Independent Medical Examinations (IMEs)

IMEs are evaluations performed by a physician not involved in the care of the examinee, for clarifying clinical and case issues. IMEs are an important component of workers’ compensation systems, and are also used to clarify other disability or liability associated cases.

Patient Information

MM slash DD slash YYYY
Type of Case

Insurance Information


Section Referral Information

(Complete only if different than listed above)
(ie: Case Manager, Vocational Specialist)

Employer Information


Physician & Location

  • All appointments scheduled on a first available basis, unless a specific physician or location is requested.
  • All physicians do not perform IMEs in all locations. For more information on our physicians and locations, please visit
  • (if any)

    If you are not contacted in 24 business hours regarding this request, call Kathleen Gleason Boyd at 570-344-3788 x315.