An independent medical examination (IME) is an objective medical-legal examination requested (by L&I or self-insurer) to establish medical findings, opinions, and conclusions about a worker's physical condition. These examinations may only be conducted by L&I-approved examiners.
To be paid for IMEs for Washington workers' compensation, examiners must be approved and be assigned an IME provider number. Examiners must reapply every 3 years, or when requirements change. Examiners must understand Washington workers’ compensation rules. See WAC 296-23-317 for detailed IME provider requirements.
For the Washington Administrative Codes (WACs) covering independent medical exams, see WAC Chapter 296-23 (IME WACs 296-23-302 through 296-23-392)
How to apply or renew as an IME provider
- Read the Medical Examiners’ Handbook (F252-001-000) and then sign in to My L&I, browse to the Medical Examiners' Handbook Certification Test, and complete it within 6 months of submitting your application. Print a copy of the certificate of completion to submit with your application packet.
- Print and complete the appropriate IME Provider Account Application packet.
- Review CE requirements. Include documentation of continuing education (CE) if required.
- Mail or fax a copy of your test certificate with the appropriate application packet to the address or number below. Be sure to include any required attachments as described on the application. (Only complete applications will be processed. Incomplete applications will be returned.)
Department of Labor & Industries
Provider Quality and Compliance
PO Box 44322
Olympia, WA 98504-4322
Fax: (360) 902-4249
When L&I approves your application, we will notify you in writing.
Questions about the application process?
Call the IME Program Specialist at (360) 902-5131.
Medical Examiners' Handbook
Approved examiners are required to follow department guidelines and to be familiar with the Medical Examiners' Handbook (MEH) (F252-001-000). The Medical Examiners’ Handbook contains rules, guidelines, sample reports, and other information about conducting independent medical exams and impairment ratings in Washington workers’ compensation system. The handbook is also used by treating providers who rate impairment.
Medical Examiners' Handbook Test
This publication contains guidelines, sample reports, and billing procedures for preparing and conducting impairment ratings and independent medical exams (IME) in Washington's Workers’ Compensation system. The activity was planned and produced in accordance with the WSMA Essential Elements, Criteria, and Standards of Accreditation of Continuing Medical Education.
Disclosure: None of the faculty involved with developing this handbook has any financial relationship to disclose nor do they financially benefit from this product.
This activity is accredited for Category 1 CME. This examination is open book. You may find it helpful to print the handbook for reference, as you will be referring to it throughout.
- How much time will it take?
- After reading the handbook, it should take approximately 30 minutes to complete the activity.
- How do I take the test?
- NOTE: You'll need to sign in to My Secure L&I to begin the test. If you do not already have a secure login, click on the "Sign up" button to register and follow the prompts from there.
- You will be able to print your certificate of completion when you pass the test.
Impairment ratings use 2 systems
- To rate impairment of extremities for workers covered by L&I, use the 5th Edition of the AMA Guides.
- To rate impairment of the spine, mental health, and other systems, use the category rating systems in the Medical Examiners' Handbook (F252-001-000).
Questions about impairment ratings? Contact the IME program’s Occupational Nurse Consultant at 360‑902‑6818.
Find a Medical Examiner
For a list of approved IME providers or to search for an approved examiner by specialty and/or location, use the Find a Medical Examiner search tool.
What is an assignment letter?
Claim managers create a request for an independent medical examination (IME) through the online scheduling system. This request or assignment letter contains instructions 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.
Self-insured employers do not use the scheduling system. They schedule the exam and provide the claim file directly to the IME provider. A cover letter will be included to describe the reason for the IME and any questions to be answered.
What if I need to reschedule an exam?
To reschedule an exam requested by L&I, you can submit a request through the online scheduling system or contact the L&I scheduling unit.
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).
Scheduling System for L&I (State Fund) IMEs
Get registration steps, login instructions, and contact information for help with the scheduling system. In June 2015, L&I launched the Independent Medical Examination (IME) scheduling system for all L&I independent medical exams.
Approved IME providers interested in conducting IMEs for injured workers covered by L&I's State Fund must use this system to accept and schedule IMEs.
Providers must use My L&I to access the scheduling system. Providers who do not yet have a My L&I account can access the scheduling system using their existing Claim & Account Center (CAC) user ID and password.
- Sign In instructions: In addition to your My L&I or CAC login, you will need your Provider ID and the personalized code emailed to you to complete registration.
- Problems logging on? Contact Web Customer Support at 360-902-5999.
- Need help navigating the scheduling system? Contact Stuart Bammert at 206-515-2799.
Central Scheduling Unit: 800-468-7870.
Submitting your IME reports
Submit your report within 14 days of the examination or within 14 days of receiving any test results.
Submit the report to L&I through the online scheduling system. (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.
You do not need to mail the report for State Fund claims.
Accessing Medical Records / CAC
L&I provides access to medical claim files only on our online Claim & Account Center (CAC). When an IME is scheduled, the claim manager grants the IME temporary access to the claim file using the claim and provider numbers. L&I revokes the access after we receive the IME report or addendum.
Billing Codes and Fees
This site contains the policies, payment methods and maximum fees used to pay health care and vocational providers who treat injured workers and crime victims. (Make sure to check the Updates & Corrections tab for any changes to the Payment Policies or Fee Schedules.)
See billing and payment policies Chapter 13 for IME code descriptions.
IME Email List
IME Laws & Rules
Get an IME Form or Publication
For information about Becoming a Provider with L&I
Comments / Quality Concerns
Submit comments or concerns (F245-053-000) about your IME experience. Comments must be submitted in writing and mailed or faxed to:
Department of Labor & Industries
Provider Quality and Compliance Mgr.
PO Box 44322
Olympia, WA 98504-4322
Fax: (360) 902-4249
Who to Contact?
- IME occupational nurse consultant 360-902-6818
- IME Application & Requirements 360-902-5131
- IME Scheduling Questions/Problems 206-515-2799
- Medical Examiners’ Handbook Test web help 360-902-5999
- Billing Questions Provider Hotline 800-848-0811