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Workers' compensation insurance carriers, auto insurance carriers, and self-insured employers have a legal right to this request. Should the doctor/therapist performing the independent medical examination conclude that a patient's medical condition is not related to a compensable event, the insurer may deny the claim and refuse payment.
An independent medical review (IMR) is the process where physicians review medical cases in order to provide claims determinations for health insurance payers, workers compensation insurance payers or disability insurance payers. Peer review also is used in order to define the review of sentinel events in a hospital environment for quality ...
The topic of workers' compensation fraud is highly controversial, with claimant supporters arguing that fraud by claimants is rare—as low as one-third of one percent, [63] others focusing on the widely reported National Insurance Crime Bureau statistic that workers' compensation fraud accounts for $7.2 billion in unnecessary costs, [64] and ...
An impairment rating is a percentage intended to represent the degree of person's permanent physical or mental impairment. For people who have had an accident or an illness that has resulted in long term or permanent reduction in the use of a part of their body or bodily function, the impairment rating can be used to measure the loss.
MMI is relevant in multiple contexts, including personal injury cases and workers' compensation cases. When a worker receiving Workers' Compensation benefits reaches maximum medical improvement, their condition is assessed and a degree of permanent or partial impairment is determined.
The Office of Workers' Compensation Programs administers four major disability compensation programs which provide wage replacement benefits, medical treatment, vocational rehabilitation and other benefits to certain workers or their dependents who experience work-related injury or occupational disease. [2]