Procedural Justice and the Use of Independent Medical Evaluations in Workers’ Compensation

Abstract

Workers’ compensation systems aim to service both employer and worker needs following workplace accidents; however, there is increasing debate about the influence of the compensation system itself on recovery of the injured worker. Independent medical examinations (IMEs) are one of the processes within workers’ compensation systems that have been reported as distressing for injured workers. The aim of this study was to understand how workers’ compensation systems influence the work of psychologists who see clients with compensation claims, and their clients’ recovery. Semi-structured interviews were conducted with 19 psychologists. Interviews were transcribed verbatim, and data were analysed according to thematic analysis principles. In this manuscript, we focus specifically on the issue of IMEs—a component of the workers’ compensation process that was often raised in interviews with psychologists. Five main themes were identified: how IMEs complicate psychological therapy; how psychologists’ consider IMEs can exacerbate injury; disincentives for psychologists to practice within the workers’ compensation system; the limitations of independent opinions and suggestions for alternatives to the current IME process. Psychologists’ views of the impact of IMEs are discussed in relation to procedural, interactional, informational and distributive justice principles. Redesign of the IME process to meet procedural justice principles would likely reduce the negative and adversarial attitudes that injured workers and psychologists have towards insurers and workers’ compensation systems.