By GNGF on April 12th, 2023 in
If you’ve been injured on the job and need to seek workers’ compensation benefits, the process can sometimes be complex and confusing. This is especially true when it comes to understanding key claim components such as an Independent Medical Examination (IME). Knowing the purpose and implications of an IME can make a significant difference in the outcome of your workers’ compensation claim in Illinois.
What Is an Independent Medical Examination (IME)?
An Independent Medical Examination (IME) is a medical evaluation conducted by a doctor who is not involved in your treatment. Usually, the IME physician is hired by an insurance company on behalf of your employer. The purpose of an IME is to obtain an “objective” assessment of your medical condition and determine the extent of your work-related injuries, although stories about respect to how objective those assessments really are. An IME report is generated by the IME physician to verify the extent of your injuries, the necessity of the treatment you’re receiving, and your ability to return to work. At times, opinions are rendered with respect to what work restrictions (think lifting restrictions, etc.) are necessary.
What Is The IME Process in Illinois?
Under the Illinois Workers’ Compensation Act, Section 12 (820 ILCS 305/12), an insurance company or employer has the right to request an IME. If an IME is requested, you are required to attend the examination or risk losing your workers’ compensation benefits. However, the employer must pay for your travel expenses and other costs associated with the IME. You do not pay for the examination.
To prepare for an IME, the insurance provider will typically gather your medical records and send them to the IME physician with any other information that the company wants the doctor to review. Sometimes, the insurance provider will send witness statements, videotape surveillance, job descriptions, and other information.
During the examination, the IME doctor will review your medical history, ask questions about your injury, and perform a physical examination. The IME doctor will then put together a report of findings as to the medical assessments (also called diagnosis), opinions of the necessity of medical care already provided, and the need for future medical care. The IME doctor will also usually provide an opinion of “causation,” and issue a statement of whether your work injury or work duties caused the diagnosis and need for medical care.
How Does an IME Affect My Workers’ Compensation Claim?
The IME report can significantly affect your workers’ compensation claim. The doctor’s opinion almost always influences the insurance company’s decision on whether to approve or deny your claim and pay for additional medical bills. If the IME doctor’s opinion differs from that of your treating physician, this can lead to disputes and potential delays in receiving your benefits. Your attorney will often have to set your case for arbitration to obtain a decision from the workers’ compensation arbitrator on whether you are entitled to additional medical benefits.
How Long Does It Take to Get an IME Report?
Typically, your attorney might expect to receive the IME report within a few weeks after the examination. However, the timeframe may vary depending on the complexity of your case and the doctor’s schedule. If you disagree with the findings of the IME report, you can consult with your treating physician and consider disputing the report’s conclusions. Your attorney can take the doctor’s deposition in order to cross-examine the physician on his or her report.
Navigating the IME Process – Do’s and Don’ts
Following these dos and don’ts can help ensure a smoother IME process and increase the likelihood of a favorable outcome in your workers’ compensation claim –
- Prepare for the examination – Review your medical records and treatment history, and be ready to discuss them with the IME doctor.
- Be punctual – Arrive a few minutes early for your appointment to show that you are taking the process seriously.
- Dress appropriately – Wear comfortable clothing that allows for easy movement during the physical examination.
- Provide accurate and detailed information – Be honest about your medical history, symptoms, and limitations. Avoid exaggerating or downplaying your condition.
- Be respectful and cooperative – Be courteous and follow the doctor’s instructions during the examination.
- Take notes – After the examination, write down your recollection of what occurred, including the questions asked and tests performed.
- Consult with an attorney – An experienced workers’ compensation attorney can help you navigate the IME process and protect your rights.
- Withhold information – Failing to disclose relevant medical history or previous injuries can harm your credibility and potentially jeopardize your claim.
- Exaggerate or fake symptoms – This can also damage your credibility and put your benefits at risk.
- Refuse to answer questions or undergo tests – Cooperate with the IME doctor during the examination, but be mindful of your rights and limitations. If you have questions, ask your attorney.
- Be confrontational or argumentative – Remain calm and composed, even if you disagree with the IME doctor’s opinions or conclusions.
- Discuss legal matters – The IME doctor is not there to provide legal advice. Focus on your medical condition and the examination itself.
- Speculate or guess – If you’re unsure about a question or don’t remember specific details, it’s better to say that you are having trouble remembering rather than guess or speculating.
Contact an Illinois Workers’ Compensation Attorney
An Independent Medical Examination could be a crucial part of the workers’ compensation claim process in Illinois. If you have concerns or questions about your claim, seeking legal advice from an experienced workers’ compensation attorney is highly recommended.
The Illinois Worker’s Compensation Lawyers at the Noll Law Office have extensive experience handling workers’ compensation claims and can guide you through the IME process. If you need assistance with your workers’ compensation claim or have questions about an IME, contact the Noll Law Office today for a free consultation at (217) 414-8889.