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APPLICATION FOR WATER/SEWER SERVICE Hardin County Water District No.1 1400 Ayersville Road Radcliff, KY. 40160 Phone: 3513222 FAX: 3513420 web: www.hcwd.com Automated Payment System 12708720967 TYPE.
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Independent Medical Examination (IME) Questionnaire What is your full name? What is your date of birth? Are you? ... What is the date of your injury? Have you ever had any previous problems or injuries, including any other work-related, recreational, or motor vehicle injuries?
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How to Write an IME Report Introduction and Executive Summary. Background Information. Qualifications of the IME Physician. Disclosure of Medical Records Reviewed. History of Examinee. Physical Examination. Opinions (Including Answers to Specific Questions Posed by Referral Source) Disclaimers.
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Independent Medical Examination (IME) Questionnaire What is your full name? What is your date of birth? Are you? ... What is the date of your injury? Have you ever had any previous problems or injuries, including any other work-related, recreational, or motor vehicle injuries?
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If the report is well-reasoned and well-supported, regardless of the favorability of the opinion, it is a good report. When evaluating an IME report, consistency matters. Inconsistent reports are not credible and they also make it difficult for the reader to figure out what, if anything, must be conceded on the claim.
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Independent Medical Examination (IME) Questionnaire What is your full name? What is your date of birth? Are you? ... What is the date of your injury? Have you ever had any previous problems or injuries, including any other work-related, recreational, or motor vehicle injuries?
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3 Things Not to Tell the Doctor During Your IME Don't Exaggerate Your Symptoms. Yes, you want to make sure your symptoms don't go unnoticed by your doctor. ... Don't Speak Negatively About Your Employer. Do not be rude or difficult, and don't speak negatively about your employer. ... Don't Lie.
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During a psychiatric IME, the psychiatrist will spend time one-on-one with the person, obtaining a relevant history, review records, test results, sometimes question collateral informants and synthesize all of this information to arrive at a diagnosis and conclusions.
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How Should You Handle Your IME? Always be truthful. It's critical that you remain truthful during your IME, making sure you answer questions without exaggerating or making up symptoms or medical problems. Ask for clarification.
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If the report is well-reasoned and well-supported, regardless of the favorability of the opinion, it is a good report. When evaluating an IME report, consistency matters. Inconsistent reports are not credible and they also make it difficult for the reader to figure out what, if anything, must be conceded on the claim.
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Checklist for Preparing for Your Independent Medical Examination (IME) Be Appropriately Cleaned, Groomed & Dressed. ... Arrive at Least 30 Minutes Early. ... Be Familiar with Your Medical History. ... Be 100% Honest – Don't Exaggerate Your Injuries.
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