If you have a workers' compensation case in Illinois, there's a good chance the insurance company is going to send you to an Independent Medical Examination, or IME. And I'm going to be straight with you: there is nothing 'independent' about it. The IME doctor is chosen and paid by the insurance company. Their report is used by the insurance company to dispute your claim. Understanding how the IME works is critical to protecting your benefits.
Here's what happens at an IME. The doctor reviews your medical records, asks you questions about your injury and symptoms, and performs a physical examination. The whole thing usually takes 15 to 30 minutes. Then the doctor writes a report giving their opinion about your diagnosis, whether your condition is related to your work injury, and whether you need ongoing treatment. More often than not, the IME doctor's report favors the insurance company — shocking, I know.
But here's the thing: you can't refuse to go to the IME. Under Illinois law, if the employer requests a reasonable IME, you're required to attend. If you don't show up, the insurance company can suspend your benefits. So you have to go. The question is how to handle it so the IME doctor's report doesn't torpedo your case.
Tip number one: be honest. Don't exaggerate your symptoms, and don't minimize them either. If something hurts, say it hurts. If you're having a good day, it's okay to say you're having a good day. The IME doctor is watching for inconsistencies — if you say you can't raise your arm above your head, and then they observe you reaching for your coat on a high hook, that's going in their report.
Tip number two: don't volunteer information. Answer the questions you're asked, but don't launch into a long story about everything that's ever been wrong with you. The more you talk, the more ammunition you give the IME doctor to connect your current problems to something other than the work injury.
Tip number three: tell your lawyer exactly what happened at the IME. We may need to challenge the IME report by deposing the doctor or presenting your treating physician's contrary opinion. The more we know about what went on in that room, the better prepared we'll be.
If you have an IME coming up and you're worried about it, call us at 312-500-4500. We'll prepare you so you know exactly what to expect.
IME stands for Independent Medical Examination. Even though it has the word "Independent" in it, do not be fooled. The Workers Compensation insurance company will choose a doctor who is friendly to them to examine you and write a report. And their purpose is to cut off your benefits and decrease the value of your case. They choose doctors who practice but who want you case to get beat.
Insurance companies tend to choose from the group of doctors who cut off injured workers' benefits and treatment. This way, the insurance company saves money on your Workers Comp claim. But you, the injured worker, end up on the short end of the stick.
You are required by law to go to the IME and cooperate with the doctors' examination of you. If you fail to go to the appointment or cooperate, then Workers Comp can cut off your pay and medical treatment. So you have to go.
First, the doctor is not on your side. Whether the IME doctor acts nice or acts like a jerk, it doesn't matter. They have been hired by Workers Comp insurance to lower the value of your case. If the doctors do not help the insurance company, then the insurance company stops hiring that doctor. So it is very likely that the doctor you are going to see is financially motivated to find a problem with your case or your medical treatment.
Second, exaggerating your pain is the worst thing you can do. The physical exam they give you has a number of tests in it to tell whether you are telling the truth.
In other words, you might think that a particular movement is testing your legs when it is actually testing your lower back. If you say you have lower back pain in one test but not in another, the doctor will say you are lying or exaggerating your pain. This can kill your Workers Comp case.
That's why I tell all of my work injury clients two things before an IME:
You have to go to the IME doctor's office. If it is far away, the Company has to pay you a travel fee to get to and from the appointment.
Then the doctor usually asks you questions. Some doctors ask very few questions, and some ask a lot. Make sure you keep your answers truthful because they ask questions for one reason: to try to get you to lie and catch you. So just tell the 100% truth.
Then, the doctor does a physical examination of you. Some exams are very short. Others are quite long. Either way, do not exaggerate symptoms. The point of the exam is to make it seem like you are not being truthful. So beat them at their own game by being 100% truthful.
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After your IME exam, the doctor writes a report. Insurance companies usually want the doctor to say one of three things:
All of these positions mean the Company can try to send you back to work or perhaps fire you and cut off your benefits. A good Workers Compensation lawyercan help you avoid that outcome. In fact, getting a good lawyer BEFORE you have an IME is your best protection.
Even if you do a great job, doctors can still spin the exam in favor of the Company and against you. Sometimes, this means that the IME doctor out and out lies about what happened at the exam.
