Independent Medical Evaluation (IME)
Independent Medical Evaluations or IMEs represent CMA’s marquis service. IMEs are requested by a diverse client base to determine critical issues specific to a given claimant’s disability status.
Depending on the nature of a customer’s request, an IME can address:
- Causality of injury or illness
- Maximum Medical Improvement (MMI)
- Identification of work restrictions and/or limitations
- Need for alternative treatment or diagnostic workup
- Medical necessity of care
- Reasonableness of current treatment
- Fitness for duty or return-to-work (RTW) status
- Injury status
- Pre-existing injuries
Impairment Rating Evaluation (IRE)
Pennsylvania’s Workers’ Compensation Act (Act 57) allows the use of IREs that determine the degree of whole body impairment caused by a compensable injury. IREs are used to determine the degree of compensability by focusing on whether an injury has resulted in permanent disability or temporary disability by a physician certified in utilizing the AMA Guides to the Evaluation of Permanent Impairment 4th, 5th and 6th Editions.
Fit for Duty
Determining if an individual has the ability to return to work and perform the specific job duties as outlined by the employer.
A Permanency Evaluation renders an impairment rating of the accepted body part. CMA is well versed in the methods that vary from state to state.
Functional Capacity Evaluation (FCE)
Functional Capacity Evaluations or FCEs assess the degree of disability relative to a return-to-gainful employment. FCEs augment the data generated through an IME and can be combined with an IME.
Utilizing vocational experts to provide labor market surveys to offer prospective employment positions that fall within the claimant’s physical capabilities as outlined by the physician.
Medical Record Review
A medical record review can address issues similar to an IME. They generally focus on the medical necessity and reasonableness of a given episode of care and can be completed without a physical examination.
Nurse Case Review
- Recommendations to help move the case forward
- Medical record review with chronology of treatment
- Medical billing review and case relationship
- Determination of missed medicals for case completion
- All reviews will be completed by a Registered Nurse with a Bachelor’s degree, a legal nurse consulting certification (LNCC) and an ABA certificate in paralegal studies.
- Experience in claims, medical and legal reviews including Emergency Room, Intensive Care Unit, Orthopedics, Long Term Care Facilities, Worker’s Compensation and Nurse Case Management.