What is an assignment letter?

Claim managers create a written request for an independent medical examination (IME) in an assignment letter. This letter contains instructions for the Central Scheduling Unit about the location for the examination and the specialty of the examiner(s) requested.

The assignment letter also states the purpose of the IME and includes specific questions to be answered by the examiner. After the IME has been scheduled, L&I adds the letter to the claim file to the Claim and Account Center (CAC) or, on request, will mail it to the IME firm or the individual examiner.

What if I need to reschedule an exam?

• To reschedule an exam requested by L&I, contact the Central Scheduling Unit at 800-468-7870.
• To reschedule an exam requested by a self-insurer or the Crime Victim’s Compensation Program, contact them directly.

How to write your IME reports

• Write the IME report for a non-medical audience.
• Use lay terms to explain all causal, diagnostic, logic, deductions and conclusions.
• Answer all questions in the assignment letter.
• Don't include a disability rating when the worker hasn't reached medical stability or a rating was not requested.
• Order any non-invasive testing required to complete your examination or to supplement your findings; you do not need pre-authorization from L&I.

• Include recommendations for invasive testing or additional treatment.
• Use the Independent Medical Exam Template (F245-058-000); see Appendix A of the Medical Examiners' Handbook (F252-001-000) for more details.
• A single report and/or addendum can cover:
  • Multiple claim numbers for the same worker.
• Exams conducted on the same worker by multiple examiner specialties (such as orthopedic surgery, neurology, or psychiatry).

Submitting your IME reports

• Submit your report within 14 days of the examination or within 14 days of receiving any test results.
• Fax the report to L&I at 360-902-4567. (For self-insured claims or Crime Victim’s Compensation claims, send the report to the firm requesting the IME.)
  • Make sure all claim numbers are at the top right-hand corner of every page.
• Fax only 1 worker's information at a time. Do not batch reports for multiple workers in the same fax transmittal.
• Do not use a cover transmittal sheet.
• Do not fax the assignment letter, it's already in the file.
• If you fax the report, do not mail it.

For assistance

• Central Scheduling Unit: 800-468-7870.
• Provider Hotline: 800-848-0811.

IME program Occupational Nurse Consultant Carol Britton: 360-902-6818.