Illinois Lawyer Referrals and Legal Guidance
Independent Medical Examinations
Under Illinois workers’ compensation law, injured workers get to choose who their treating doctor is. Unlike some other states, the employer or insurance company can not make you treat with a doctor of their choice. That said, they do have a right to send you to a doctor that they pay for called an independent medical examination or IME.
Although an IME is a doctor’s appointment, an IME is not really considered medical treatment. It is more of an expert opinion from the IME doctor and is generally used for litigation purposes. The IME report generated can be used to challenge the injured employee’s injury and amount of money he or she receives. The IME doctor can also testify in court regarding the IME exam and their findings. Unlike a normal visit to your doctor, the IME will likely ask more questions about how you got hurt and your current complaints. They are supposed to examine you based on what the insurance company wants to find out, not what is best for you.
Usually, the reason an IME is requested is to determine benefit payments for an injured worker or to determine damages in a trial or settlement. One reason may be that the injured person is claiming an assumed injury but has not yet visited his or her doctor. Other reasons vary. The IME may address whether there really is an injury and whether the injury is as severe as the person says it is. In the case of a workers’ compensation case, the IME may seek to determine if the injury was actually caused because of his or her job or if it was caused by some other reason. This is the same in a personal injury case, like a car accident, where the injury is in dispute. An IME can also be used to offer another opinion on the length of time an injured worker will be unable to work.
Do I have to get an IME if one is ordered?
Many states handle this question differently. Here in Illinois, if an injured worker files a worker’s compensation claim, that person falls under the Illinois Workers’ Compensation Act. Therefore, if an injured worker is entitled to receive compensation because of an injury, the injured worker “shall be required” if requested by an employer to attend an IME. Even though attendance is required, a reasonable time and a convenient location for the IME must be offered to the injured worker. Reasonable notice of the IME date must also be provided to the injured party. The insurance pays for the IME, travel time, and expenses. If you don’t attend the IME, your benefits can be suspended. So you definitely should attend the exam, but make sure you are prepared before you attend.
What Can I Expect if I Have to Attend an IME?
Many IME doctors are legitimate physicians who will truly offer their honest opinion as to whether or not a worker is hurt and what treatment is needed. A handful are “hired guns” who have reputations of basically saying whatever the insurance company wants them to say. These exams are big business and many doctors make six figures a year just from doing these exams.
We have heard many horror stories of doctors doing these exams and only being in the room with the injured worked for two minutes yet somehow they conclude the worker is 100% fine. There is no way to stop an unethical person from doing this, but you can be prepared by keeping track of how long the exam lasts and writing down (after you are done) what the doctor asked you.
Any experienced attorney would tell you to show up, be polite and don’t try to exaggerate your injuries. This is specifically what they are looking for. As with any case, the most important thing is to tell the truth. If they ask about your job duties, be clear on what contributed to your problem, but don’t feel the need to volunteer what you think they should know.
The IME doctor will ask many questions and will look over your medical records and history. The doctor will then evaluate your injury. This may include medical tests, x-rays, or range of motion exercises. It all depends on your injury. Above all, reasonable compliance the IME doctor’s tests and requests will help speed up your case and will benefit both parties in the long run.
Finally, unlike your normal doctor’s appointments, it is likely that a nurse case manager for the insurance company will be present at this one time visit. This is allowed under Illinois law because it’s not your doctor, but rather the doctor for the company.
What if the doctor says I’m fine, but my doctor says I need surgery?
This happens all of the time. If it happens to you, it means that you need a good attorney in your corner who is experienced with trials and taking depositions of doctors. Your attorney will likely ask the doctor questions under oath and will make an argument to the Judge about why your treating physician’s recommendations should be followed. It’s not the law, but if you have a credible doctor and facts on your side, most Judges will listen to the doctor who has seen you many times over many months versus the one time exam doc. The IME doctors who are hired guns do have bad reputations and most Judges are aware of them.
Choosing an Attorney
Any attorney that we recommend will have handled hundreds of workers’ compensation cases. No one can ever guarantee a result, but our extensive resources throughout Illinois will give you the best chance for a successful result. This is why people come to us. If you would like our help in finding a law firm in Illinois, please contact us at (800) 517-1614. We will speak with you and do whatever we can to help you. All calls are free and confidential.
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