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Independent Medical Opinions in Workers' Compensation

What is a Division Independent Medical Examination (DIME)?

A Division Independent Medical Examination (DIME) is a legal medical opinion sought by an injured worker or an insurer when there's a dispute about the date of Maximum Medical Improvement (MMI) and/or impairment rating. An injured worker or insurer may consider requesting a DIME if they desire an independent and unbiased physician's opinion.

A DIME aims to resolve disputes without going to court, promoting resolution and minimizing legal conflicts, which are often costly and time consuming. However, requesting a DIME still has a financial cost. Depending on the situation, either party to the workers' compensation claim may be responsible for this cost. It is also important to remember that there is no guarantee that the findings of the DIME will go in favor of the party that requested it. 

DIME Steps

Step 1: DIME Request

  1. A report of Maximum Medical Improvement (MMI) is issued by the treating physician
  2. Within 30 days, the insurer files a Final Admission (FA) or applies for a DIME
  3. If an insurer files an FA, within 30 days the injured worker must object in order to apply for a DIME
  4. The party requesting the DIME must apply by filing a WC77 Notice and Proposal and Application with the DIME Unit

Step 2: Physician Selection

  1. The parties have 30 days to attempt to negotiate a DIME physician
    1. If agreement is reached, all parties and physician must agree on the fees and sign a Negotiation form
  2. If parties are unable to reach an agreement, the insurer must file a Negotiation form and the Division will issue a 3-physician panel.
    1. If no negotiation form is filed after 30 days, notify the DIME unit
  3. The requesting party has 5 days to strike one name from the physician panel
  4. The opposing party then has 5 days to strike one of the two remaining physician names
  5. The DIME unit sends the parties a confirmation notice of the physician selected to conduct the DIME

Step 3: Payment and Scheduling

  1. Within 14 days of the confirmation notice, the responsible party must pay the fee to the DIME physician
    1. Exception: if an injured worker has filed the WC35 Application for Indigent Determination, then the responsible party must pay the fee to the physician within 14 days of the indigent order or physician selection (whichever is later)
  2. The party requesting the DIME schedules DIME Appointment within 14 days
  3. The physician must receive payment before scheduling the appointment
  4. The appointment should be scheduled within 45-75 days from the date of the confirmation

Step 4: Medical Records

  1. Within 14 days of the confirmation notice, the insurer must submit the initial medical records packet to the injured worker
  2. Within 10 days after receiving the initial packet, the injured worker shall submit any additional relevant medical records to the insurer
  3. Within 14 days of the scheduled examination, the insurer shall submit the final medical records packet to the DIME physician (and Additional Fees for DIME Packet Record Review, if applicable)
  4. Submission of supplemental records requires a prehearing conference and order by an Administrative Law Judge (ALJ) finding good cause

Step 5: Examination

  1. The injured worker attends the examination
    1. Failure to attend may result in fees
  2. The DIME physician conducts examination
  3. Within 20 days the DIME physician submits a copy of the report to all parties (injured worker and insurer) and the DIME Unit

Step 6: Report Review

  1. The DIME Unit reviews the report and issues one of the following notices:
    1. "concluded" notice to all parties
    2. "incomplete" notice to all parties
    3. "not at MMI" notice to injured worker and insurer
    4. "additional work-up needed" notice to injured worker and insurer if additional assessment is required
  2. If concluded, insurer can file a final admission (FA) or file an application for hearing
    1. Within 30 days, injured worker can object to FA and file an application for hearing
  3. If incomplete, the physician must address the issue(s) and submit a response to all parties and DIME Unit within 20 days
  4. If not at MMI, a follow up DIME shall be requested once recommendations have been completed

Contact the DIME Unit

cdle_IMEunit@state.co.us

All documents are required to be submitted via email to cdle_IMEunit@state.co.us. To help facilitate a timely response and prevent unnecessary delays, do not send documents by mail.


Division of Workers' Compensation
Division Independent Medical Exam Unit
633 17th Street, Suite 400
Denver, CO 80202
Phone: 303-318-8655