One of the rights employers and insurance companies have under Illinois workers’ compensation law is requiring that you see a doctor of your choosing. You might get a letter asking you to go to a Section 12 exam or independent medical examination (“IME”). It’s a one time exam with a doctor who is supposed to be independent, but often is not. Their purpose is to look at you, your medical records and answer whatever questions the insurance company has. These questions usually include whether or not you had a work related injury, what your diagnosis is, what treatment you need, is that treatment related to a work injury, what is your prognosis and what restrictions, if any, do you need at work.
You’d be surprised (or maybe not) at how often they say either you are hurt, but it’s not work related or despite what the treating doctor says, you are fine.
Clients can be anxious about these exams and understandably so. Here are some frequently asked questions about going to an IME in Illinois and some tips:
1. Do I have to go? You do, and if you don’t, your benefits can be suspended. That said, they can’t send you to a second one unless it’s for a different reason.
2. Do the IME doctor and I have patient confidentiality? No, you don’t because he’s not your doctor. They are expected to share everything you say with the insurance carrier.
3. How long will the exam last? There’s no set time, but I’ve seen cases where a doctor is in the room for only two minutes. They will say that they are more so relying on your medical records to make their opinion, but that seems like b.s. to me. On average I’d say the exams take 10-15 minutes from beginning to end. Sometimes they order x-rays or other diagnostic tests. If you can, I’d suggest slyly starting a timer from the moment they walk in the room to the moment they leave.
4. Will they ask me questions? They will. We suggest you answer honestly and completely. Be cooperative. But don’t volunteer info they don’t ask about and be concise. Less is more.
5. Since they are trying to figure out if my injuries are work related, should I play it up a little so they know how hurt I am? No! Be honest. Don’t exaggerate in any way. If they think you are exaggerating it will be in the report and it will hurt you.
6. Is it true I get paid to attend this exam? Not paid, but they have to provide you a mileage reimbursement check before you go. If they don’t, you don’t have to attend.
7. Do I have to pay for this exam? No, you’ll never get a bill for it no matter what happens in the case.
8. Will I get a copy of their report? They won’t send you one, but we can get a copy of it for you.
9. Is it true that some of these doctors do hundreds of these exams a year? It is true for some. The good news is that most Arbitrators know who the hired guns are because they see them over and over on their cases. That doesn’t guarantee anything, but certainly hurts the credibility of these doctors.
10. What’s one thing about IME’s that most people don’t know? For some exams, nurses are instructed to watch you as you get out of your car or head back to your car. Sometimes doctors even do it themselves. They are checking to see if your movements are consistent with what you say in the office. It happens a lot with back and leg injuries.
Hope this helps. Be calm. Be honest. An IME is just part of the process. And as always, if you have any questions or need help with a case, you can contact us for free at any time.