Independent Medical
Examinations: An Independent Medical
Examination (IME) can be conducted for a variety of purposes. For
example, an IME can be performed for legal purposes, to get a second
opinion about diagnosis or treatment, to determine suitability for
specific types of employment, to determine readiness to return to
work, or evaluate possible impairments with specific tasks. An IME
is not the same as a psychiatric evaluation used to determine a
diagnosis and treatment plan. An IME is used to answer specific
questions, which may include diagnosis or treatment, but may also
require very specialized examination techniques outside the scope of
the usual psychiatric evaluation. IME's are usually not covered by
health insurance, although an insurance company may pay for an IME
if they request the examination. IME's are usually one-time
examinations (although the examination may take place over one or
more dates). A report is written and submitted to the court or
attorney who requested the evaluation. The conduction of an IME does
not constitute a doctor-patient relationship, and the doctor
performing the IME does not provide on-going treatment for the
examinee.
Disability Examinations: A disability examination is a
specialized evaluation to determine the level of functional
impairment. During the examination, information about the examinee's
emotional and behavior symptoms is obtained, and a mental status
examination is performed. If applicable, a diagnosis is determined
and a treatment plan is proposed. The functional impairment is
determined according to criteria set by the Social Security
Administration, or other criteria that may be set by insurance or
state agencies. The actual determination of "disabled" is made by
the Social Security Administration or other government agency, based
on information from many sources including disability examinations.
Disability examinations are usually not covered by health insurance,
although an insurance company or government agency may pay for the
disability examination if they request it. A report is written and
submitted to the agency or attorney who requested the evaluation.
Defendant Evaluations:
An examination of a defendant or a plaintiff is almost always
requested by the court or by an attorney. The is almost always a
specific legal question involved, for example, is a defendant
competent to proceed in a criminal trial. The doctor attempts to
answer the legal questions using criteria specified in the laws and
regulations. During the examination, information about the
examinee's emotional and behavior symptoms is obtained, and a mental
status examination is performed. If applicable, a diagnosis is
determined and a treatment plan is proposed. A report is written and
submitted to the court or attorney who requested the evaluation.
|
Victim Evaluations:
Often, an understanding of the emotional state or mental health of a
victim can be very helpful to an attorney, court, or insurance
company involved in a case. Sometimes a victim may develop Post
Traumatic Stress Disorder or other psychiatric disorders as a result
of a crime or accident. During an evaluation of a victim,
information about the examinee's emotional and behavior symptoms is
obtained, and a mental status examination is performed. If
applicable, a diagnosis is determined and a treatment plan is
proposed.
Custody Evaluations:
Parent's separation and divorce is usually a very stressful series
of events for children. In some divorce situations, the mother and
father each believe that the children would do best with themselves
rather than their spouse. This can lead to a custody dispute, which
requires the a judge's decision. A custody evaluation can provide
information to the court to help the judge decide with which parent
the children would live. Optimally, a custody evaluation is actually
a series of several separate evaluations. Each parent and child are
evaluated separately. Also, the children may be interviewed with
each parents. Psychological testing may be given to provide more
complete information. A custody evaluation may also be performed in
situations were there has been suspected child abuse or neglect.
Expert Testimony: A psychiatric or
psychological expert is required to do much more than "tell the
truth, the whole truth, and nothing but the truth" in court or
during deposition. During testimony, an expert must be able to
testify precisely and accurately about the "standard of care" that
may apply in a particular case. The "standard of care" involves
understanding the processes of diagnosis and treatment planning that
is performed by the community of psychiatrists and psychologists,
including current research and standards developed by professional
groups. An expert should be able to explain mental health concepts
and standards in a manner easily understandable by any one without
psychiatric or psychological training. An expert should be able to
maintain clarity and accuracy during cross-examination by an
opposing attorney who may attempt to discredit the expert.
|
