OUR MEDICAL LEGAL SERVICES
IME, Inc., offers a comprehensive range of medical legal
services that are matched precisely and cost effectively to our client's needs.
Cost confirmations are provided after scheduling to keep our clients well
IME, INC. PROVIDES THE FOLLOWING SERVICES:
(IME) Independent Medical
Evaluations (IME) render impartial opinions to help determine cash, medical, and/or rehabilitation benefits for
claim's cases. Causality of injury or illness
and a return to work status are determined as well as the claimant's impairment rating, if requested. Efficacy of treatment and the time frames for medical
recovery are all addressed. The medical experts performing independent medical evaluations must know the criteria and context of the client's request
since different independent medical evaluations are looking for different things. The issues in most
independent medical evaluations are: 1) diagnosis,
2) causal relationship, 3) prognosis, 4) maximum medical improvement, 5) % impairment rating, 6) work capability, 7) appropriateness of care, 8)
recommendations with possible functional capacity assessments, 9) treatment is never rendered.
Legal Deposition & Live Testimony: After conducting services, our medical
experts are able to provide oral pre-trial testimony for use in court or serve as expert witnesses. Our experts come with impressive credentials and experience.
Nurse/Physician Chart Review: Our experienced healthcare professionals will assure you a knowledgeable
review by an active up-to-date healthcare provider. With a critical eye, they will
identify, organize, review, and summarize the essential records. Addressed will be issues
such as appropriateness of treatment and compliance.
Legal Nurse Consulting (LNC) / Expert Witness: We have nurses on staff with both medical expertise coupled with
training in the law and legal procedures who can add a whole new dimension to your case.
With their knowledge and experience they can help you sort out the complex medical
issues, focus your case, identify issues, and make recommendations to minimize loss, saving
time and money.
A Legal-Nurse Consultant can significantly contribute to the satisfactory resolution of
your case by reviewing the medical and non-medical issues, then using her/his assessment
skills to make recommendation essential to the outcome of your case. These include:
timing of the IME, appropriate physician selection, and pertinent medical records needed
for a thorough, balanced and value added report. The legal nurse
consulting can also educate on medical
options and make sure that all elements of the IME report are appropriately addressed.
Malpractice Case Evaluations & Workup Both medical and nursing experts in several specialty areas are
available to review any medical related cases for merit and offer bottom line opinions.
Elements of duty, breach of duty, causation and damages will be addressed as well as the
strengths and weaknesses of your case which will help you best prepare. Our experts will
define relevant standards of care and determine whether there was deviation/adherence,
vital factors in the outcome of your case.
The primary interest is to
address causality, mechanism of injuries, extent of
damages, prognosis, appropriateness of treatment, degree
of disability and potential for recovery.
Medical Case Discovery A medical specialist reviews the records to determine the compensibility
of the case and focuses on termination or mitigating for resolution.
Medical Research & Education
Over 30 years combined experience in our medical-legal research
department will help to strengthen your position and add credibility to your case/claim.
Our staff will also educate you on the complex medical aspects of your case so you can go
to deposition prepared to win, addressing all pertinent issues.
We will also prepare your client or expert witness for deposition and/or testimony to
We will provide you with a competent medical specialist who will review
the medical records and address such issues as whether treatment was medically necessary
and reasonable, the efficacy of treatment within the specialty and over use/under use of
the medical options.
Medical Illustration Illustrates the anatomy, physiology, and pathology of all major body
systems. Through full color illustrations and visual explanations, issues such as
pathology and mechanism of injury will be simplified and understood.
Disability benefits are provided under the Social
Security Act to those persons expected to be totally
disabled for at least 12 months.
Individuals can also purchase private short-long term
Employers may provide disability benefits such as short-term
benefits (typically from the time of injury up to a few
weeks) or long-term benefits (typically with a waiting
period of sixty or ninety days).
qualify, a claimant must have a “medically determinable”
impairment. The impairment must have a demonstrable
anatomic, physiologic, or psychological abnormality. To
meet the definition of disability in the Act, the
claimant’s impairment must be of such severity that they
are not only unable to do the work done previously, but
also can not perform any kind of substantial gainful
An independent exam
from a medical doctor must cover statements which details
what a claimant can do despite of their impairments.
that need to be addressed in order of importance are:
diagnosis that is causing the disability
relationship to the disability (what caused them to be
rendered incapable of performing work)-Causation is
frequently a critical issue in workers’ compensation and
this a temporary or permanent condition
is the Prognosis-This gives the probability and
predicted in time of recovery. The recovery could be
strongly influenced by factors other than the diagnosis.
