Workers’ compensation is supposed to be an easy, no-fault benefit system that gets injured workers the medical care that they need and some replacement wages while they wait on their bodies to heal.
However, workers’ comp is full of pitfalls and traps that don’t exactly make it all that easy, after all. One of these is the independent medical exam (IME).
You don’t really have an option except to comply
Once your employer’s insurance provider requests an independent medical examination, Section 12 of the Illinois Workers’ Compensation Act requires you to submit to the exam in order to retain your benefits. That means knowing how to navigate this situation when it comes up (not “if”) is essential.
Why is the IME being requested? There can be all kinds of reasons for the request, but they generally are scheduled when:
- The insurance company thinks your primary treating physician is biased
- You don’t seem to be making progress in healing as anticipated
- The insurance company has doubts about the extent of your injuries
- The insurance company thinks your injuries couldn’t have occurred as described
- Your claim is simply getting too expensive and they’re looking for a way to end it
You should keep these thoughts in mind when you go to your IME, so that you’re on your guard and aware of what may be at stake. Although this exam is supposed to be entirely independent, the reality is that the physician is being paid by the insurance company. If they tend to weigh in more heavily for the injured workers they see, the insurance referrals are likely to stop.
How do you navigate the IME? Here are some tips:
- Review your treatment history before you go so you can quickly describe what you’ve already done and how well it has worked.
- Be ready to explain exactly how your condition limits you in plain language. You cannot assume that it will be obvious, even to a doctor.
- Be polite and gracious to the physician. Even if you suspect they’re on the insurance company’s side, nothing is to be gained from antagonizing them.
- Take someone with you. Having a witness can be invaluable if the doctor only spent a couple of minutes with you then wrote a missive denying your condition is serious.
When your workers’ compensation claim isn’t going the way that it should, you aren’t without legal options.