Information on medical examinations (webpage)

Independent medical examinations are different to your usual medical appointment in some important ways.

For example, an Independent Medical Examiner (IME) will ask you in detail about what treatment you have had, but is not allowed to provide you with direct treatment advice because they are not your treating practitioner.

If you have an independent medical examination scheduled, the information below will help you understand what to expect.

What is an independent medical examination and who conducts them?

An independent medical examination is an examination of your condition conducted by a specialist medical practitioner or allied health professional.

The IME will talk to you about your condition and may need to conduct a physical examination of your injuries.

The IME will write a report which goes to the TAC.

The report helps the TAC understand what is needed to support your recovery, rehabilitation and ability to work. The report may also be used to help inform a decision about your entitlement to weekly payments and medical and like services.

IMEs are required to provide their independent opinion

IMEs are healthcare professionals engaged by the TAC with the specific purpose of providing their independent opinion about your condition.

IMEs are not employees or representatives of the TAC. However, they are paid by the TAC to examine injured clients and to provide an independent medical report.

IMEs have to be experienced specialists in their fields, understand trauma and transport accident injuries and be engaged in active clinical practice.

Attending independent medical examinations

Please arrive at least 15 minutes early for the appointment.

You should allow plenty of time to get to the location of the medical examination and allow ample parking meter time.

Please understand that if you are late for the medical examination, the IME may not be able to see you and the appointment may need to be rescheduled.

If the IME is running late and you cannot wait, please advise the consulting rooms staff prior to leaving.

Participating in a telehealth video-conference examination

A telehealth video-conference is a clinical examination performed via a video-conferencing platform, where the client and consulting specialist are not in the same physical location.

Telehealth video-conferencing is an alternative method for obtaining an independent medical opinion during the COVID-19 crisis.

All telehealth services require prior approval from the TAC and must be consented to by the client and the independent medical examiner.

For further information about video-conferencing (including how to decide if it is right for you and how to prepare) please see the appendix below: ‘Helpful telehealth information’.

If the medical examination does not go ahead for any reason, then it is very important that you contact the TAC immediately so we can reschedule your appointment.

How long will the independent medical examination take?

The length of the medical examination can vary depending on the type of examination and complexity of your injuries.

Many medical examinations can be an hour but some may be shorter.  Independent medical examinations may take several hours to complete or may involve additional testing done by someone other than the IME.

Before the medical examination commences, the IME will already have been provided with some information about your condition by the TAC, such as reports from medical practitioners or x-ray reports that may be part of your TAC file.

Will the IME give me direct advice about treatment of my injuries or tell me the diagnosis?

No. The IME is not your treating practitioner and is not allowed to provide you with direct treatment advice or discuss their diagnosis or opinion.

The IME will ask you questions about your treatment, including medications, so that this can be documented in the report. This discussion is not providing you with direct treatment advice, but clarifying treatment being provided by your treating practitioner.

Following your medical examination, the IME will provide a report to the TAC outlining their examination, diagnosis and opinion.

What will happen at the independent medical examination?

Setting expectations

At the start of the medical examination, the IME should explain their area of medical practice, their role and the purpose, nature and extent of the examination that will be conducted. If you have questions about the purpose, nature and extent of the examination, please ask the IME to clarify them for you.

Talking to you

The IME will talk to you and ask about your injury and condition, including:

• the medical history of your injury
• treatment you have had or are receiving
• your current symptoms
• your relevant personal or social history
• your work history (e.g. your duties at the time of your injury, whether you have returned to work, or your capacity for work)
• your daily activities and interests

The medical examination often includes a direct form of questioning which may appear impersonal.

Please be aware that the IME may also ask questions that do not directly relate to your injury, as the IME needs to understand the extent of your injury and how it affects your life.

It may be necessary to ask you in-depth questions about your family and personal history, to better understand your circumstances. These types of questions are more likely to be asked by psychologists and psychiatrists.

The physical examination

The independent medical examination may include a physical examination to properly assess your injury, including the need to test joint movements. Sometimes the medical examination will involve parts of your body which may not have been injured, to better understand the way the injury is affecting other parts of your body. An example of this is the need to examine the arms and legs when there has been spinal injury as nerves to these parts travel through the spine.

The type of medical examination will vary depending on the specialty.

Video examinations

The video appointment will run similar to a face-to-face appointment. However, it uses technology (like computers and mobile phones) to connect you with the IME at a different location to you.

If you are attending a video appointment remotely (e.g. from your home), you will receive details from the provider with the information you need to connect to the video-conference, this may include an option to test your internet connectivity to the video-conference service.

Five minutes before your appointment, follow the instructions to join your video call online.

