IME payrate

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Justanothergrad

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For those who do IMEs, what do you bill per hour? I've got a company proposing a contract with a few per year and want to gauge rates. They're offering between 200-250 an hour depending on the eval, max hours billable of 8 for general diagnostic and 12-20 for more complex cases

Thanks.

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I’m surprised you haven’t heard from people here who do IMEs but I would think that for that type of work, $250/hour would be the lowest rate I would consider accepting, generalIy speaking.

I don’t do IMEs and I already make more than that per hour in my clinical work so I would require significantly more to even consider it, but I have no interest in doing IMEs. I would also make sure to clarify prior the conditions when you may require more hours to complete the evaluation and how you will be compensated for that.
 
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I apologize if this is in another thread, but how does one get into IME work? And is there an amount of time you need to be in the field post licensure before you can get into it?
 
I apologize if this is in another thread, but how does one get into IME work? And is there an amount of time you need to be in the field post licensure before you can get into it?
It's mostly word of mouth and/or finding your first case, as I don't believe any state has a "limit" on who can do IME work, as long as you are fully licensed. Sometimes clinicians will just get cold-called from a law office looking for an expert. These are opportunities, but you really want to make sure you understand what is being requested, if it is a clinical v. forensic case, and what deliverables and expectations they have in regard to your participation. If they want to use insurance, that is a RED FLAG...both in regard to payment, but also potential insurance fraud by the lawyer. Some lawyers will try to use medical insurance early on, so as not to need to spend their own $$. It gets sketchy if they know they are going to take the reports and use them in a legal case, so it's important to know what is going on before accepting a case.

I had limited forensic work in my first handful of years of practice, mostly being the "treating clinician" in cases that go legal. In that setup, you are being retained to speak to the clinical treatment provided, not as an independent expert.

Going through the workers comp system could be an option to get some exposure doing reviews et al. It likely varies by state.

It still takes time to build a reputation and become someone who gets on the short-list for firms, as most firms have their people they like, while other firms will be looking for other experts to handle their cases. You can also crush the opponent's expert and get more work that way too.

There are companies that "match make" experts with lawyers/cases. They vary greatly in quality and what they offer. Some places are simply pass-thru, and they contract you at a cheap(ish) rate, and you do the work, and they pay you. Ideally, you'd want to find is a 3rd party company that has a good reputation and you can charge your full forensic rates (there is usually a range of rates), and they will add a couple/few %-pts for their cut. I'm not sure if things are regional or what, so your mileage may vary (YMMV).

A bit longer than expected, but hopefully helpful.
 
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For those who do IMEs, what do you bill per hour? I've got a company proposing a contract with a few per year and want to gauge rates. They're offering between 200-250 an hour depending on the eval, max hours billable of 8 for general diagnostic and 12-20 for more complex cases

Thanks.

I was contracted with an IME company in Ohio - I charged $350/hr.
 
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It's mostly word of mouth and/or finding your first case, as I don't believe any state has a "limit" on who can do IME work, as long as you are fully licensed. Sometimes clinicians will just get cold-called from a law office looking for an expert. These are opportunities, but you really want to make sure you understand what is being requested, if it is a clinical v. forensic case, and what deliverables and expectations they have in regard to your participation. If they want to use insurance, that is a RED FLAG...both in regard to payment, but also potential insurance fraud by the lawyer. Some lawyers will try to use medical insurance early on, so as not to need to spend their own $$. It gets sketchy if they know they are going to take the reports and use them in a legal case, so it's important to know what is going on before accepting a case.

I had limited forensic work in my first handful of years of practice, mostly being the "treating clinician" in cases that go legal. In that setup, you are being retained to speak to the clinical treatment provided, not as an independent expert.

Going through the workers comp system could be an option to get some exposure doing reviews et al. It likely varies by state.

It still takes time to build a reputation and become someone who gets on the short-list for firms, as most firms have their people they like, while other firms will be looking for other experts to handle their cases. You can also crush the opponent's expert and get more work that way too.

