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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 give the IME survey to the worker after the exam. |
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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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IME
Rules |
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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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