10 Situations That May Warrant an Infectious Disease IME
When a worker develops an infectious disease, claims professionals often face a difficult question: Did the employee contract the illness at work?
Answering that question can prove challenging. In many cases, multiple exposure sources exist. Additionally, treatment plans, disability duration, and future medical needs may remain unclear. As a result, an Infectious Disease IME can provide valuable insight and objective medical guidance.
A CDC review of workplace infectious disease investigations from 2006 through 2015 found that healthcare workers, laboratory personnel, animal-contact workers, and public service workers faced increased exposure risks. Furthermore, the study showed that workplaces can contribute to disease transmission within both the workforce and the community.
For more information, review the CDC article, Case Investigations of Infectious Diseases Occurring in Workplaces, United States, 2006–2015:
CDC review of workplace infectious disease investigations
Because workplace infection claims often involve complex medical questions, attorneys, adjusters, employers, and nurse case managers frequently seek specialist opinions. The following situations often justify an Infectious Disease IME.
Common Situations That May Benefit from an Infectious Disease IME
1. A Healthcare Worker Reports an Occupational Exposure
Healthcare workers routinely encounter bloodborne pathogens and infectious diseases. Therefore, needlestick injuries, patient exposures, and bodily fluid incidents often require specialist review.
2. An Employee Claims Workplace Exposure
Sometimes an employee reports exposure through contact with coworkers, customers, patients, or biological materials. In these cases, an IME can help determine whether the workplace likely caused the illness.
3. The Source of Infection Remains Unclear
Many infectious diseases spread in both workplace and community settings. Consequently, determining the most likely source of exposure often requires expert analysis.
4. A Tuberculosis Claim Raises Questions
Tuberculosis claims frequently involve complex exposure histories. An Infectious Disease physician can evaluate testing results, risk factors, and occupational exposure evidence.
5. A Worker Attributes COVID-19 or Another Respiratory Illness to the Job
Respiratory illnesses often circulate widely in the community. Therefore, claims professionals may need an independent opinion regarding work-relatedness.
6. A First Responder or Public Service Worker Reports Exposure
Police officers, firefighters, EMS personnel, correctional officers, and other frontline workers regularly interact with the public. As a result, they may encounter infectious hazards during routine duties.
7. Laboratory Personnel Experience a Potential Exposure
Laboratory incidents can involve uncommon pathogens and unique workplace conditions. Therefore, these cases often benefit from specialist review.
8. Animal Contact Plays a Role
Veterinary professionals, agricultural workers, and animal handlers face potential exposure to zoonotic diseases. In these situations, an Infectious Disease IME can clarify causation and risk factors.
9. Treatment Recommendations Create Disagreement
Sometimes stakeholders disagree about treatment necessity, duration, or effectiveness. An independent specialist can review the records and provide an objective opinion.
10. Litigation or Settlement Discussions Require Expert Analysis
Attorneys often need clear medical opinions regarding causation, prognosis, impairment, or future medical care. Consequently, an Infectious Disease IME can strengthen case evaluation and decision-making.
How an Infectious Disease IME Can Help
An Infectious Disease IME evaluates key medical issues that affect claim outcomes. For example, the physician may assess causation, treatment recommendations, maximum medical improvement, work capacity, and future medical needs.
Additionally, an independent review can identify gaps in the medical record and address conflicting opinions. As a result, stakeholders gain a clearer understanding of the claim and its medical complexities.
At Merit Medical Evaluations, our board-certified Infectious Disease physician performs independent medical examinations, medical record reviews, peer reviews, and expert witness services. We provide objective, evidence-based opinions for workplace exposure claims and occupational infectious disease cases.
Ultimately, when questions arise about workplace-acquired infections, an Infectious Disease IME can help clarify the facts and support informed claim decisions.