There are companies that "match make" experts with lawyers/cases. They vary greatly in quality and what they offer. Some places are simply pass-thru, and they contract you at a cheap(ish) rate, and you do the work, and they pay you. Ideally, you'd want to find is a 3rd party company that has a good reputation and you can charge your full forensic rates (there is usually a range of rates), and they will add a couple/few %-pts for their cut. I'm not sure if things are regional or what, so your mileage may vary (YMMV).

A bit longer than expected, but hopefully helpful.
Thanks, this is definitely helpful!

I'm acquainted with the initial advice about expert vs. fact witnesses for forensic cases, lawyers trying to abuse health insurance to pay for evals, etc. from practicum experiences (especially a supervisor I had for a neuropsych prac), but I don't know much about the business side of things my clinical science-focused program doesn't do a great job of providing mentorship in this area.

Can you or anyone else speak to the non-neuro side of things? E.g., for what non-neuro areas do/have you done this work (general psych, health-related stuff, etc.), how did you get into doing it, what's pay like, are there any pitfalls/issues/headaches/etc. doing it that aren't apparent beforehand?
 
For those who do IMEs, what do you bill per hour? I've got a company proposing a contract with a few per year and want to gauge rates. They're offering between 200-250 an hour depending on the eval, max hours billable of 8 for general diagnostic and 12-20 for more complex cases

Thanks.
Hourly rates can vary by geographic region, though in my experience anything less than $300-$350/hr for IME work is not worth the hassle for most who do legal work. Starting out you aren't going to charge what people who have been doing it for 15-20yrs charge, but <$300hr is likely too low, IMHO. You should consider calling around to practices in your geographic area who do IME work and inquire about their rates. Some will list their rates on their website, though most probably will provide upon request.

As for non-neuro, I charge the same. Non-neuro can cover anything from PTSD to pre-surg evals, though those are in the minority of the types of cases I see bc I like to stick to my niche areas and pass on the rest.
 
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Thanks, this is definitely helpful!

I'm acquainted with the initial advice about expert vs. fact witnesses for forensic cases, lawyers trying to abuse health insurance to pay for evals, etc. from practicum experiences (especially a supervisor I had for a neuropsych prac), but I don't know much about the business side of things my clinical science-focused program doesn't do a great job of providing mentorship in this area.

Can you or anyone else speak to the non-neuro side of things? E.g., for what non-neuro areas do/have you done this work (general psych, health-related stuff, etc.), how did you get into doing it, what's pay like, are there any pitfalls/issues/headaches/etc. doing it that aren't apparent beforehand?

For IME work, I browsed some local job boards via the state psychological and psychiatric associations in Ohio; I saw a posting that a company was seeking a psychiatrist and/or psychologist for IME work and I began a conversation with them. I'm listed in the directory for my state psychological association to provide various testing/assessments which prompted some folks to reach out to me to contract to do police evaluations with them, including the state trooper academy. I cold-called a bunch of universities throughout the state to let them know I was open for business and started getting referrals for violence risk evaluations from 3 different universities. Pay varies based assessment types. You will find that deadlines also vary. Also, some IME companies will have some strict "non-compete" contracts where despite you being an independent contractor with them, they want you to be exclusive to them, and, if you somehow get approached by a lawyer to do IME work, they want you to connect that lawyer with the IME company you would be contracted with. I did not like that and is why I declined to work with one company.

Since most of my background has been in neuro testing, I really didn't have much experience doing forensic work, so I sought out some colleagues around me who were ABPP; heck, one is ABPP, J.D., has been on the ABPP committees, state board ethics committee, and various other committees, and took me under his wing where he brought me on as a contractor to do SSD evaluations. He has been a consultant and mentor for me as I develop my forensic background. Most people who go on to get ABPP(FP) did not complete a formal forensic post-doc, so that was also encouraging to hear from him. Presently, I just established my PLLC forensic practice after moving from Ohio to Texas, and, I was recently offered a contract to do some police evaluations with this multi-state practice that was seeking folks with either PsyPact or Ohio licensure.
 
