Independent Medical Exam (IME) Scheduling Notice

Claim letter template for coverage investigation.

coverage investigationcoverage investigationclaimant facing

IME Scheduling Notice

This letter notifies the claimant that an Independent Medical Exam (IME) has been scheduled to evaluate their medical status.

Required Components

1. Examination Details

You are required to attend an Independent Medical Examination (IME) with:
  • Doctor: [Doctor Name]
  • Specialty: [Specialty]
  • Date: [Date]
  • Time: [Time]
  • Location: [Full Address]

2. Purpose of the Exam

The purpose of this exam is to get an independent opinion about your current medical condition, your ability to return to work, and the relationship between your injury and your job duties. This doctor is not your treating physician and will not provide medical care.

3. Attendance Requirements

Please arrive 15 minutes early to complete any necessary paperwork. Bring any relevant medical records or imaging (such as X-rays or MRIs) that you have in your possession.

4. Reimbursement for Travel

You may be entitled to reimbursement for travel expenses to and from this appointment. Please keep track of your mileage and any parking fees. [Attached Form/Instructions] explains how to submit these costs for payment.

5. Consequences of Non-Attendance

It is important that you attend this exam. Failure to attend or cooperate with the exam may result in a delay or suspension of your Workers' Compensation benefits. If you cannot attend for a valid reason, you must contact us at [Phone Number] at least [Number] hours before the appointment.

Adjuster Guidance

  • Provide clear directions to the facility if possible.
  • Ensure the doctor's specialty matches the nature of the injury.
  • Confirm the notice period meets local requirements (usually 10-14 days).

Related Letters

Last reviewed: 2026-03-30