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At
the request of the Management-Labor Advisory
Committee (MLAC), the Workers' Compensation
Division (WCD) conducted a study of independent
medical examinations (IMEs) in Oregon. The
study included surveys of injured workers,
attending and IME health care providers, worker
and defense attorneys, and IME facilities.
Focus groups were held to get insurer and third-party
administrators input. The study results can
be found here.
WCD made recommendations to MLAC and as a result,
Senate Bill 311 was created. The 2005 Legislature
unanimously passed Senate Bill 311. The bill:
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Requires
health care providers to be authorized by the
Director of the Department of Consumer and Business
Services (DCBS) to conduct IMEs for workers'
compensation claims in Oregon. |
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Worker
Requested Medical Examination provider selected
from IME list of authorized providers. |
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Requires
a Quality Assurance statement at the end of the
IME report. |
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Provides
the worker an opportunity to request review by
the Director of the reasonableness of the location
selected for the IME. |
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Imposes
a monetary penalty against a worker who fails
to attend an IME without prior notification or
without justification for not attending. |
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Imposes
a sanction against a health care provider that
unreasonably fails to provide diagnostic records
required for an IME in a timely manner. |
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Provides
the Director of the DCBS authority to investigate
complaints and exclude a health care provider
if they violate standards of professional conduct. |
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Requires
DCBS to develop or approve any training curriculum
for claims examiners used by insurers, self-insurers,
or third-party administrators related to interactions
with IME providers. |
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addition to the legislation, administrative rules
were developed that: |
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Require
health care providers to receive training to
be on the authorized list of health care providers. |
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Require
the insurer to send a brochure
with the appointment letter to the worker providing
information about IMEs.
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Require
the insurer to send the IME survey to the worker
with the appointment letter. |
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Allows
a worker to have an observer present during
an IME without the doctor's permission, except
for psychological exams, as long as an observer
form is completed. The observer form is
included in the brochure sent to workers with
the appointment letter.
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Require
the IME provider to make the brochure
available to the worker upon request by the worker
or when needed to complete the observer
form. |
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| Resources |
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Training |
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Senate
Bill 311 |
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History |
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Industry
notices |
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2004
IME Survey analysis:
Injured Worker Survey
IME Facilities Survey
IME Physician Survey
Defense Attorney Survey
Claimant Attorney
Survey
Attending Physician
Survey |
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IME
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