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If you properly market an expert witness practice, increased referrals can help drive up your hourly. Third-party referrers will take a cut. Key is to get direct referrals. FYI $250/hr is on the lower side...it is for non-medical experts. I was once involved in a case (I am a forensic psychiatrist) where the opposing expert was a non-forensic psychologist (but a "top" PTSD researcher). She charged $700/hr (I don't think she was interested in doing a good volume of work). FYI, although she knew PTSD her report was not as solid as the other forensic psychology report.
 
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Just a point of clarification about 3rd party referrers, I haven't come across any that take a cut. Rather, you provide them your fee schedule and they charge on top of your fees to collect theirs. So, while you could still likely make more working directly with an attorney, you are still getting your full requested fee. There are some attorneys that I work directly with as they have been vetted, but it's nice to have a third party run all of the logistics and pay me promptly after submitting an invoice every time.
 
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I talk a lot about billing & revenue below bc that’s a significant component of this type of work. Being a forensic expert is more stressful, has a greater risk of liability (but still low compared to some medical specialities), and most people avoid it like the plague. I avoided it my first few years, but then realized I actually really enjoy the work. Working with mentorship is key though, so is learning your state’s case law and whatever quirks are baked into the court system.

Tom4705 said:
Also, if you don't mind me asking, how frequently do you travel as part of your work? As a forensic psychologist, do you testify alot? Also do you mind if I ask the ballpark of how much you earn doing what you do?

Travel is highly dependent on the type(s) of forensic work chosen. I’m a neuropsychologist who specializes in acquired brain injury and a few psychiatric diagnoses. I work almost exclusively on the civil side, as opposed to criminal, but there are a bunch of different assessment options in each area. There are also immigration evals, but I don’t know anything about them, other than there is always a need for them (but payment could be limited).

As for location…I can request permission from out of state licensing boards to conduct an eval and/or appear in another state’s court for a case. They can provide temp privileges, usually w a cap on the # of days per year they’ll allow an out of state expert to “practice” in their state. It’s more common in certain regions to keep multiple licenses active, especially on border cities like NYC, PHI, DC, B’more, etc.

A quick note about criminal work, I know some experts will travel to jails and prisons to do evals, while others will see ppl at the person’s lawyer’s office or their own office. There are a number of different types of evals an expert could offer, it just depends on your expertise and what is needed

NGRI evals seem easy to get if you want the work; they aren’t my interest, but usually the expert can negotiate a good rate and work w the county/gov’t on these evals. Beware though, some courts will only pay a capped hourly rate, but most have problems getting enough experts, so they usually will pay more.

I refuse all child custody cases bc they are a very narrow focus with a high-stress setup. Experts can charge $$$ for child custody eval cases, but you’ll definitely get sued by disgruntled parents, and the retaining clients can be a nightmare to navigate. Each community tends to only have a couple/handful of experts who do these evals, and you better have solid mentorship bc you can screw them up really easily.

The vast majority of my forensic work is in my home state, but I travel btw major cities and get paid portal to portal. P2P is great when I have to be deposed or when I have to go testify in court bc I get paid the second I leave my home until the second I return to my home or office. Some court stuff is still done via zoom, a holdover from the peak of COVID, but many court appearances are back to in-person. I’d say 80-90% of my cases never reach deposition or court, so I may only get deposed/appear in court 1-4x per year out of a couple/few dozen cases per year.

By design, probably 1/2 to 2/3 of my cases are “record review only”, so I don’t eval or interview the claimant, I only review the records and provide opinions based on those records. These cases are often earlier on in the process (and might not even have the case filed yet w a court), so they tend to be smaller reviews and/or the beginning steps in a case.

The other 1/3 to 1/2 are cases require an interview and/or formal assessment. The latter is great for the bottom line (hours charged), but I usually prefer just doing record reviews bc it avoids having to schedule an in-person appt and the logistics of testing. Sometimes opposing counsel can be a PITA, so the less I (& my staff) have to deal with them, the better. Other times I just collect the cancellation fees and treat myself to a long weekend vacation bc I already took the time “off” from my clinical work.

