mercredi 12 juillet 2017

Process of IME (Neuropsychological Assessment)

Judge with hammer and scale

The process of independent medical evaluation can raise several questions for the subject who is submitting to the evaluation, given the relative importance of the results to the follow-up (the disposition of the insurance claim, litigation, return to work, etc.).

In the context of a neuropsychological assessment, the objective is to analyze the results with psychometric tools, along with the clinical files submitted (medical history), subjective complaints from the subject, as well as behavioral observations, in order to answer specific questions that are set out in an initial mandate to which the subject agrees.

In this context, the neuropsychologist and the subject being evaluated do not have a traditional professional-client relationship, and it is ensured that such a relationship did not exist initially (e.g. former client who received neuropsychological services), in order to minimize bias. The goal is to provide an objective, impartial, neutral, and fair assessment that will answer the questions of the referring party and that will advance the file of the subject being evaluated, regardless of the context.

Normally, measures of validity and effort are part of the evaluation, in order to ensure that the evaluated subject makes an appropriate effort or investment that allows us to consider the data as valid and representative of the subject's functioning.

Dr. Charles Leclerc, a neuropsychologist at the Y2 Consulting Psychologists Clinic, in the Gatineau/Ottawa region, conducts IME's (Neuropsychological Assessments) and stresses the importance of defining the subject's effort, cognitive functions (reasoning, memory, attention/concentration, executive functions, language, visual-spatial functions, etc.), as well as the functions of psychological adjustment and personality factors. In effect, it is essential to separate what is of an organic/neuropsychological nature from the psychological adjustment reaction to an event that is traumatic, shocking, disappointing or other. The prognoses are different, as are the modes of treatment. Normally, all parties gain clarity with the problem, potential solutions, and prognosis. It is in this spirit that we conduct IME's.

With regard to the practical aspect and the course of an IME, the neuropsychologist generally receives a mandate (from a lawyer, an employer, an insurance company, etc.) accompanied by a file spelling out the medical and psychosocial situation of the subject to be assessed. A meeting date is then selected, and in most cases an IME takes place over a full day (9:00 am to 4:00 pm), punctuated by several breaks. This makes it easy to see how the subject is functioning over a full day, whenever possible. Some situations or particularities may make several sessions of one or two hours preferable, but this must be discussed in advance with the referring party and depends on the reason for the evaluation.

Ultimately, after the meeting, the neuropsychologist prepares a full report, with clear answers to the questions set out in the original mandate. The report is sent directly to the referring party, who will generally use these opinions/answers in the context of their concerns (e.g. several other types of professionals may have been consulted to give their perspectives in their fields of expertise).

In summary, in our experience, it is a process that can be initially stressful for the subject, but it is a fair evaluation, carried out in a respectful context, and which more often than not represents a positive experience for the evaluated subject, and a valuable tool for referring parties.

We will be pleased to provide you with any additional details if necessary.

Blog prepared in collaboration with:
Dr. Charles Leclerc, Neuropsychologist
Dr. Yaniv Benzimra, Psychologist
Y2 Consulting Psychologists

Please contact Dr. Yaniv M. Benzimra by phone at 819-777-7744 x248 or by email at for more details.

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