IME : Where to start?

[bronchospasm]

Was approached by my neighbor who is also a personal injury lawyer about doing IME’s? Thinking about it.

Which certification exam is better or recommended .. ABIME or ACIME. ?

Any recommends courses ?

Pros and Cons?

I’m just doing my due diligence whether it is worth my time, effort and peace of mind to enter this.

Any and all advice is appreciated.
Thank you.

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[Agast]

I think the only reason it’s not more popular is a lot of us get uncomfortable with medical-legal. Would it require you to testify on the stand? I’m just thinking of the disaster that was the Amber Heard psychiatrist.

I can’t recall the article, but there was some lawsuit over allegations of child abuse where the parent was originally found guilty. In the appeal and counter suit they also sued the expert witness and pointed out specific areas where they thought the doctor was negligent in their work up and assessment.

I think it pays well for a different kind of stress and it makes sense to do it if you have the time.

 

[cowboydoc]

ABIME is the only cert I’ve seen around here. Very few of the docs that do IMEs have a cert in the cases I’ve seen. One of the 2 I know that has ABIME is a shady occ med doc that doesn’t know anything, but will parrot what the payor wants to hear. Almost everyone else’s report is essentially a detailed H&P, summary of record review and answering specific questions presented.

If you already do WC or any Medicolegal, it’s not a big jump. I find it’s not stressful if I can do it during the week. Trying to carve out time on the weekend created stress for me and the family. I limit myself to 1-2 per month. Great secondary income stream.

The record review can be time consuming. First, charge accordingly. Also, paying staff to organize/summarize/type the mundane parts of the report will save a ton of time and make it much more lucrative. Physicians are really expensive secretaries! You’ll be able to review a tabulated record that already has records ‘copied and pasted’ into a document much more efficiency than thumbing through.

Be a referee, call it like you see it, not all questions have a clear answer, and you can say as much (causation). “More likely than not” is not as definitive as it seems.

I really hope to not start a diversionary argument, but PM&R training is much more likely to have exposed one too relevant experience in this arena than most other fields. (I did scut work on these and life care plans in residency). If you don’t have some of that experience, the certification/course may be worthwhile. When I looked into the cert, it just looked like a racket, akin to board MOC.

I like it overall. It amounts to 1/2 day a week or less and nets ~$50k/year. In 8 years, I’ve only done 8-10 depositions and testimony in 1 jury trial. Despite what you see on TV, these cases are 99% paper pushing.

Caveat emptor, I live in flyover country, and the process is generally quite civil here. I’ve heard (and experienced a couple times in cases based elsewhere) of attorneys attempting to discredit (or eviscerate) physicians opining in a manner counter to their position.

 

[Agast]

I really hope to not start a diversionary argument, but PM&R training is much more likely to have exposed one too relevant experience in this arena than most other fields. (I did scut work on these and life care plans in residency). If you don’t have some of that experience, the certification/course may be worthwhile. When I looked into the cert, it just looked like a racket, akin to board MOC.

I think you’re absolutely correct here. It’s part of why I don’t comment on disability unless it’s glaringly obvious and refer for Functional Capacity Evaluations.

I remember on the pain boards exam, there was a stem where the patient had met Maximal Medical Improvement and I was like, what in the heck is that. Probably got it wrong.

 

[MitchLevi]

I do an occasional IME and I see at least one WC pt per day. I've been deposed a number of times, all but one were easy and no problem at all. One was very gross and deeply disturbing (not directed at me thankfully).

I've actually never heard of a certificate for this.

In terms of disability and future work status...I defer to an FCE.

 

[painfree23]

I do them. Every week. Deposition tomorrow.
Two overlapping trials in two weeks. Full time clinical practice.

Training: SEAK.com for report writing and deposition skills.
Marketing: SEAK.com, thank you gifts, and excellent work backed up by medical literature (best source is IAIME training for content)
Record reviews can be outsourced where they index everything and give you a clickable pdf so you can look at linked key documents with ease.
It’s not a job where you can BS for long, you have to have evidence. For example if doing a causation analysis you need to use the Hill criteria otherwise you may end your medicolegal career by being dauberted out because of basing your opinions on nothing.

U have to do depositions for IME? Is this including record review for cases related to work injury/accidents?

 

[Pain Applicant1]

I've done a few of them early on. I'm not certified and the attorneys found me. It was good money but I didn't like doing them so I stopped. I found it to be too dull for my tastes and I hated being between 2 lawyers fighting.

I also had a PI attorney schedule an appointment with me to discuss my opinion on cases. I'm assuming they check you out to see if you're interested in playing ball. I think if you are, you can probably do very well financially.

