Specialized expertise for complex, high-risk claims.

Substance use-related claims are among the most complex a team will face. When substance use intersects with mental health, safety-sensitive roles, or prolonged disability, a general IME often leaves decision-makers with more questions than answers.

SOMA’s Substance Use IMEs are built for this complexity - providing integrated clinical insight, defensible evidence, and a clear direction forward.

SUD claims don’t stall because of bad decisions. They stall because no one holds the full picture.

Substance use is not a discrete disorder. It intersects with mental health, pain, trauma, stress, and the demands of work in ways that make standard clinical frameworks - and standard IMEs - fall short.

In a typical SUD-related disability file, the challenge isn’t usually a lack of good intentions. It’s a lack of integrated insight.

Each part of the system sees something real - but incomplete:

Clinicians
see symptoms and treatment progress

Employers
see attendance, performance, and safety risk

Insurers
see timelines, policy obligations, and financial exposure

The individual
lives the full experience of all of it

When no one holds the integrated picture, planning becomes difficult. Files stall. Decisions are delayed. Return-to-work attempts fail. And the cost - clinical, financial, and human - accumulates.

Stalled SUD cases are rarely the result of poor decision-making. They are the result of complexity - and a system that wasn’t built to hold it. A SUD-specific IME changes that.

A SUD IME may be the right next step when:

  • Information about substance use is unclear, vague, or conflicting across clinical records
  • Substance use is intersecting with a mental health condition, chronic pain, or trauma
  • Return-to-work planning has stalled and the driver isn’t clear
  • The individual has completed treatment but there is no clear RTW direction
  • Safety concerns exist in a safety-sensitive role where “cleared to return” isn’t sufficient
  • There is uncertainty about whether impairment is driven by substance use, a co-occurring condition, or both
  • Legal teams require a defensible, function-focused opinion that will hold up under scrutiny

Not sure if a SUD IME is the right fit for your file? Alexandra Perry is available for a no-obligation consultation before any formal referral.

Assessments should end with a roadmap. Not a question mark.

SOMA’s SUD IMEs are designed around one principle: the focus is clarity, not just diagnosis. Each assessment is tailored to the specific questions being asked and the clinical, functional, and workplace realities of the individual.

Each SUD IME may include:

  • Comprehensive assessment of substance use patterns, history, and current status
  • Evaluation of co-occurring mental health conditions and their interaction with substance use
  • Functional capacity assessment - what the individual can safely and sustainably do right now
  • Safety readiness evaluation for safety-sensitive or judgment-intensive roles
  • Evidence-based, individualized treatment recommendations aligned to functional goals
  • Guidance on relapse risk, safety mitigation, and monitoring
  • In-depth return-to-work planning with realistic, phased recommendations
  • Clear, decision-ready reporting written for insurers, employers, and legal teams

Follow-up IMEs are available at key transition points - including post-treatment discharge and graduated RTW milestones.

What a SUD IME delivers for your team:

✔ Quicker, more confident decision-making

✔ Reduced back-and-forth and re-referrals

✔ More appropriate and timely treatment pathways

✔ Improved RTW success and sustainability

✔ Clearer alignment between treatment, function, and work

✔ Better risk management in safety-sensitive roles

✔ Defensible evidence that holds in disputes or litigation

✔ A clear path forward - for the file, and for the person

Common Questions

How is a SUD IME different from a standard psychiatric IME?

A standard psychiatric IME focuses on diagnosis and functional limitations related to a mental health condition. A SUD IME specifically assesses substance use patterns, the interaction between SUD and co-occurring conditions, and safety and RTW readiness in a way that standard mental health frameworks may not fully address. The clinical expertise required is distinct.

When is the right time in a claim to refer for a SUD IME?

Earlier is usually better - when there is clinical uncertainty, the file has stalled, safety concerns exist, or treatment is underway but RTW planning hasn’t progressed. If you’re unsure, reach out to Alexandra for a no-obligation consultation before making a formal referral.

What if the individual has both a SUD and a mental health condition?  

This is precisely the scenario SOMA’s SUD IMEs are designed for. A functional approach is key here — it allows us to understand the “why” behind behaviour, untangling the relationship between substance use and mental health rather than treating each in isolation. Co-occurring conditions are best assessed through an integrated lens that considers how conditions interact, how each shapes the other, and how both affect an individual’s capacity to work and recover. Alexandra specializes in exactly this clinical picture.

Are follow-up assessments available?

 Yes. Follow-up IMEs are available at key transition points including post-treatment discharge, graduated RTW milestones, and longer-term monitoring checkpoints. Reassessments are particularly valuable in RTW discussions. Employers often assess an individual against their pre-treatment functional baseline — not against where they are weeks or months after completing treatment. A reassessment provides current, comparable data that can demonstrate meaningful change and improvement, making the case for a confident and appropriate RTW decision. Where an individual has not engaged with recommended treatment, reassessment data can equally support the decisions that follow from that.

Have a SUD file that needs clarity? We’re ready to help.

Our team is available to consult on complex, high-risk, or stalled SUD files - before you make a formal referral, or when you’re ready to proceed.

Make a referral