Impairment Rating Referral Process for Adjusters and Nurse Case Managers

If you are a claims adjuster or a nurse case manager, and your claim needs an impairment rating, please follow the steps below.

  1. Download and fill out our IME Agreement Form for an Impairment Rating 
  2. Send us the signed agreement form and pertinent patient records 
  3. Fax to (206) 338-3005 or email* to the signed agreement form and the following patient records:  
    • The Doctor’s First Report AND The last PR-2 report
    • Surgical/procedure/consult notes for each injury
    • The last imaging and diagnostic reports for each injury
  4. Register the patient into our HIPAA secure portal:

If you have any questions, please email or call/text 707-481-1727.

*Warning: While convenient, normal unencrypted email is an insecure technology. Sender assumes all responsibility for sending sensitive information via insecure methods of communication.