I didn't participate due to lack of interest but if you're smart you should consider following spinebound's lead. That sounds like a good setup and likely very lucrative.

 

[kstarm]

OP: I thought you were pulling in like 20k wrvus a month...how do you see this benefitting your current practice?

 

[bronchospasm]

Don’t know exact wrvus but it is not more than 1000/ month. Looking to diversify knowledge base as well as referral source but wondering whether if it is worth the headache.

 

[PMR2008]

I am CIME and do about 2-3 IME's a month. I also do 1-2 life care plans and have a rolling caseload of expert witness cases/chart review. Average about 1-2 depos a month and 1-2 trials a year. I think for every 10 cases I do I get 2-3 depos. Most don't go trials as mentioned before. But I don't mind trials. My staff sorts out the paperwork for me but I do my own work (I don't mind because I charge $500+/hr for chart review)
CIME is easy to get and can help with Depos. I started doing medlegal right out of fellowship and have been slowly ramping them up. Plan is to have 25% of my practice doing med legal in the next 5 years and maybe 50% by the next 10. I like them but they are not for everyone. I use a company to get me life care plan cases but the rest are all word of mouth. I live in a big city and have 4 large law firms that like my work and send me more than I can handle. I am very picky with cases. I do not testify against other docs and do mostly PM&R related cases.

 

[RoloTomassi]

live in a big city and have 4 large law firms that like my work and send me more than I can handle.

Plaintiff or defense firms? WC or PI?

 

[PMR2008]

I don't do WC or PI. I do mostly plaintiff but have done defense as well.

 

[RoloTomassi]

I don't do WC or PI. I do mostly plaintiff but have done defense as well.

So med mal?

 

[PMR2008]

I have done a couple but avoid them.

 

[RoloTomassi]

I have done a couple but avoid them.

Sorry for being so inquisitive, genuinely interested in what you do, but if you don't do WC, PI, or med mal, what kinds of cases are these?

 

[PMR2008]

Workcomp I personally stay away from. A lot of cases are personal injury but as a Physiatrist I am doing the IME, life care plan, chart review to mostly discuss standard of care, future expenses etc. I don’t treat the patient but I suppose they are still under the category of personal injury. IMEs and life care plans help avoid testifying against other physicians. Sorry for the confusion.

 

[lobelsteve]

Workcomp I personally stay away from. A lot of cases are personal injury but as a Physiatrist I am doing the IME, life care plan, chart review to mostly discuss standard of care, future expenses etc. I don’t treat the patient but I suppose they are still under the category of personal injury. IMEs and life care plans help avoid testifying against other physicians. Sorry for the confusion.

PMR guy is a lurker in pain forums. Post more here more often sir.

 

[PMR2008]

I wish I had the time!! I legit have 2 full time and 2 part time jobs lol.

 

[cowboydoc]

I wish I had the time!! I legit have 2 full time and 2 part time jobs lol.

Are the life care plans really worth your time with the company taking so much off the top if you're that busy?

I discussed with Jacob (assuming it's the same company) and my conclusion was $400/hour wasn't worth it with my current workload. If I were working part time and billing $400/hr from a vacation spot, it would be great.

I trained under a guy who trained the founder of this company. He made several thousand/hr on these life care plans, as he wrote his own software for calculations. It was really impressive.

 

[PMR2008]

They do so much for me though. Marketing, collecting records, summarizing records, software that all I have to do is plug in a few things and spits out a beautiful report. I know I can make more doing it independently which maybe I will eventually but I like using them for the ease.

 

[Ligament]

I do them. Every week. Deposition tomorrow.
Two overlapping trials in two weeks. Full time clinical practice.

Training: SEAK.com for report writing and deposition skills.
Marketing: SEAK.com, thank you gifts, and excellent work backed up by medical literature (best source is IAIME training for content)
Record reviews can be outsourced where they index everything and give you a clickable pdf so you can look at linked key documents with ease.
It’s not a job where you can BS for long, you have to have evidence. For example if doing a causation analysis you need to use the Hill criteria otherwise you may end your medicolegal career by being dauberted out because of basing your opinions on nothing.

Would you mind sharing which company you use to do this?

 

[Ligament]

I have done plenty of IMEs and depositions. Most of it is not bad, but what I absolutely hate is dictating the review of records into my reports. It is just clerical work and a waste of my time. How do you guys deal with this particular aspect of the job?

 

[cowboydoc]

I have done plenty of IMEs and depositions. Most of it is not bad, but what I absolutely hate is dictating the review of records into my reports. It is just clerical work and a waste of my time. How do you guys deal with this particular aspect of the job?

I pay my staff to do it. A nurse with some experience sorting this on the front end and prepping the document is golden. I basically do a physical exam, assessment and answer any specific questions.