10 Things To Know About IME’s

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Under Illinois workers’ compensation law, employers and their insurance carriers have certain obligations they owe injured workers, as well as certain rights. One of those rights is the ability to require an employee to attend an Independent Medical Examination (IME).

An IME is a one-time medical evaluation by a physician chosen and paid for by the insurance company. Unlike your treating physician, this doctor does not have a duty of care toward you. Their role is limited. They examine you, review your medical records, and create a report. That report addresses specific questions from the insurance company, such as whether your condition is work-related, whether you require certain medical procedures, and whether you are capable of working. There is a lot to know about these exams before you go to one. Here are 10 things most injured workers need to know.

1. Many injured workers are surprised by how brief the exam is, sometimes less than five minutes. It is not uncommon for workers to report that the doctor asked very few questions and performed only a short exam. Despite this, the physician’s report can have a major impact on your case.
2. IME doctors are often well compensated for this work, sometimes earning hundreds of thousands of dollars annually from these exams alone. Because of this financial incentive, many IME reports tend to align with the interests of the insurance company. Common findings include claims that an injury is not work-related, that surgery is unnecessary, or that the worker can return to full duty despite contrary opinions from treating physicians.
3. You have to be given compensation for your travel to the IME before it happens. It’s usually mileage door to door.
4. If the IME doctor’s opinion contradicts your treating physician, your benefits may be suspended, and necessary medical treatment may be delayed. This can be incredibly frustrating, especially when the IME was based on a brief exam while your treating doctor has spent considerable time with you.
5. Sometimes, insurance companies delay providing the IME report or refuse to share it altogether. This often happens when the IME agrees with your doctor, and their evidence would support your case rather than theirs. In some instances, the IME doctor may even communicate findings verbally to avoid putting anything in writing.
6. Under Illinois law, however, if no IME report is provided, Arbitrators are permitted to assume that the absent report would have supported the worker’s position.
7. You do have a right to bring someone into the IME with you. You can also record it, but we generally advise against that.
8. The law generally allows only one IME. However, in limited circumstances, a second IME may be permitted if a new medical issue arises. For example, if you undergo surgery after the first IME, the insurance company might be entitled to a second exam to address your recovery. What they cannot do is request repeated exams simply because they did not like the result of the first one.
9. If the IME doctor finds against you, and that is very common, all is not lost. Your lawyer can get a written opinion from your doctor and take your case to trial. Arbitrators in Illinois work comp cases generally favor the opinion of a treating doctor over an IME.
10. Sometimes the IME doctor will offer to become your treating doctor. That is odd, predatory behavior and we do not recommend you agree to that.