Independent Medical Examiners should only answer the questions posed by the referring client.

These questions should be answered truthfully, without giving any benefit of the doubt to the referring client. Examiners should not opine on other areas. If there is any doubt regarding what issues the client would like addressed, these should be cleared up with a quick phone call to the referral source.

Example 1.21: Questions to be answered

Report States:

I appreciate the opportunity of seeing Mrs. Weiss for an Independent Medical Examination. I do not have a letter identifying the questions relating to this, but I suspect I have been asked to determine the current medical status.

Resulting Cross-examination:
Q. Doctor, you didn’t know what you were doing when you examined Mrs. Weiss for an IME, correct?
A. I am a board certified orthopedic surgeon, so I clearly know what I am doing.
Q. You would agree that an IME could be set up to determine any number of issues?
A. Yes.
Q. What are the typical issues you are asked to deal with in an IME?
A. Causation, prognosis, maximum medical improvement, permanent impairment, work capacity, appropriateness of care, diagnosis, and current medical status.
Q. Did you know which one of these eight issues you were supposed to be dealing with and examining for?
A. Not precisely.
Q. In fact, you state right in your IME report, “I do not have a letter identifying questions relating to this, but I suspect I have been asked to determine the current medical status,” isn’t that correct?
A. Yes.
Q. So you took a guess about the purpose and performed an exam based on a suspicion?
A. An educated guess.
Q. So you really didn’t know what you were doing when you did this IME, correct?

Comment: IME physicians need a clear understanding of the issues and why the IME is being requested so that they can properly address the issues in their reports. Doing an IME report based on an educated guess or suspicion is illadvised. When there is ambiguity as to the issues to be addressed, the IME physician should clarify the purpose of the exam before proceeding.  

I did not have a letter identifying the issues to be addressed. I called the insurer and determined that the purpose of the exam was to determine the examinee’s current medical status.

Excerpted from the text: Writing and Defending Your IME Report