If this happens, your lawyer will interview you closely and we may have to fight it at trial. Or it might be that the Judge or Arbitrator in the Workers Comp case will trust the treating doctor over the IME doctor. Basically, you are in for a fight if you get a bad IME report.
Yes, and it does happen. In my law firm, after I explain the above information to my clients about how IMEs work, they do a good job. And if the IME doctor is basically honest, he or she will say that my client has a good case.
If that happens, the case will often settle and I can get my client's benefits reinstated.
So obviously, IMEs are pretty important to make sure you get all of the benefits you deserve after a work injury.
To be perfectly honest, when an injured worker gets scheduled for an IME in Workers Comp, it usually means the Company is trying to fire the worker or cut off their benefits. That's why it is a good idea to hire a competent Workers Comp lawyer BEFORE your IME.
But even if you do not do that, talking to a Workers Compensation lawyer after your IME is still a great way to protect your case value and vastly increase your chance to win your case.
An IME - Independent Medical Examination - is a medical evaluation ordered by the insurance company. The name is misleading. The physician conducting the IME is hired and paid by the insurance company, which creates obvious incentive to minimize your injuries and support the insurer's position. IME doctors in Illinois workers comp cases routinely produce opinions that are more favorable to the insurer than your treating physician's opinion. The IME opinion is used to dispute the extent of your injury, recommend cutting off benefits, or reduce the permanency rating at settlement.
Yes - refusing to attend an IME can result in suspension of your workers comp benefits. You are required to attend and cooperate. However, you have important rights: you can bring a witness, you can record the examination in some circumstances, and you should tell your attorney about the IME immediately so we can prepare you. I prepare every client extensively before an IME so they understand what to expect and how to present their symptoms accurately and completely.
Be accurate and complete about all your symptoms - don't minimize and don't exaggerate. Describe your worst days, not your best days. Bring a written list of all your symptoms, limitations, and how the injury affects daily activities. Be consistent with everything you've told your treating physician. Know that the IME doctor is not there to help you. Everything you say and do during the examination is being observed and will be reported. I give clients a full preparation session before any IME.
This is a dispute of medical opinions - extremely common in workers comp cases and exactly what I handle. The IWCC arbitrator weighs both opinions. Treating physicians who have an ongoing relationship with you and have examined you repeatedly generally receive more weight than one-time IME examiners. I challenge IME opinions through cross-examination, pointing out inconsistencies with your medical records, and in some cases retaining my own expert to rebut the IME findings. Call 312-500-4500.
The insurance company pays the IME doctor's fee - that is part of why the doctor's opinion tends to favor the insurer who hired them. The insurance company is also required to reimburse you for reasonable travel expenses to and from the IME, particularly if the appointment is far from your home. Save your gas receipts, mileage records, and parking receipts. If the insurance company refuses to reimburse your travel, that is something I address as part of the case.
Yes - and you should. Bringing a spouse, family member, or trusted friend gives you a witness to what was said and done during the exam. The IME doctor's report will describe what happened. If the doctor's account contradicts what your witness saw, that is powerful impeachment material later. The witness usually sits in the waiting room during the actual exam but can be present for the interview portion in most situations. I recommend bringing a witness to every IME.
We fight it. If the insurance company suspends your temporary total disability (TTD) checks or stops paying for treatment based on the IME, I file a Petition for Penalties and Fees with the Illinois Workers' Compensation Commission. The arbitrator can order benefits reinstated, award penalties for the unreasonable suspension, and award attorney's fees. The treating physician's opinion often outweighs the IME at trial, and a bad IME report alone is not the last word on your case. Call me at 312-500-4500.
Yes. Your treating physician needs to know an IME happened so they can review the IME report and respond to its findings. The treating doctor's response - whether through a follow-up note, deposition testimony, or trial testimony - is often the most important piece of medical evidence in challenging an unfavorable IME. I send the IME report to the treating doctor in every case and work with them to develop the rebuttal evidence we need.
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If you or a loved one is dealing with a situation like this, give us a call any time, day or night. We are here to help. 312-500-4500
Scott DeSalvo founded DeSalvo Law to help injured people throughout Chicago and surrounding suburbs. Licensed to practice law in Illinois since 1998, IARDC #6244452, Scott has represented over 3,000 clients in personal injury, workers compensation, and accident cases.
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