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Reasons to Request an Independent Medical Assessment
1. Lack of Improvement
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The Client is concerned that the primary care providers are not providing appropriate therapeutic direction to the Claimant.
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2. Information Gathering
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Details of the incident, seatbelt usage, loss of consciousness, other accidents, WCB claims, etc.
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Work history.
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Stressors other than the incident.
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Prior disease as indicated in pre-incident medical history (GP chart notes, imaging studies, statement of benefits, etc).
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Review of medical documentation.
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Present complaints.
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Abnormalities and impairments on examination.
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3. Inconsistencies on File and Client’s "Sixth Sense"
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Clinical or surveillance information inconsistent with claimed disabilities.
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"Gut feeling" that something is not quite right with the Claim.
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Concerns of possible factitious reporting, malingering or fraud.
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4. Variances from the Expected Norm
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Discrepancy between vehicle damages/repair costs/velocity at impact and reported injuries.
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Prolonged recovery despite various therapies.
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Inconsistencies and non-organic signs on examination (Waddell’s signs).
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5. Causality, Disability and Treatment
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Causation of impairment and disability.
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Questionable passive/alternative therapies (past and present).
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Medically essential treatment plan.
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Return to Work plan.
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Prognosis.
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To support or counter an opinion put forth by the treating GP or by a specialist retained by legal counsel.
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6. Assistance on Claim Management
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Is there objective justification for the insurance company to continue providing benefits relative to the insurance policy and regulations, and for how long?
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