Independent Medical Examinations - information for service providers

What is an independent medical examination?

Independent medical examinations are sometimes required during the life of a worker’s work injury claim to provide the compensating authority (i.e. ReturntoWorkSA, their claims agent or self-insurer employer) with an independent opinion regarding the worker’s injury and treatment to assist with decisions about recovery and return to work and entitlements to compensation.

An independent medical examination may be arranged to confirm diagnosis and the connection between an injury or disease and a worker’s employment; when a worker’s recovery is not progressing as expected; to support the worker’s return to work activities; when there are complex matters that may or may not be related to the worker’s injury but are affecting the recovery and return to work process.

An independent medical examiner (IME) is a specialist with qualifications relevant to the worker’s injury.  They are medical specialists registered with the Australian Health Practitioners Regulation Agency (AHPRA).

IMEs are not employees or representatives of ReturnToWorkSA or its claims agents, and they are not the treating medical practitioner for the worker.  An IME does not replace a worker’s nominated treating doctor.

What are the service expectations for an IME?

Independent medical examiners should follow the principles and standards of professional practice when conducting examinations as outlined in:

The examination will be face to face. Telehealth examinations are not appropriate for IMEs and would only approved in very exceptional circumstances.

How does an IME receive a referral?

Referrals for independent medical examinations are received through ReturnToWorkSA’s Online Services, which enables service providers to safely and efficiently send and receive documents including reports and invoices. To register for Online Services - click here.- external site- external site- external site- external site

A referral to an IME comprises of several questions to better understand the extent of the injury or illness and how it impacts on work.  Those questions include things like:

  • past and present medical history as it relates to the work injury;
  • the cause of the injury or condition;
  • how the injury impacts the worker;
  • current treatment and how effective that is.

The examination is expected to be conducted in a respectful and professional manner, with the IME making all efforts to preserve modesty and not exacerbate the work injury or cause pain.  Workers are not expected to undertake any activity that can’t be done safely during the examination.

What is an IME Report?

The IME will produce a report based on the interview with the worker, the examination and the information provided by the referrer.  The report must:

  • be accurate, unbiased, precise and consistent;
  • be based on clinical findings and be consistent with accepted clinical practice;
  • address all questions asked by the referrer;
  • be limited to the circumstances of the worker’s injury and document any inconsistencies noted between symptoms and objective findings;
  • use simple language;
  • assess the worker’s general capacity to perform duties where possible.

More details about report requirements can be found in the ReturnToWorkSA: Independent Medical Examination Fee Schedule- external site- external site- external site- external site and Policy.
The report will be provided to the treating medical practitioner and the worker and, upon request, the worker’s employer.

What are workers required to do for an independent medical examination?

Workers are required to attend the IME appointment and are expected to:

  • confirm the appointment with the appointment with the referrer and advise of any special needs such as an interpreter;
  • wear comfortable and appropriate clothing for the examination;
  • arrange support if they need to and advise the IME prior to the appointment.
Who pays for the IME?

The compensating authority will pay for the examination.  The Return to Work scheme provides a fee schedule and policy, which is annually reviewed, and outlines all the fees and charges for an independent examination.

How do I become an Independent Medical Examiner?

You are eligible to become an IME for the Return to Work scheme if you are a medical specialist with qualifications registered with the Australian Health Practitioners Regulation Agency (AHPRA).

Please note, for these purposes a General Practitioner is not considered a medical specialist.

More information?

For more information regarding independent medical examinations or Online Services please contact the Scheme Support team on 8238 5757 or email .

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