Best Practices for the Independent Medical Examination of Mental and Behavioral Disorders

Abstract

Abstract Independent medical examinations (IMEs) are elective evaluations of clinical conditions and differ from a clinical consultation in several important ways. They are conducted in many medicolegal contexts and are performed by a regulated health professional who is not the treating health care provider. An IME seeks objective information about the examinee's diagnoses, functional abilities and impairments, and other features relevant to addressing medicolegal-related cases by relying on multiple data sources. Best practice guidelines have been established for the completion of physical IMEs. However, similar mental and behavioral disorder (M&BD) standards are less common, and M&BD IMEs often do not follow a consistent process. This article offers guidance on applying and adapting existing standards to M&BD IMEs. We outlined the appropriate use of psychiatric nomenclature and how to apply recent changes to Chapter 14 of the AMA Guides to the Evaluation of Permanent Impairment. The article further offers a mechanism for introducing greater objectivity into an otherwise subjective process by employing relevant psychological validity testing and conducting a coherence analysis in formulating an opinion. In summary, we provide a synopsis of current best practices and offer the examiner a method for aligning M&BD IMEs with equally high standards of excellence.