IME reports. What weight do independent medical examinations have in court?

A reader asks:

My doctor says I need back surgery and it is related to my job injury.  I went to an "Independent" medical examination and not only did this hack say that I didn't have an accident, but he also says I can work full duty and need no further treatment.  How can he say I didn't have an accident when I was working with hundreds of pounds of raw materials?  My doctor is a respected orthopedic surgeon.  Will the insurance company get away with this because their doctor is a crook?

The situation described is not un-common.  Your employer or their insurance company has a right to send you to a doctor of their choosing.  If they disagree with your doctor then we go to trial.  That's one way we earn our money.

We can't guarantee who the Arbitrator is going to agree with, but all things being equal, treating surgeons who have seen you multiple times are given much more credibility than a one time visit doctor who maybe spent 10 minutes with you.  The Arbitrators know who the hired guns are and who gives an honest opinion.  If you testify credibly about how you got hurt and there are no other problems in your case like surveillance or intervening injuries, things will probably go fine.

If they get an IME we just have to go through the process.  It can be frustrating to hear that, but that is why you get a good attorney in the first place.

We are workers' compensation attorneys that help people with Illinois work injuries anywhere in IL via our statewide network of attorneys.  Contact us and we will answer your questions or find the right lawyer for your situation.

Illinois workers' compensation- company doctors

It's not uncommon if you get hurt on the job in Illinois for your company to send you to one of their doctors.  This could be for a one time independent medical examination or it could be a company clinic.   There are two important things to know about this.

1. You don't have to receive treatment with their doctor on an ongoing basis, but you can.  You are allowed two choices of physicians in an Illinois work comp case and since they are sending you to that doctor that is not considered one of your choices.

2. If their doctor says your injury is work related, you need surgery, etc., the opinion of that doctor is held against the company.  It's not a slam dunk that a Judge would agree with that opinion, but that is usually the case unless one of your choices says something different.  We often see a company doctor go against the company and then the insurance carrier tries to send you to another doctor to fight that opinion.  Technically they can do this, but it is seen as "doctor shopping" and would work against them at trial.  In fact while we don't guarantee a result, we have never lost a case where the company doctor was in the corner of our clients.

If your company wants to send you to a doctor of their choosing you should go, be honest and after it's over write down what happened.  A lot of our clients report that an independent medical examination took less than five minutes and that the doctor hardly asked any questions and didn't perform much of an exam.  These same doctors are the first to say whatever the company wants them to say.

Again, we can't guarantee a result, but we find that when our clients testify as to what really happened at these quick exams as compared with their doctor who spent more time with them, things usually work out for the best.

 We are workers' compensation attorneys that help people with Illinois work injuries anywhere in IL via our statewide network of attorneys.  Contact Us and we will answer your questions or find the right lawyer for your situation.

 

Illinois workers' compensation medical bills

A new client came to us after having had one surgery for his knee from a work injury.  After months of therapy it wasn't getting better and his doctor suggested that he have an additional surgery based on a review of a MRI.

As is their right, the insurance company sent this worker to an independent medical examination (IME) with a doctor of their choosing.   Quite often these are hired guns, but many of these doctors are honest as was this one.  In fact the doctor in his report said that he agreed 100% that the worker needed a new surgery and that it was related to the work injury.

Seems pretty obvious that the insurance company should pay for this surgery and the worker can get better, right?  Well apparently the insurance adjuster felt that he should do more therapy first so even though two orthopedic surgeons agreed surgery was needed, the adjuster put her medical "expertise" above them.

Should he just sit there and get screwed?  NO!!!  Not only can we get the surgery ordered by an Illinois Workers' Compensation Commission Arbitrator, but we can find out how much the surgery costs and the insurance company should have to pay a 50% penalty to our client.  In other words, if the surgery is going to cost $50,000, they should pay this guy $25,000 because their behavior is so unreasonable.

If you are hurt and the evidence is on your side the system will protect you.  You just have to proceed forward.

 We are workers' compensation attorneys that help people with Illinois work injuries anywhere in IL via our statewide network of attorneys.  Contact Us and we will answer your questions or find the right lawyer for your situation.