A very frustrated worker contacted me recently. She didn’t need an attorney as she actually had a quite good one in her corner already – not my office and not someone in my statewide network of law firms, but still a firm I like and respect. This lawyer had taken her case to trial and won. There was a dispute as to whether or not she needed a back surgery and if so, was it related to a job injury.
The issue at the trial was who did the Arbitrator find more credible; the IME doctor that saw her once for about 10 minutes and said no surgery was needed and any injury wasn’t work related or the treating orthopedic doctor that has seen her over 15 times and believes a surgery is needed due to a job accident.
Just reading that last sentence, you’d realize that in most cases the treating doctor’s opinion will be given a lot of weight. That doesn’t guarantee a win, but if your lawyer is willing to go trial and do the work necessary, you usually have a great chance at winning and that’s what happened in this case. It’s not unusual for Illinois workers’ compensation at all.
So here we are three years or so after the trial and she’s had her surgery. Her doctor says she can’t return to her old job. The insurance company sent her back to the same doctor for another IME, this time to address whether or not she needs any work restrictions. Surprise, surprise, he says she is fine.
The caller was understandably upset because she sees no reason that this doctor should be able to see her again. As good as Illinois workers comp law is for injured workers, it’s not perfect. The reality is that this is a new case issue, so the insurance company does have a right to send her back to the IME. It’s a joke of course because we know if this goes back to trial she’s going to win again, but they are entitled to fight it if they want. If anything, it gives them some leverage in negotiating a settlement.
For longer term injuries, it’s not unusual to go to more than one IME. There is no law as to how many they can send you to, but generally speaking, it can’t be done for pure harassment. The IME has to serve a purpose that hasn’t already been addressed. For example, you may see their hack, er, I mean IME doctor and he could ask you to come back after you have a MRI. If a long time has passed, they might see you to report on progress that you’ve made since the first visit.
And in cases like this one, if there is generally a new issue at hand such as whether or not you need work restrictions, they can send you back for an exam. They are wasting their money and your time, but it’s within their rights.
My advice is to go to the exam, don’t embellish your symptoms answer their questions and go from there. Most of the reports I read are based more on your medical records than anything else, although it’s not uncommon for them to observe you in the parking lot and compare how you move there to how you move in their office. If you have a good treating doctor and attorney in your corner, things will work out fine. And that’s true whether you have to go to one of these exam or five.
