Medical expertise is a key tool used to resolve a situation involving a worker’s absenteeism, disability or employment injury. It is one of the best practices that ensure effective case management. Let’s demystify medical expertise, especially the concept of an independent medical evaluation.
What is medical expertise?
The provision of medical expertise involves formulating an independent medical opinion of a person’s health and the related facts. It includes independent medical evaluations (IMEs), files studies and expertise related to the practice of medicine. This article focuses on the IME.
An IME involves the provision of a written independent medical opinion concerning a person’s health. It is requested by a third party, usually an insurer, an employer or a public body that wants to resolve a situation involving absenteeism, disability or employment injury; to that end, it seeks the opinion of an independent medical evaluator on various questions concerning the worker’s health.
When is it relevant to request an independent medical evaluation?
The time when an independent medical evaluation is requested is decisive and varies considerably from one case to another. Here is a non-exhaustive list to help you identify situations in which an IME is relevant:
- You question an employee’s ability or inability to perform work;
- You question a healing or consolidation period that exceeds the average;
- You question the diagnosis and/or the treatments prescribed by the attending physician;
- The case has stalled (for example, there is no change from one medical appointment with the attending physician to the next).
You should ensure that the file is as complete as possible before proceeding with your request, including a clear, specific expertise mandate. We suggest you consult this article, which provides tips for writing an expertise mandate in accordance with industry best practices.
What does an independent medical evaluation report contain?
To meet medical expertise standards, an IME report must be clear and precise so that the requestor can readily understand it.
It usually includes:
- an introduction;
- a review of the facts and the patient’s medical history;
- a review of the current situation;
- an objective examination;
- a conclusion; and
- answers to the questions asked in the mandate.
How can you find an independent medical evaluator?
A number of firms offer medical expertise services. Here are several features that characterize the suppliers that are best equipped to help you manage your absenteeism, disability and employment injury files:
- Their network of physicians includes many independent practitioners who travel or are accessible where your workers are located.
- They offer a broad range of medical specializations to cover all your needs.
- Their physicians are known for their respect for workers and their ability to provide objective conclusions based on recognized medical knowledge.
- They continually train their physicians in best practices and ensure knowledge transfer from senior to junior physicians.
- They have a secure, user-friendly portal enabling them to gather information without compromising its confidentiality.
- They have a quality assurance team that ensures their medical expert reports are clear and well documented.
At Ducore Expertise, our evaluations are always carried out in a professional, respectful manner. Our know-how optimizes the chances of a positive prognosis and resolves impasses related to chronicity.
Contact us for more information: expertises@ducoreexpertise.com.