You will see your IME on the computer screen and will be able to talk to them as you would in a face-to-face appointment.

The IME will follow the same process as a face-to-face appointment as outlined in the previous two sections ('Talking to you' and 'The physical examination').

As with face-to-face consultations, no-one (including you or the IME) may record the consultation unless consent is obtained from the other party.

What should I bring to an independent medical examination?

Your appointment letter will let you know what you need to take to the medical examination.

What should I wear to the independent medical examination?

Please wear suitable clothing and footwear that will assist the IME to assess your physical condition.

You may be required to remove some clothing or to change into a medical gown for examination purposes. Please do not hesitate to ask the IME for a gown if you have not been offered one. Please also wear under-garments.

May I take a friend or family member to the appointment and will they be allowed in the consulting room?

A friend or family member can accompany you to the appointment. If you would like a friend or family member to accompany you into the consulting room, you should discuss this with the IME, who will advise you if it is appropriate.

If a friend or family member is permitted to be in the consulting room, they must not interfere or obstruct the medical examination and should not attempt to answer questions asked by the IME.

A psychologist or psychiatrist will rarely allow a family member or friend to attend an examination because of the personal nature of the questions that may be asked.

Can I bring my children with me?

It is preferable that children do not attend the appointment. If it is unavoidable that a child attends with you, another person should come to supervise the child while you are in the consulting room. It is important that both you and the IME are able to give full attention to the examination process.

Assistance from the TAC

In order to minimise any difficulties that attending an independent medical examination may cause, we provide the following help if needed:

An interpreter: Contact the TAC and we will arrange a professional interpreter who speaks your language to be present at your medical examination. A family member or friend should not act as your interpreter.

Travel costs: The TAC will reimburse the reasonable cost of travelling to and from medical examinations. For more information, please see our Travel and Accommodation policy.

Accommodation: If you live in rural Victoria or interstate and are asked to attend a medical examination in Melbourne, there is a TAC rate for reimbursement of accommodation and travel expenses. For more information, please see our Travel and Accommodation policy.

Time off work to attend: If you have to take time off work to attend a medical examination and you lose income as a result, we will reimburse you for lost wages. For more information, please see our Expenses when attending medical/impairment examinations policy.

You can call the TAC on 1300 654 329 and ask for a copy of this information.

Who do I contact if I am unhappy with the independent medical examination?

If you have any concerns during the medical examination, talk to the IME.

If you are unhappy about the way the independent medical examination was conducted, please contact the TAC at complaints@tac.vic.gov.au or 1300 654 329.

Privacy

The TAC is committed to protecting your privacy and treats all information about you in strict confidence. The Transport Accident Act 1986 and other legislation regulate the use of information about you.

For more information please refer to Your privacy and the TAC and the TAC privacy policy.

Alternatively please call the TAC on 1300 654 329 and request a copy of the TAC privacy policy.

Appendix:  Helpful telehealth information

The TAC and independent medical examiners must consider the appropriateness of this mode of service delivery for each client on a case-by-case basis, i.e. the principles and considerations of good clinical care continue to be essential in telehealth services.

Independent medical examiners are responsible for delivering telehealth services in accordance with the principles of professional conduct and the relevant professional and practice guidelines to ensure that all care is taken to ensure the privacy, confidentiality, safety, appropriateness and effectiveness of the service.

All telehealth services require prior approval from the TAC and must be consented to by the client and the independent medical examiner.

Is a telehealth video-conference right for me?

To determine if telehealth video-conferences are right for you, please discuss this option with your TAC case manager.

Some of the considerations will include:

• Client safety
• Client clinical need
• Clinical effectiveness
• Client preference
• Is an interpreter or support person required?

Is telehealth video-conferencing easy to use?

Yes. In most instances, your independent medical examiner or their medicolegal representative will send you instructions in an email with a link to the session. They may also contact you prior to the appointment to arrange a test to ensure you can connect to the video-conference service successfully.

What do I need for the video-conference session?

The essential IT requirements are:

• Internet connectivity
• Device or computer (with camera, speaker and microphone)
• Internet browser: Google Chrome

To help with a successful video-conference:

• Ensure your device is fully charged.
• Use a quiet, well lit room.
• Don’t sit with your back to a window as the light can flood the camera and you won’t be seen.
• Maintain your privacy if others are nearby (a room with a door that can be closed if you need to).
• If you would like a friend or family member to be in attendance, you should discuss this with the IME, who will advise you if it is appropriate.
• If a friend or family member is permitted to be in the room, they must not interfere or obstruct the medical examination and should not attempt to answer questions asked by the IME.
• Wear suitable clothing and footwear that will assist the IME to assess your physical condition.