Claimant Info
Full legal name, date of birth, claim number, employer, and contact details for accurate identification and record matching.
A complete, correctly formatted notice reduces scheduling disputes, preserves evidentiary weight, and helps avoid objections that delay adjudication. Using a standard Colorado Notice and Proposal for Division Independent Medical Examination clarifies expectations for parties, supports procedural fairness, and documents the examiner selection and scope of evaluation under Division rules.
Parties involved in a Colorado IME process include the carrier, employer, claimant, treating providers, and Division administrators. Notices are prepared by claims staff or attorneys.
A claims adjuster or insurer representative prepares and signs the notice, certifying that the proposed IME is necessary and that scheduling details comply with Division rules; the adjuster is responsible for timely delivery and documentation of service.
The claimant or their attorney or representative acknowledges receipt and either accepts the proposal, requests alternatives, or objects in writing; their response and any objections should be logged to preserve procedural rights.
Full legal name, date of birth, claim number, employer, and contact details for accurate identification and record matching.
Name, specialty, license number, clinic name, address, and contact information so the claimant and Division can verify qualifications and availability.
Date, start time, and estimated duration; include multiple options if feasible to reduce rescheduling conflicts.
Specific medical issues, body parts, diagnostic focus, and whether testing or records review is included.
List of relevant medical records to be provided to the IME examiner and instructions for secure transfer or pickup.
How the notice was delivered (mail, email, e-service), and contact person for scheduling and questions.
| Field | Configuration |
|---|---|
| Claimant ID | Mandatory, exact-match validation |
| Records Upload | Required PDF attachments; label each file |
| Signature | eSignature with audit trail |
| Delivery Log | Automatic timestamped service record |
Use secure platforms that capture audit trails, timestamps, and proof of delivery when submitting IME notices electronically.
| signNow | DocuSign | Adobe Sign | PandaDoc | HelloSign | |
|---|---|---|---|---|---|
| Starting Price | $8/user/mo | $15/user/mo | $14/user/mo | $19/user/mo | $15/user/mo |
| Free Trial | 7-day free trial | No | No | Yes | Yes |
| Bulk Send | Yes | Yes | Yes | Yes | No |
| Audit Trail | Yes | Yes | Yes | Yes | Yes |
| Envelope Cap | No cap | 100 envelopes/user/year | No cap | No cap | No cap |
| Criteria | Colorado IME Notice | Medical Authorization |
|---|---|---|
| Primary Purpose | schedule exam | release records |
| Notarization | rarely required | sometimes required |
| eSignature Allowed | ||
| Typical Scope | single exam focus | broad records access |
Varies by insurer and Division; confirm required response timeframe
Coordinate exam within mutually agreed period to avoid rescheduling
Confirm date/time with examiner and claimant in writing
Examiner typically files report when complete; check Division rules
Keep delivery receipts and signed confirmations for the claim file
Complete form fields and attach relevant records before serving.
Serve parties and capture proof of delivery and any acknowledgements.
Conduct IME per scope and document any ancillary tests performed.
Examiner files report with Division and serves parties; retain copy.
Optica standardized its IME notice template to include claim IDs and records lists, reducing scheduling disputes.
A medical group moved to electronic delivery with signed PDFs and delivery receipts.