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Telehealth IME vs In-Person Exam — What States Allow

Telehealth has entered workers' comp IME-adjacent work narrowly: Texas allows MMI certification by telemedicine only for minor, non-impairment cases, and Washington's fee schedule lists specific telehealth-eligible services — most IMEs still require in-person examination.

2 sections·2 sources·Verified 2026-08-15 ✓
01

Why impairment ratings stay in person

Rating depends on reproducible clinical measurement (ROM, DRE findings) and observation of effort — both hard to validate remotely. Texas explicitly excludes impairment-rating exams from the telemedicine allowance.

02

What to check

State telehealth rules change quickly; the tracker on this hub will be refreshed quarterly. Verify current rules before scheduling.

Rating basis by jurisdiction10 states profiled
CaliforniaQMELabor Code § 4660(b)(1)AMA Guides 5thPennsylvaniaIRE34 Pa. Code § 123.105; Act 142AMA Guides 6thTennesseeIR trainingState-approved training listAMA Guides 6thColoradoDIMERule 11Edition set by agencyOhioIME / DMEBWC policyEdition set by agencyTexasDesignated Doctor28 TAC 130.1Edition set by agencyWashingtonIMEL&I Medical Examiners' HandbookEdition set by agencyFloridaIRE / Schedule1996 Florida Impairment Rating ScheduleState schedule, not AMANew YorkIME / SLU2018 SLU guidelinesState schedule, not AMAArizonaDMENo canonical state source verifiedNot confirmed

Telehealth status is set per jurisdiction and moves. Of the 10 states profiled here, only Texas and Washington publish a position we could verify; the other 8 are marked unconfirmed rather than assumed. The rating basis below is the other jurisdictional variable that decides what an examination is worth.

Key facts

Texas (2025)

MMI by telemedicine allowed for minor injuries, no impairment; impairment ratings excluded (28 TAC 133.30)

Washington (2025)

MARFS Chapter 24 lists telehealth-eligible IME-adjacent services; most IMEs in person

Impairment rating

Not permitted via telemedicine in the verified rules

Verdict

Telehealth is an exception, not the default

Sources

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Last verified: 2026-08-15