What is an IME vs. IRE?

An IME, or independent medical examination, is requested by your employer or their workers’ compensation insurance company to have you examined by a doctor of their choosing. This is a one-time examination, and you are NOT being seen for treatment, including diagnostic tests or studies. In fact, any good IME doctor worth his salt will tell you at the beginning of the examination that he is evaluating you at the request of the employer, and that there is no “doctor-patient“ relationship between the IME doctor and you. The IME doctor is hired by your employer or their insurance company to assess your work injury and determine whether you’re fully recovered from the injury or recovered enough to be able to return to work in some capacity. If the answer is “yes” to either one of these questions, then litigation to try and stop or reduce your workers’ compensation benefits will likely follow. You should let your lawyer know immediately when you’re asked to attend an IME since there are rules that apply as to whether you must attend, how often, and the number of IME’s an Employer is allowed at any one time. Generally, an employer is entitled to one IME every six months. These examinations are far from INDEPENDENT as the name of the examination might suggest. IME’s are done at the request of, and for the benefit of, the employer, so they tend to be biased in favor of their position.
An IRE, or an impairment rating evaluation, on the other hand, is an examination requested by the employer or their workers’ compensation insurance company to determine whether or not you are less than 50% whole- body impaired, according to the American Medical Association (AMA) Guides of Permanent Impairment. The purpose of this examination is to try and change the status of your benefit from total to partial disability status because partial disability benefits are subject to a 500-week cap. In other words, you can’t receive more than 500 more weeks of partial disability benefits once you are found to be less than 50% whole-body impaired. This is why the employer is looking to change your status through an IRE examination: so they can limit their liability for paying you compensation into the future. If you’re less than 50% impaired, the status of your workers’ compensation benefit changes from total to partial disability. The amount of your benefit doesn’t change. But, this status change establishes a finite period of time as to how long your Employer has to pay you wage loss benefits. This status change is often times a good thing because it usually signals that the insurance company is ready to settle your case since they now know their potential exposure. There are rules that apply to these examinations just as there are with IME’s, so you need to let your lawyer know whenever you receive a notice to attend an IRE.
You should NEVER attend an examination scheduled by your employer or their workers’ compensation insurance company without discussing it with your lawyer first. Otherwise, you might inadvertently jeopardize your workers’ compensation case. The lawyers at Banks Law are ready to advise you about these examinations, and the impact they might have on your workers’ compensation case. Call us if you have any questions regarding these employer-requested examinations.