Form IME-5 Claimant's Notice of Independent Medical Examination - New York

What Is Form IME-5?

This is a legal form that was released by the New York State Workers' Compensation Board - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form IME-5?
A: Form IME-5 is the Claimant's Notice of Independent Medical Examination used in New York.

Q: Who needs to use Form IME-5?
A: The claimant, or injured person, needs to use Form IME-5 to notify the insurance company that they will be attending an independent medical examination (IME).

Q: What is an independent medical examination (IME)?
A: An independent medical examination (IME) is a medical examination conducted by a doctor who is not involved in the claimant's treatment, to evaluate the claimant's injuries and condition.

Q: Why is Form IME-5 important?
A: Form IME-5 is important because it notifies the insurance company that the claimant will be attending an IME, as required by New York state law.

Q: When should Form IME-5 be submitted?
A: Form IME-5 should be submitted to the insurance company at least 10 days before the scheduled IME.

Q: What information is required on Form IME-5?
A: Form IME-5 requires the claimant's personal information, the date and location of the IME, and the name of the examining physician.

Q: What happens after Form IME-5 is submitted?
A: After Form IME-5 is submitted, the insurance company will review the notice and schedule the claimant's IME appointment.

Q: Can I bring someone with me to the IME?
A: In most cases, the claimant is allowed to bring a witness or a representative to the IME.

Q: What should I do if I have questions about Form IME-5?
A: If you have questions about Form IME-5, it is recommended to consult with an attorney or contact the New York State Workers' Compensation Board for assistance.