History of Senate Bill 311 and summary of IME changes
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 administrator 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, which:
Requires health care providers to be authorized by the Department of Consumer and Business Services (DCBS) director to conduct IMEs for workers' compensation claims in Oregon.
Worker Requested Medical Examination provider is selected from IME list of authorized providers.
Requires a Quality Assurance statement at the end of the IME report.
Provides the worker an opportunity to request review by the director of the reasonableness of the location selected for the IME.
Imposes a monetary penalty against a worker who fails to attend an IME without prior notification or without justification for not attending.
Imposes a sanction against a health care provider that unreasonably fails to provide diagnostic records required for an IME in a timely manner.
Provides authority to the DCBS director to investigate complaints and exclude a health care provider for violation of standards of professional conduct.
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.
In addition to the legislation, administrative rules were developed that:
Require health care providers to receive training to be on the authorized list of health care providers.
Require the insurer to send a brochure with the appointment letter to the worker providing information about IMEs.
Require the insurer to send the IME survey with the appointment letter to the worker.
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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