s across multiple jurisdictions. A typical IME is now required to demonstrate an objective, evidenced based opinion centred on a biopsychosocial approach, with measurable and demonstrable effectiveness delivered within defined timeframes. 

In addition, IME fees are increasingly being bought under legislative control as a means of cost containment. The focus on quality is driving scrutiny of not only the actual but the perceived independence of the IME.  Such scrutiny is putting pressure on both plaintiff and defendants firms to review their process of selection for an IME.  The old “medical expert - gun for hire” model is fast becoming unsustainable.

The availability of electronic assessment booking systems and the professionalization of the IME process is resulting in access to a wider choice of quality IME’s in broader geographic locations with access to realistic appointment timeframes.

However, increased reliance upon modern technology is also driving the need for improved security around storage and transmission of personal information.  This has given rise to increased legislative control to protect personal confidentiality, health records, and legal rights which may be impacted upon as a result of the IME process.  Currently there is little legislative requirement to mandate the use of electronic encryption or dedicated intranet portals for the transmission of personal information. However, the ready availability of such technology would make it difficult to sustain a practice of transmission of personal information without such security systems in place. 

The challenge for the legal profession will be to ensure that they are across the increasing challenges when making and IME to maximise their effective management of their clients matter.

Summary

  • Increased financial pressure requiring sound financial returns on investment in an assessment.
  • A more sophisticated market demanding higher standards of all aspects of the examination process.
  • Increased compliance requirements to meet new standards in document security.
  • Increased focus on empowering an injured person and protecting their autonomy and legal rights.
  • Assessment bias, whether actual and perceived, is becoming increasing less tolerated.

 

5 Tips for Organising an Effective IME

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  1. Provide an overview of the case at the time of booking to ensure the specialist with the most appropriate expertise is selected.
  2. Provide a detailed letter of instruction with a comprehensive outline of what it is you wish the specialist to review.
  3. Construct succinct questions in the letter of instruction to avoid ambiguity and repetition.
  4. Ensure the case file contains all relevant information, unnecessary or duplicate information should be removed.
  5. If the matter has a complicated history, request that the specialist contact you before the assessment.
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