Such factors include attitude, social environment,
concurrent problems, and probable future risks.
the claimant met maximum medical improvement-This is
when further recovery and restoration of function can no
longer be anticipated to a reasonable degree of medical
capability or Functional Capacity-Parameters contained
in the U.S. Department of Labor’s Dictionary of
Occupational Titles, which are primarily lifting
Appropriateness of Care-Or issues of missing records
that need to be obtained, additional diagnostic studies
or consultations are addressed
Impairment Rating-Impairment is not synonymous with
Impairment is a measurable decrement in health status
evaluated by medical means. AMA Guidelines are most
often the criteria used.
Disability is assessed by the consideration of
non-medical issues such as the person’s educational
and vocational skills, experience and age
Recommendation-include unnecessary and/or omitted
diagnostic evaluation and inappropriate, excessive,
and/or omitted treatment.
The employer is questioning whether the injury is a direct
result of the claimant’s employment. As causality is the
most important issue, restrictions for return to work or a
disability status. A percentile of disability may be
required by certain states and special criteria to be
addressed. Previous history is important and the current
treatment along with further treatment is addressed. A job
description is helpful to the physician when a return to
work status is one of the requirements for the exam.
Auto No Fault: The
carrier is currently paying medical expenses and/or wage
loss benefits and/or assistance for activities of daily
living (i.e. assistance with household chores or
assistance with personal hygiene.) In many auto accidents
a pre-existing condition is exacerbated. The report must
give a projection of an end plate or time frame for
treatment and what services are or are not needed and a
time frame of how long. This could be either an individual
who is seeking compensation from the insurance carrier of
the responsible party (a third party case) or an
individual who has been denied benefits by his/her own
insurance carrier and is disputing the denial.
Auto Tort: The carrier
needs an expert to sort out the injuries of the accident
to determine who was at fault. The exam by the experts
often determines who will pay the medical bills and
attorney fees. Physicians will testify live in court if
the dispute of the case is challenged.
Independent Medical Opinion:
Individual may set up these exams to verify if their
treatment is reasonable and necessary and or if surgery is
indicated. Insurance companies will also use these exams
to assist the claimant in finding appropriate treating
doctors. Litigation is not an issue. Many of the second
opinion physicians may resume treatment after the exam if
the individual so desires.
Long / Short Term Disability:
In this instance, a person is collecting short or long
term disability benefits for a non-work related injury or
illness. The most important issue in these cases is
whether the person can return to work in either his/her
regular position or in a restricted position. These
policies are insurance benefits paid by the employer and
are the company's choice to offer these policies. The
insurance will cover wages as long as the employee cannot
work. Some policies have time frames for these benefits.
Family Medical Leaves:
The Federal Government regulates family medical leaves.
Wages may or may not be covered by this leave. All
companies that have over 25 employees are eligible for
this leave with or without pay. The law gives any employee
(12) weeks of leave based on a family emergency or an
individual health need. Up to 24 weeks can be taken if an
individual qualifies for this leave. Our physicians make
the determination if the employee qualifies for this
benefit. Often times it is not the employee that is
evaluated, but a spouse or child. It is important to
question this leave if it goes beyond (12) weeks. The law
states that employers must keep a job for this employee.
General Liability: In
these cases, the claimant is seeking compensation for an
injury, which generally occurred on the property of another
party. Generally, there is no relationship between parties
prior to the incident. A complete history of the injury, a
current diagnosis, any treatment needed for the
injury sustained, medical history prior to the incident,
restrictions for return to work or disability status and
more important, cause and relationship of the injury to the
incident are all addressed in final report after review of
all data and evaluation.
negligence and or a breach of standards of care. It constitutes
and flagrant action by the professional that has caused
harm to a patient. Injury to the individual is evaluated
and facts of how it affected their life style, what was
the cost of the damages and how is the damage going to
affect their future. Pain and suffer is also considered in
the damages. The expert is usually of the same specialty.
The plaintiff is the one that was damaged by the act and
will hire a plaintiff attorney to represent the case. The
defense attorney represents the malpractice insurance
carrier or the doctor in question. Our experts explore
all avenues of the case and come to a detailed conclusion
based on guidelines of Standard of Care and harm to the
Early Assessments: IME,
Inc., has a copyright on the first document that addresses
all issues needed to determine causation, diagnosis,
efficacy of treatment and projection of further treatment
of claim. Employers can set up an exam within the first 10
days of the employee absence from work. Insurance carriers
also may get an opinion early in the claim on that
diagnosis that are miss managed and assigned for the gain
of the claimant.