Cancellations, No Shows, having cases settle at the last minute, and charging rush fees are all great ways to get paid for dealing w the hassles inherent to taking legal work. As long as you document & disclose your fees (most/all states require these to be disclosed), you can get paid for any cancellations within 1-2wks and add “rush” fees when clients drop last minute requests on you; the expert sets the timeframes. Over the course of a year, this can easily reach $10k-$40k+/yr of additional revenue for clinicians who do more than a handful of cases per year.

As for rates…ppl get spooked talking about money, but as long as we aren’t organizing to set pricing in a given region (like the mob and for-profit corps like insurance carriers do), then we should be fine.

Rates can be very geographically and niche dependent. I’ve seen ppl use double their clinical rate as a rule of thumb bc forensic work is inherently more of a PITA. I’ve seen others call around to experts and lawyers in the community to insure about rates. Fees can also be pulled from court documents, as they are all required to be disclosed. My rates were about average when I started, and now are on the high-end after I built a solid reputation regionally/nationally.
 
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If you properly market an expert witness practice, increased referrals can help drive up your hourly. Third-party referrers will take a cut. Key is to get direct referrals. FYI $250/hr is on the lower side...it is for non-medical experts.
3rd party IME companies range from predatory to sought after, and everything in between. I’ve seen some that are VA Comp & Pension eval sweatshops, who pay a flat rate and upcharge 2x-3x. There are ones that do this with disability evals, charging thousands and paying the clinician <$400 per eval. They target early career and naive clinicians who don’t have mentorship and who don’t know any better. While others can be very picky bc they’ll pay your full fee, but you need to do the work for a while and be known locally and/or regionally before they’ll take you on as one of their potential experts. I know you prob know all of this already, but I shared for others reading.

I was once involved in a case (I am a forensic psychiatrist) where the opposing expert was a non-forensic psychologist (but a "top" PTSD researcher). She charged $700/hr (I don't think she was interested in doing a good volume of work). FYI, although she knew PTSD her report was not as solid as the other forensic psychology report.
There is definitely something to be said about topic/research experts v. Expert Witness/IME. I reviewed documentation the other day that was better than average for a clinical report, but it was woefully insufficient for an IME. I could tell they were in over their head, which made my rebuttal super easy. They actually did pretty well documenting details, but HOW the report was written and WHAT they focused on were dead giveaways they were a clinician asked to weigh in and not an actual expert. I was even really nice in how I destroyed their claims, but I’d be shocked if they don’t settle after they read my rebuttal report.
 
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(Wis & I have talked about this previously, but it’s worth sharing for anyone following this thread.)
Just a point of clarification about 3rd party referrers, I haven't come across any that take a cut. Rather, you provide them your fee schedule and they charge on top of your fees to collect theirs. So, while you could still likely make more working directly with an attorney, you are still getting your full requested fee. There are some attorneys that I work directly with as they have been vetted, but it's nice to have a third party run all of the logistics and pay me promptly after submitting an invoice every time.
100% agreement.

The places that take a cut tend to be sketchier and often will secure large gov’t/state/local contracts and farm out the evals. I’ve seen it most often in prisons and VA hospitals, buts it’s also super common with disability evals (as you know). Some state prison systems will fly in ppl to do a bunch of assessments in a week & pay $$$, but be wary of companies recruiting for those same opportunities bc they’ll take a large chunk of your money for doing basically nothing while the contracting psych keeps all of the actual liability and hassle.

Speaking of payment, ALWAYS get a retainer when you are dealing directly w a lawyer/firm, as they can drag their feet paying. Some 3rd party companies pay quickly, others don’t, so negotiating a payment schedule can be helpful. I’m currently waiting on a few checks for July, but they add up quickly. Thankfully, cancellation fees, clinical assessment and intervention work, and some corp consulting fill out the rest of my schedule and help even out my cash flow.
 
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I charge $350/hr for anything that I do (e.g., interviewing, test admin, review of records, report writing). If one of my psychometricians administer tests (e.g., neuropsychological testing), I charge $180/hr.
 
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