Impairment Evaluations

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These evaluations focus on function and help to prevent further injury and disability.

Evaluations

An examination requested by an employer to determine if an employee can perform his/her job duties in a safe manner.

This evaluation may be requested as part of an employer’s human resource policy.

An evaluation to determine a worker’s ability to safely return to work and perform job duties.  This evaluation is typically completed after a medical leave. 

Return to Work Evaluations are requested as part of an employer’s human resource policy. The Physician or Other Licensed Health Care Professional (PLHCP) will determine whether the worker can perform job duties and if medical accommodations are needed in order to safely return to work.

 

 A comprehensive medical evaluation to determine level of impairment.  In New York State as related to work injury/illness, this determination is based in part on the NYS Workers' Compensation Guidelines for Determining Impairment.

This is determined from the type of injury or illness, medical interventions, and time since injury.  

An evaluation completed by a physician to determine the degree of functional loss after a work injury.

For more infomation, view  the NYS Workers' Compensation Impairment Guidelines.

Schedule Loss of Use (SLU) award is a type of workers’ compensation benefit given to persons who have permanent, work-related injuries. The SLU is a percentage assigned by a physician to the injury or impaired body part that reflects the amount of functional loss resulting from that injury.

This evaluation is performed after the determination of the type of injury or illness, medical interventions, and time since injury.  

For more infomation, view  the NYS Workers' Compensation Impairment Guidelines.

An Independent Medical Examination (IME) is a non-biased medical evaluation under the laws of workers’ compensation that is completed by a medical professional to answer questions asked by the parties in a workers’ compensation case. The questions might relate to current or proposed treatment. They may also relate to opinion on causality or to questions of permanency or function.

The physician who performs the evaluation may not be the injured worker’s treating physician, recommend treatment directly to the injured worker, or take on the injured worker as a new patient. The purpose of the physician in an IME is to review the medical information supplied, perform an appropriate examination, and provide an unbiased opinion relative to the questions asked. An IME does not establish a patient-doctor relationship.

The examinee should report to the evaluation on time and come with a form of identification such as a driver’s licence. Typically, only the requesting party is authorized to change or cancel IME appointments. Depending on the question(s), this examination may take from 30 minutes to an hour or more. A report is then generated and supplied to the requesting party.

Outside of the workers’ compensation system, similar evaluations are done to determine the status of a disability claim. The same structure exists, except that causality is usually not a question being raised.

For more information, view the NYS Workers’ Compensation Board Independent Medical Examinations.

This evaluation is requested by the Veterans Benefits Administration (VBA) via a contractor and is used to determine the status of a service-connected loss. It involves review of the veteran’s service medical record and subsequent care for conditions that the veteran believes were caused by or worsened by military service. Results of the evaluation are provided to the VBA to make timely disability award determinations.

The provider reviews records and performs a directed examination to define the status of the condition. This is an unbiased opinion on the part of the physician who has to follow very specific regulatory guidelines to answer the required question(s). Once accepted for evaluation, the veteran is notified by the contractor regarding the evaluation time and place. Only the contractor can change the appointment. In addition to the records provided, the veteran may bring other records to the evaluation but must also submit them to the VBA. Typically, the evaluating physician is not the treating physician for the veteran. Treatment can be recommended via the VBA unless the matter is medically urgent. 

The veteran will receive instructions from the contractor as to what documents need to be brought to the evaluation. As part of this evaluation, a review of the medical history and a directed physical examination is performed. Depending on the complexity of the condition and the number of questions raised, this evaluation may take 60 to 90 minutes.     

On Sept. 11, 2001 (9/11), the World Trade Center (WTC) disaster along with additional devastations at several other locations in the NY City area, the Pentagon, and Shanksville, Pennsylvania, impacted the physical space, health, and welfare of these communities. Since then, organizations were mobilized, and many people have stepped forward to help. The initial search and rescue effort became a recovery effort. Some of the persons involved in rescue and recovery have developed a variety of medical conditions attributed to their involvement. There are many conditions that are accepted as related to these WTC disaster-related exposures. These medical issues are still unfolding. 

There are federal programs for participants in the 9/11 events, as well as for residents in defined areas of New York City. Such individuals are eligible for health monitoring to determine if a WTC condition exists and to monitor the status of the condition. EmblemHealth Health@Work participates in this program via a contractor. Our providers perform a medical history and physical to determine the presence or possible presence of conditions that may relate to the WTC disaster-related exposures. The contractor expands on the development of the information and the WTC Program determines if certification for these conditions is appropriate. If certified for accepted conditions, the individual is eligible for benefits including related medical care.

These evaluations occur initially and then annually to monitor for WTC disaster-related conditions. They are performed at EmblemHealth Health@Work. While the referral contractor determines the testing to be done at these evaluations, our providers can also recommend further testing. These comprehensive medical evaluations typically take an hour to complete, which includes the requested ancillary testing.

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Our medical staff is trained to perform physical examinations, screenings, and vaccinations. They can also discuss specific occupational health problems with workers.

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