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Form must be submitted when the claimant previously had a Division IME and was determined to be not at MMI, and the insurer/respondent is now requesting a follow-up IME. Per Rule 11, to the extent possible the follow-up IME will be held with the original IME physician. If the original physician is unable to perform the follow-up, please notify the Division s IME Unit. The requesting party is responsible for payment, and also shall pay any additional examination expense as set fort.

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