Panel IMES: Many states
require panel IMEs where two or more specialists are
needed to surface the injuries alleged in the incident.
The team has to agree on the diagnosis. It is the mission
of the physicians to establish a care plan that will take
the claimant to wellness or MMI.
Legal Nurse Consultants
Like physicians, nurses have different specialties in
their field. IME, Inc. has nurses on staff with both
clinical knowledge and experience coupled with the law and
legal procedures. These nurses can help you sort out the
complex medical problems, focus the case, identify missing
documents and make recommendations to manage the expense
of your claim. The LNC also testifies in court on
professional issues that may have caused harm to a patient
by another nurse. The standards of care and negligence of
a patient is determined. The LNC also saves attorneys
money in screening malpractice, workers compensation and
any personal injury case for merit. See the section on
Legal Nurse Consultants to understand the resources the
nurse can contribute to focusing the direction of your
Professionals of the same specialty review the medical
records and CPT codes of the bills. Issues are approached
such as medical necessity and reasonable care for the
condition of the claimant. The efficacy of the treatment
being rendered is also assessed. The medical records and
diagnostic test results are compared with the CPT, ICD-9
codes for the appropriate billing codes that document the
treatment rendered. Excessive treatment and under care
are also reprimand. The peer reviewer will also comment on
the correct area of expertise needed to bring the case to
Nurse / Physician Chart Review:
The most important element of the case is the medical
records. Nurses who are trained with a critical eye can
identify, organize, review and summarize the essential
records. Missing data can be brought to provider’s
attention. The focus is on the facts of the case and the
total file of the claimant will tell the story. A complete
organized file saves the costumer money by decreasing the
physician’s time of putting in order the medical records.
The organized file by the nurse also makes for a
chronological detailed report.
Phone Consultations / Consultations /
Medical Case Discovery: The experts
are available for phone consultations after the review of
the file. Discovery of the facts early in the case help
the attorneys and insurance carriers manage the file. It
is through knowledge and direction that makes the
difference in the administration of the case. This phase
of the investigation is called the discovery phase. File
reviews with no reports are also a tool for attorneys who
are using a new doctor and do not feel at ease in knowing
how the expert will present himself or herself.
Illustrations of the anatomy, physiology, and pathology of
the human body. All major injuries are made visual and
explanations of the mechanism of damages are demonstrated.
The illustrations become alive, leading to more universal
understanding of a non-medical audience.
Medical Research: Some
cases may require on going study with the latest or newest
refine treatment that may make a difference in the final
outcome of your case. Research also gives extended
knowledge to the customer to better understand the needs
of the case. Research assists the insurance carriers in
proper direction, influences the appropriate treatment and
cost, which directly impacts the claimant’s recovery.
Deposition: When a case
is in dispute of benefits or settlement, a deposition is
set up with the attorneys involved and the expert that
evaluated the claimant. Our experts have over 30 years in
testifying. The attorneys cross-examine the physician to
determine the diagnosis and causality of the incident on
the claimant. A resolution is drawn from the facts
presented at the deposition.
Certain states and types of cases may require a court
hearing. In this case the expertise will provide oral
testimony at trial. The judge determines if the individual
qualifies as an expert. Our physicians come with
impressive credentials and experience. Many are dual
degreed and are certified with SEAK, ABIME, AADEP. These
are all companies that educate and certify physicians in
the medical/legal field.
Testing: NIDA Lab Approved:
IME, Inc. administrates the Department of Transportations
regulations enforced by the Federal Government to
individuals with CDL and meet the Rules that were put into
effect in 1992. All drivers operating over the road
vehicles that weigh over 26,000 lbs must conform to the
rules for drug testing. Companies must test new employees
before allowing them to drive. Random drug testing needs
to meet 25% of all operators and 10% random alcohol in
order to meet the audit and regulations of the DOT,
Federal Regulations. In the case of an accident with the
vehicle the driver has 2 hours to be alcohol and drug
tested. IME, Inc. assists trucking companies in
administering the program. We also write policies that
spell out the regulation for the personnel file. IME, Inc.
also keeps records to meet the DOT regulation in case of a
governmental audit. If any company is not compliant with
the Federal rules, a $10.000 fine is issued per
citation of non-compliance. Companies also
have to keep up on the changing regulations. It is wise for these companies to use an
outside source like IME, Inc. to keep up on the regulation
and administer the program with record keeping on all
Determining the identity of your true biological parent or
child is a major life event. Child support is totally
dependent on the biological parent. This test stands up in
a court of law. You can trust IME, Inc. with this
important issue in life. The test has 99.99% probability
of paternity or non-paternity. Reports are issued in 10
working days after receipt of samples. The test is used
for identifying the father for child support. It has been
used for inheritance (estate claims).
