Services Committed to Providing Insurers With Our Reliable Service Our Services Independent Medical Evaluation (IME) Independent Medical Evaluation’s are evaluations performed by an independent physician who is not involved in the claimant’s treatment for the purpose of clarifying a medical status or diagnosis. An IME is used by insurers to determine a claimant’s diagnostic need for continued treatment, degrees of permanent disability, or ability to return to work. IME’s may be performed anytime there is a dispute, concern, or question regarding the medical treatment. IME’s can address: Diagnosis Causation Work-relatedness of Proposed medical treatment Diagnostic efforts appropriate work and general activity level Ability to return to work (fitness for duty) and reasonable accommodation Impairment rating Stability of the medical condition Status regarding maximal medical improvement Identification of other nonmedical factors that can have a significant impact on the outcome of the medical condition or treatment Medical Record Review A medical record review is a formal evaluation of the claimant’s data and medical records to validate a diagnosis. It may also be performed to investigate legal implications stemming from sustaining an injury. Utilization Review A utilization review is a procedure to evaluate how services are being used and delivered to confirm that they are being utilized in a way that is efficient and cost-effective. Peer Review A peer review is a system where physicians evaluate the performance and quality of a claimant’s treatment of their peers in the profession. Peer reviews determine whether the doctor’s clinical care/treatment of his or her patient meets the acceptable standard for patient safety. Radiology/Film Review A re-read or comparison of previous completed diagnostic testing. Diagnostic Testing Core IME coordinates noninvasive diagnostic testing with licensed and registered professionals and diagnostic facilities. All diagnostic tests must have a signed prescription. Noninvasive diagnostic testing includes: Audiogram, a hearing test to evaluate the ability to hear by measuring the ability of sound to reach the brain. Electroencephalography (EEG), recording of electrical activity along the scalp. EEG measures voltage and fluctuations resulting from ionic current flows within the neurons of the brain. Electromyography/Nerve Conduction Study, (EMG/NCV), measures the electrical activity of muscles at rest during contraction. Nerve conduction studies measure how well and how fast the nerves can send electric signals. Electronystagmogram (ENG), measure involuntary rapid eye movements called nystagmus and evaluates the muscles that control eye movements. Magnetic Resonance Imaging (MRI), uses a powerful magnetic field, radio frequency pulses, and a computer to produce detailed pictures of organs, soft tissues, bone, and virtually all other internal body structures. Radiograph (X-ray), is an imaging technique that uses electromagnetic radiation other than visible light to view the internal structure of a non-uniformly composed and opaque object. Functional Capacity Evaluations A functional capacity evaluation (FCE) is a set of tests, practices, and observations that are combined to determine the ability of the evaluated to physically function in a variety of circumstances. An FCE evaluates an individual’s capacity to physically perform. The FCE process compares the individual's health status and body functions. The primary purpose is to evaluate a person’s ability to participate in work, although other instrumental activities of daily living that support work performance may also be evaluated. Who can benefit from an FCE? Someone who has been injured on the job to determine his or her ability to return to the job or alternate work Someone applying for Social Security disability benefits Someone seeking to return to work or volunteer activities after an injury or illness Someone injured in a catastrophic accident for whom an FCE can determine performance skills and abilities resuming former employment or a new job Litigated Claims/Liability Cases Depositions and conferences are coordinated to accommodate client needs and trial dates. Litigated and liability cases can be complex and require special exceptions. Please contact CORE IME for any questions with regards to exceptions that need to be made.