Dr. Charl Els

Psychiatrist, Addiction Specialist, and Occupational Physician

Clinical Professor
Department of Psychiatry and Department of Medicine
University of Alberta

Occupational mental health disability claims continue to increase. As the physical impact of COVID-19 has diminished, the mental and behavioural impact continues. Given the pre-existing service gap in mental health service delivery in Canada, the pandemic has exacerbated what was already clearly an issue.

Along with other pre-existing factors, this resulted in an increased demand for mental and behavioural disorder independent medical examinations (M&BD IMEs, or psychiatric/psychological IMEs). There exists a need for broad adoption of IME best practice guidelines and standards for M&BD IME service providers. Anecdotally, despite the high cost of requesting an IME, and the relatively invasive nature of the assessment, IME report quality and validity varies widely, with at times questionable ability of such reports to stand up to judicial scrutiny.

This presentation introduces a best practice IME standard aligned with Canadian jurisprudence. It reflects appropriate use of the current Diagnostic and Statistical Manual of Mental Disorders (DSM) nomenclature, while incorporating updates from recent Guides to the Evaluation of Permanent Impairment. Most importantly, it provides an empirical mechanism to remedy the most salient challenge encountered in the validity of IMEs today, i.e. the absence of sufficient objectivity in an otherwise subjective psychiatric assessment process. Further work is underway for inclusion of a national standard in Canadian Occupational Medicine and Civil Forensic practice and program settings.