What is: Independent Medical Examination (IME)

An important part of working is being able to carry out the job safely and effectively. If someone cannot perform their role safely then they are potentially putting themselves, co-workers, patients, and visitors at risk. If someone cannot perform their role effectively puts strain on resources which can impact on themselves, co-workers, patients, and visitors.

The responsibilities to be safe and effective are outlined in:

• Work Health and Safety Act (Qld) 2011
• Public Sector Act (Qld) 2022
• Code of Conduct for the Queensland Public Service

A person’s health can sometimes impact on these responsibilities. It is important that employees advise their manager if their health might impact on their work or the safety of the workplace.

People can be reluctant to discuss work relevant health issues. Normally any health impacts can be managed through a discussion with the employee. Conversations about health should be confidential, respectful, and compassionate. Most health challenges are minor and require no special consideration. Usually health challenges can be managed:

• without specific medical advice or
• with advice from the employee’s treating health professional.

Examples:

• using crutches while recovering from a broken leg
• dealing with a medically controlled health condition

There are times when an employee’s health situation is complex or where you believe independent specialist advice would assist. In these circumstances you may sometimes request an Independent Medical Examination (IME).

IME’s can only be considered when an employee is:

1. absent from the workplace or there is unsatisfactory performance; and
2. it is reasonably suspected to be health related; and
3. independent specialist medical advice is believed likely to provide useful information.

If you can obtain adequate health information directly from the employee or obtain consent to seek advice from their treating medical professional without an IME, you should do so.

What is an Independent Medical Examination (IME)?

An IME is the process of obtaining a medical report from an independent specialist medical practitioner on the work-related aspects of an employee’s health. If the medical report identifies health challenges that are relevant to the workplace then the medical report is used to guide management on how to best manage the situation.

• The Public Sector Act 2022 (Qld) allows Metro North Health to seek medical information about an employee if there is a reasonable belief that the employee’s absence or unsatisfactory performance may health related.
• Only registered Medical Officers can conduct the IME.
• The appointed Medical Officer must be independent to the employer and the employee (unless there is no other relevant specialist reasonably available).

If the IME Medical Officer’s professional view is that the employee does have (or is likely to have) a relevant health issue, then a range of actions may follow. IMEs usually have one of three outcomes:

1. No significant impact on the workplace.
2. Reasonable adjustment to the workplace may be required.
3. Reasonable adjustment may not be viable.

The employer and the employee may have to negotiate, compromise or be creative in attempting to find a practical path forward. Discussions and decisions following an IME should be:

• compassionate
• respectful

Reasonable Adjustments to the Workplace

Most IMEs confirm that a health issue can likely be managed by making reasonable adjustments to the workplace. There is a legal obligation to consider reasonable adjustment to accommodate a health condition in the workplace. This obligation is contained in:

• Anti-Discrimination Act (Qld)
• Work Health and Safety Act

Reasonable adjustments can include:

• Changes to the role
• Changes to the way the employee works

For more information refer to the Reasonable Adjustment Micro Skill, your local Human Resource Business Partner or Work Health and Safety officer.

Reasonable Adjustment may not be viable

On very rare occasions an IME may state that health or condition cannot be reasonably managed in the workplace. In these circumstances it is possible that the employee may retired from their employment. Ill health retirement is considered as a last resort only.

A thorough assessment of alternatives must be undertaken before an employee is considered for ill health retirement. There are specific consultation requirements that must occur with the employee.

Ill Health Retirement (IHR) has significant impact on the employee and should only be used after all reasonably practical alternatives have been considered.

Note: “Ill Health Retirement” (IHR) is not the same as “Voluntary Medical Retirement” (VMR). VMR is only available to Public Servants and not employees of Metro North Health.

Alternative employment options

Sometimes the Medical Officer may believe it is not safe for the employee to remain in their current role. In these circumstances the manager, employee and Human Resource staff work together to attempt to identify another role that the employee can safely perform and be transferred into.

The preferences of all parties are important but are dependent upon the existence of a safe compatible role for the employee. Sometimes this means the employee may be required to consider accepting a role in a different location, profession or pay grade.

The preferences of all parties are important but dependent upon the existence of a safe compatible role for the employee.

Why is this important and what’s my role in this?

Employees must be able to perform their role safely and effectively. You have an obligation to consider an employee’s circumstances in your management decisions. This includes considering relevant health issues.

What do I need to do?

• Monitor both performance and attendance of your staff.
• If you notice issues you should have timely, respectful, and compassionate discussions with the staff member.
• If you are advised of, or suspect health issues are relevant, then you should discuss them with your staff member in private.
• Be prepared to consider how you might be able to adjust the workplace to assist this staff member.

IMPORTANT: Never contact an employee’s treating health practitioners without consulting with HR and obtaining written consent from the employee.

Frequently Asked Questions

What happens in an IME?

The Medical Officer will spend some time with the employee to obtain information they require to make an informed assessment. The Medical Officer will provide their considered opinion in a written report. It can sometimes take several weeks for the written report to be received.

The written report will be provided to both the Manager and the Employee. Sometimes the Independent Medical Officer may say the report is to only be released to the employee’s medical team. This is a decision of the Independent Medical Officer and not Metro North Health. If this occurs, the employee can make an appointment with their medical team to obtain the report from them face to face.

What information is provided?

• The employee’s role description
• Specific information about the work unit
• Relevant workplace history of the employee including any challenges, changes, or areas of concern.
• Relevant information as to why Metro North Health believes an IME is appropriate
• Additional relevant information

How is the Independent Medical Officer chosen?

• The medical practitioner is selected by Metro North Health from a pre-approved panel. Metro North Health has an arrangement to use a range of pre-approved health care providers. It is complex and expensive to use providers who are not part of this arrangement.
• Selection is based on factors such as medical specialty, accessibility, and availability.
• If an employee has a specific reason for not seeing the chosen medical practitioner (e.g. has previously been a patient of that practitioner) this should be explored and considered.

Can the employee refuse?

• Attendance at a properly authorised IME is mandatory.
• Employees have the right to request an internal review of an Independent Medical Examination (IME) direction. This request is to be made to the Chief Executive in writing, within 14 days of receiving the notice.
• An employee can also lodge an Appeal against having to attend an IME through the Public Sector Commission of Queensland.
• Failure to attend a properly authorised IME without reasonable cause can have a range of consequences. It is a legal requirement under the Public Sector Act to refuse all sick leave applications from the employee until they attend the IME.

How much does it cost and who pays?

• Medical Examinations normally cost several thousands of dollars.
• Your Cost Centre will be billed for the medical examination and for any reasonable costs associated with it (such as providing the employee reasonable travel costs).

Is the employee paid to attend?

• The employee is attending at the direction of their work. They are entitled to be paid normal renumeration if they wish.
• Some employees may not wish to be paid as it may impact on QSuper, WorkCover or other claims.
• You should recommend an employee seek their own advice before deciding to claim, or not claim, the time they spend attending the IME.

Useful Links

• Anti-discrimination Act 1991
• Work Health and Safety Act
• Industrial Relations Act
• HR Policy G3 (QH-POL-210) Reasonable Adjustment
• PSC Directive 10/20 Independent medical examinations
• PSC Guideline on Managing employee health, safety and wellbeing–independent medical examinations