# Telehealth IME vs In-Person Exam — What States Allow | Content Hub > Telehealth vs in-person IME: what Texas and Washington allow, what stays in person, and why impairment ratings are excluded from telemedicine. Canonical page: https://medrecords.ai/content-hub/compare/telehealth-vs-in-person/ --- [Content Hub](https://medrecords.ai/content-hub/) › Compare ## 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 jurisdiction — 10 states profiled [California — QME — Labor Code § 4660(b)(1) — **AMA Guides 5th** ](https://medrecords.ai/content-hub/states/ca/) [Pennsylvania — IRE — 34 Pa. Code § 123.105; Act 142 — **AMA Guides 6th** ](https://medrecords.ai/content-hub/states/pa/) [Tennessee — IR training — State-approved training list — **AMA Guides 6th** ](https://medrecords.ai/content-hub/states/tn/) [Colorado — DIME — Rule 11 — **Edition set by agency** ](https://medrecords.ai/content-hub/states/co/) [Ohio — IME / DME — BWC policy — **Edition set by agency** ](https://medrecords.ai/content-hub/states/oh/) [Texas — Designated Doctor — 28 TAC 130.1 — **Edition set by agency** ](https://medrecords.ai/content-hub/states/tx/) [Washington — IME — L&I Medical Examiners' Handbook — **Edition set by agency** ](https://medrecords.ai/content-hub/states/wa/) [Florida — IRE / Schedule — 1996 Florida Impairment Rating Schedule — **State schedule, not AMA** ](https://medrecords.ai/content-hub/states/fl/) [New York — IME / SLU — 2018 SLU guidelines — **State schedule, not AMA** ](https://medrecords.ai/content-hub/states/ny/) [Arizona — DME — No canonical state source verified — **Not confirmed** ](https://medrecords.ai/content-hub/states/az/) 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 - [28 TAC 133.30](https://regulations.justia.com/states/texas/title-28/part-2/chapter-133/subchapter-b/section-133-30-d-1/) - [WA MARFS Chapter 24 (2025)](https://www.lni.wa.gov/patient-care/billing-payments/marfsdocs/2025/2025MARFSChapter24.pdf) Medrecords AI Every line cited back to its page. Send one real record set. We return a cited chronology you can check line by line, and a human decides what it means. [Test on a file](https://medrecords.ai/test-a-file/?src=content-hub-telehealth-vs-in-person) [Book a demo](https://medrecords.ai/demo/?src=content-hub-telehealth-vs-in-person) ### How Medrecords AI does this work Medrecords AI reads the same records these platforms handle. The difference is what comes back: a sorted, deduplicated file with a citation on every line, and a human deciding what it means. Judge it against the comparison above. [Solution — **Medical record review** — The review you were about to outsource, delivered as software — every line cited. Read more →](https://medrecords.ai/solutions/medical-record-review/?src=content-hub-telehealth-vs-in-person) [Product — **Medical chronology** — A dated, deduplicated timeline with a citation on every entry. Read more →](https://medrecords.ai/product/chronology/?src=content-hub-telehealth-vs-in-person) [Product — **Citations** — Every statement links back to the page and line it came from. Read more →](https://medrecords.ai/product/citations/?src=content-hub-telehealth-vs-in-person) Test it on a file you already have. Send one real record set. You get back a cited chronology and decide for yourself whether the read holds up — no obligation either way. [Test a file](https://medrecords.ai/test-a-file/?src=content-hub-telehealth-vs-in-person) [Book a demo](https://medrecords.ai/demo/?src=content-hub-telehealth-vs-in-person) ### Explore the Content Hub [ #### Software & platforms AI and case-management platforms across medical-record review. ](https://medrecords.ai/content-hub/software/) [ #### Service providers & BPOs IME, peer review, retrieval, and BPO providers. ](https://medrecords.ai/content-hub/services/) [ #### State programs Rules, AMA Guides edition, and MMI standards by state. ](https://medrecords.ai/content-hub/states/) [ #### Comparisons Head-to-head vendor and program comparisons. ](https://medrecords.ai/content-hub/compare/) [ #### Guides Editorial reference on report writing, MMI, and validity testing. ](https://medrecords.ai/content-hub/guides/) [ #### Conferences & events Workers' comp, claims, and IME conferences with editorial takes. ](https://medrecords.ai/content-hub/events/) [ #### Directories Link-out rosters of examiners, LNCs, and expert witnesses. ](https://medrecords.ai/content-hub/directory/) [ #### State matrix report All 10 verified state programs, side by side. ](https://medrecords.ai/content-hub/reports/ime-state-matrix-2026/) [ #### Content Hub home The full index of everything in the hub. ](https://medrecords.ai/content-hub/) Medrecords AI ### Minutes per file. Every line cited. 10¢ a page. Bring the hardest file from this page. Get a cited chronology and a report draft in minutes — every line traced to its source page, ready for your review and signature. - Minutes per file, not days - Every line cited to its source page - Flat 10¢/page, duplicates free — no license, no minimums - HIPAA-eligible · SOC 2 audit-ready [Test on a file](https://medrecords.ai/test-a-file/?src=content-hub-telehealth-vs-in-person) [Book a demo](https://medrecords.ai/demo/) See how Medrecords AI compares with anything on this page — over a 30-minute call, side by side. Last verified: 2026-08-15