IME, Inc. provides opportunity for tailored educational
programs to meet the need and topic of our audience. The
company brings the knowledge right to your office. The
seminar is informal and open for participation of the
learner. Nurses and physicians are available to provide
seminars on difficult medical issues and will give you
knowledge in ways to understand and better supervise the
Anatomy & Physiology Seminars:
IME, Inc. has developed a curriculum to assist attorneys
and claims adjusters in understanding the human anatomy
and physiology. Professional credits are available on
request. Understanding the normal human anatomy, the and abnormal pathology can
assist the attorney in a better simulation of their case. Those
interested in the course should e-mail the corporate
email@example.com. The curriculum can be tailored to meet
the individual law firms or insurance claims adjusters.
Let us know what your interests are so IME, Inc. can meet
all of your needs and exceed your goals. A Doctor in
Anatomy and Physiology brings the program to you with a
history of teaching at a major University. Our professor
also is a practicing Orthopedic Surgeon. This program is
made available because the professor and Orthopedic
Surgeon have moved on to DePaul University to continue his
education in law. The curriculum that is offered to you
the same information presented to the medical students at
trend of injuries may develop from many different
products. The liability insurance over the product is
responsible to investigate the case and determine if the
product is causing the injuries. Many of our specialists
resolve the dispute between the parties by giving a
solution to the cause of the injuries. The product is also
researched for similar incidents.
American Medical Association
Evaluations may require the use of the AMA
Guidelines to determine the % of impairment of the whole
body and the body part. The regulations have been revised
into the 3rd, 4th and 5th
Edition. The date of the claimant’s injury determines
which edition the expert needs to apply the rule to. These
exams take the expert three to four hours to apply the
criteria needed for each case. The customer informs the
evaluator which edition to apply the rules. Other states
have their own criteria that differ from the AMA
Guidelines. These rules will then be applied by the
evaluating physician and are supplied by the customer
requesting the exam.
Family Medical Leave (FMLA): may be found in the regulations (29
CFR Part 825) An employer may, at its own expense, require
the employee to obtain a second medical certification from
a health care provider. The employer may choose the health
care provider for the second opinion except that in most
cases the employer will call an independent company.
If IME's medical
provider's opinion differs from the employee's physician, a
third medical certification can be requested again at the
employer's expense. This third opinion shall be final and
binding. The employer can at anytime request the employee
to be evaluated if the leave is in question.
The Federal Government
regulates family medical leaves. Wages may or may not be
covered by this leave. All companies that have over 25
employees are eligible for this leave with or without pay.
The law gives any employee 12 weeks of leave based on a
family emergency or an individual health need. Up to 24
weeks can be taken if an individual qualifies for this
leave. Our physicians make the determination if the
employee qualifies for this benefit. Often times it is not
the employee that is evaluated but a spouse or child. It
is important to question this leave if it goes beyond 12
weeks. The law states that Employers must keep a job for
Fraudulent claims occur after motor
vehicle accidents, slips and falls, and job accidents.
Such claimants use abnormal illness behavior; including
fake accidents, contrived histories of injury, embellished
complaints, false examination responses and prolonged
ineffective treatment, to establish a “sick role” for
social and monetary gain. Rewards are derived from
insurance claims, lawsuits, federally funded medical care,
federal and state workers’ compensation and Social
Security. This cannot be accomplished without the
assistance of a doctor whose contribution to the collusion
may include incompetent evaluation and unfounded
diagnoses; prolonged ineffective treatment and unnecessary
surgery; false claims, reports, and testimony about a
contrived injury and disability. An attorney commonly
orchestrates this scheme. Medical records are usually
evaluated by an insurance investigator and a medical
expert as part of an independent medical examination. Our
legal nurse consultants and other medical experts are
trained and possess the knowledge needed to assist our
customers with the facts needed to defend fraudulent
Independent Medical Evaluations, Inc. Corporate Office
Lee Plaza, 3881 M-72 East
Williamsburg, MI 49690
Phone: (231) 929-1474
Toll-Free: (800) 968-4637
Fax: (231) 929-4356