| Approved Examiner Information |  | |
Assignment letter
Claim managers create a written request for an independent medical examination (IME) in an assignment letter. This letter contains instructions for the Central Scheduling Unit (CSU) about the location for the examination and the specialty of the examiner(s) requested.
This letter also includes the purpose of the IME and specific questions to be answered by the examiner. After the IME has been scheduled the letter is added to the claim file on the Claim and Account Center (CAC)
or may be mailed to the IME firm or the individual examiner by the CSU upon request.
General IME instructions
These instructions apply to all IMEs:
- Write the IME report for a non-medical audience.
- Explain all causal, diagnostic, logic, deductions and conclusions in lay terms.
- Answer all claim specific questions listed in the assignment letter.
- Don't include a disability rating when the worker hasn't reached medical stability or a rating was not requested.
- Non-invasive testing required to complete your examination or supplement your findings is pre-authorized.
- Include recommendations for invasive testing or additional treatment in your report.
- Use the Independent Medical Exam Template (F245-058-000); see Appendix B of the Medical Examiners' Handbook (F252-001-000) for more details.
- Submit your IME report within 14 days of the examination or within 14 days of the receipt of the testing results.
- Fax the report to L&I (see IME fax numbers below). For self-insured claims, send the report to the firm requesting the IME.
- Contact the CSU or the self insured firm requesting the examination to reschedule an examination.
Get Help Downloading Files (files open in a new window).| IME fax numbers | |
|---|---|
| 360-902-4292 | 360-902-5230 |
| 360-902-4565 | 360-902-6100 |
| 360-902-4566 | 360-902-6252 |
| 360-902-4567 | 360-902-6460 |
Additional resources
- L&I Central Scheduling Unit: 1-800-468-7870.
- L&I Provider Hotline: 1-800-848-0811.
- IME program Occupational Nurse Consultant Carol Britton: 360-902-6818.
- L&I Claim and Account Center Support:
- Call: 360-902-5999.
- E-mail: WebSupport@LNI.wa.gov.
- Medical Examiners' Handbook (F252-001-000):
- Order online.
- Call the Provider Hotline at 1-800-848-0811.
- Medical Aid Rules.
- 2007 Fee Schedules
- Medical Treatment Guidelines.
- Opioid Dose Calculator (www.agencymeddirectors.wa.gov) (988 KB MS Excel / 5 min).
Get Help Downloading Files (files open in a new window).