Frequently Asked Questions

Independent Medical Exams (IME)

About IMEs

What is the difference between a PCI evaluation and an IME?

A permanent clinical impairment (PCI) evaluation assesses the medically measurable (objective) loss associated with an injury. PCI evaluations can be performed by either a specialist or non-specialist physician, and these physicians do not need to be on the roster of the Medical Panels Office (MPO).

These evaluations are then used to establish a PCI rating, and corresponding PCI benefit amount. More information on PCI can be found here:

https://www.wcb.ab.ca/assets/pdfs/workers/WFS_Permanent_clinical_impairment.pdf

By contrast, Independent Medical Exams (IMEs) address a variety of medical issues, such as diagnosis, fitness for work, treatment recommendations, or prognosis. IME physicians are specialists who must be on the MPO roster.

How long will it take for an IME to be booked?

The time it takes to book an IME depends on the availability of the type of specialist required for the examination. An orthopedic examination, for example, will usually occur within 2 to 4 weeks of referral.  For injuries requiring other specializations (e.g., neurosurgery), the wait time can be longer. 

If IMEs are independent, why are they done at WCB?

IME examiners are independent and not WCB employees. Exams are performed in examination rooms located at the WCB offices in Edmonton and Calgary so that WCB staff located on site are able to provide support for the IME physicians. This support includes medical transcription, access to specialized equipment, and assistance for workers with special needs. 

Why is the appeal history included in the medical summaries prepared by WCB for the examining physician?

It is important for the IME physician to know the medical issues that have been ruled on by the Appeals Commission in order to understand the accepted facts on the claim file. For example, if the Appeals Commission has directed that a certain injury or condition be accepted, an IME opinion may not be needed for that injury or condition. However, if the worker’s situation has changed since the Appeals Commission determination, medical opinion on the condition may be required. Therefore, the appeal history forms an important part of the medical package for IME physicians.

How do I know the physician identified for my IME is an expert in my type of injury?

IME physicians are selected based upon their expertise in the specialty. Due to the extensive training and experience of the physicians, their knowledge base is significant.

Due to the overlapping effects of an injury on various body systems, there may be times when specialties other than the specialty of the worker’s treating doctor may be appropriate.

How is the specialty of the IME physician determined?

Claim owners determine the question(s) under consideration (e.g., diagnosis, causation, work fitness, further treatment), and will then partner with a WCB clinical consultant to review the file. Clinical consultants are trained medical professionals who determine the appropriate specialty for the IME, and who help facilitate the consultation requests with the MPO. 

Can an Independent Medical Examiner be compelled by WCB to perform an IME?

No. There is no mandate in either the Worker's Compensation Act nor for the Medical Panels Regulation to compel a physician to examine an injured worker. Physicians are covered by the Health Professions Act and are regulated by the College of Physicians & Surgeons of Alberta.

IME roster

Is the roster posted on the MPO website up-to-date?

Yes. All physicians approved to do Independent Medical Examinations (IME) by the MPO Commissioner are posted onto the MPO roster: http://mpoalberta.ca/workers/independent-medical-examinations/.

Why are there not more choices on the IME roster? Why was I only given one choice?

The MPO works to recruit qualified Independent Medical Examiners to increase choice; however with certain specialties, recruitment is difficult due to the limited availability of physicians in that specialty. Therefore, in some cases the MPO is only able to secure one or two physicians.

How can I learn about the credentials of the physicians on the IME roster?

The MPO website provides a biography on each Independent Medical Examiner. Additional information can also be found on the College of Physicians & Surgeons of Alberta website: https://search.cpsa.ca/.

If the MPO is responsible for the IME roster, why does the case manager tell me that WCB policies apply to IMEs?

WCB policies apply when the claim owner is determining whether an IME would be of benefit for the worker. The MPO is responsible for the roster, and recruiting and approving qualified examiners to perform these examinations.

Does the MPO or WCB investigate concerns about the bias of IME physicians?

Concerns about bias are investigated carefully when factual evidence is provided; a suspicion of bias "just because" is not enough to conclude that there is bias, and the grounds need to be serious and substantial. According to the American College of Occupational and Environmental Medicine (ACOEM), "To be most effective, IMEs must be complete, focused, rigorously and clearly reasoned, and objective". If there are ongoing concerns, then the FPO or Alberta Ombudsman may be asked to investigate.

(Note: MPO will shortly be publishing a policy on their website on how bias will be assessed)

During the exam

I’m not allowed on WCB property – how do I attend?

WCB’s security and medical services teams will partner with you to facilitate an appropriate and safe environment to attend the IME. 

Can I bring someone with me? 

One person may accompany you to the exam location (i.e., WCB building), but no one is permitted inside the exam room unless a medical need has been communicated to the scheduling team in advance of arriving.

Can I record my IME?

Recording IMEs is not permitted. This practice aligns with the Independent Medical Evaluation Best Practices established by the American Medical Association.

After the exam

Can I obtain a copy of the Independent Medical Examination report?

Yes. Injured workers have access to their entire claim file, including any IME reports.  The IME consult report will be available two weeks following your appointment (to allow for dictation, transcription and signing time) and can be requested from your claim owner or our contact center (780-498-3999).

Do IME physicians determine the outcome of a claim?

Physicians do not make any claim decisions.   Physicians provide a medical opinion to assist the claim owner in arriving at a decision. The claim owner weighs all the available evidence, including the IME opinion, on the claim. The decision is that of the claim owner, not of the physician.

Can I file a complaint about an IME physician’s actions during an exam?

Yes. Any issues can be outlined in writing and submitted to the claim owner. The matter will be investigated by WCB and the MPO, and a written response will be provided to the worker. If required, the College of Physicians & Surgeons of Alberta may be asked to assist in the review. Depending on the outcome of the review, the physician’s status on the roster may be affected.