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IMECore

Disability claims

Get an own-occupation answer the file can act on

An LTD examination has to test job demands and duration. A diagnosis recap does not close the claim.

The problem

The report recites the chart and never answers own occupation

The insurer asked whether this person can do this job, and for how long. What comes back is a diagnosis and a prognosis. The own-occupation period is already ending, and human resources still cannot set restrictions.

  • The job description is missing or two years stale.
  • Attending physician statements contradict the specialist notes.
  • The own-occupation period ends while records are still outstanding.
  • Psychiatric and physical questions get mixed in one report.
  • Restrictions have no review date anyone can use.

What changes

What IMECore does about it

  • Ask about the job, not only the diagnosis

    The referral captures the occupation, the demands, and whether the question is own occupation or any occupation.

  • Attending notes and the job file together

    Physician statements, specialist notes, pharmacy, and the job description attach to the case. IMECore flags the gaps.

  • Own occupation stays a separate question

    The template keeps own occupation, any occupation, and duration as distinct answers. A reviewer checks each one.

  • Psychiatric and physical files do not blur

    Assign the specialty the questions need. The case will not send a physiatry file to answer a psychiatric duration question.

  • Restrictions with a review date

    Each restriction carries a scope and a review date. The employer view shows capability, not the clinical narrative.

  • A committed date on a slow specialist

    Psychiatric and neurological diaries run long. The case shows the report date from the day it opens.

How it runs

Four steps, start to finish

  1. 1

    Open the LTD referral

    Capture the policy question, the occupation, and the date the own-occupation period ends.

  2. 2

    Collect the job and the chart

    Request attending statements, specialist notes, pharmacy, and a current job description.

  3. 3

    Book the specialty the questions need

    Match psychiatry, physiatry, or occupational medicine to the actual question, then set the report date.

  4. 4

    Review duration and restrictions

    Confirm own occupation, any occupation, and each restriction have answers before release.

Where the time goes

Numbers worth knowing before you buy

Published figures from fee schedules and industry surveys. Each carries its source.

Typical BC psychiatric or neurological IME cost
$4,000–$8,000+Typical BC psychiatric or neurological IME costlawyerinfo.ca, BC WCAT guide
Typical wait to book a BC specialist IME
2–6 monthsTypical wait to book a BC specialist IMElawyerinfo.ca, BC WCAT guide
Average examiner time per IME across review, exam, and report
~6.5 hoursAverage examiner time per IME across review, exam, and reportSEAK 2024 IME fee survey

FAQ

Questions people ask

Is an LTD examination the same as a SABS insurer examination?

No. LTD sits on the disability policy, not on the SABS. The questions are occupation, duration, and restrictions. Ontario FSRA SABS rules do not govern the file.

What records does the examiner need?

Attending physician statements, specialist notes, pharmacy, imaging, and a current description of job demands. Without the job file, the own-occupation question has nothing to test.

Can the employer see the diagnosis?

The employer view shows capability and restriction. Clinical detail stays with the insurer and the examiner unless the employee consents to more.

What if we only need a paper review?

Open a file review on the same questions. It is faster when a specialist examination will not land in time. It cannot speak to current presentation.

How do we handle a change from own occupation to any occupation?

Put both questions on the referral. The report template treats them as separate answers with separate dates.

See it against one of your own files

Bring a case that keeps getting passed around. We will run it through IMECore on the call.