Some of the best Illinois work comp topics we blog about come from great questions we get from injured workers. We aren’t always thinking about what you are thinking about and many of the questions we get are inspiring. Take this recent one on independent medical examinations (“IME”).
How many IME’s do I have to go to? I’ve been to a few in the last two years and now they want to send me back to the first one for what they called an addendum. I feel like they keep sending me to new doctors to see if anyone will change their opinion.
First off, this is a somewhat unique scenario in that it’s unusual to go to more than one IME during the course of a case. But this is a worker with a severe back injury that is not getting better and he’s had multiple surgeries.
Typically an insurance company can send you to an IME and they are generally stuck with the opinion of that doctor if it doesn’t go their way. Many of these doctors are “hired guns” but some are honest and others have cases so blatantly clear in favor of the worker that they have no choice but to tell the truth. If you have a compressed disc in your back that will leave you paralyzed without surgery, it’s hard for even a hack to say surgery isn’t needed.
What happened to this worker is that they never got a lawyer. They went to the first IME and that doctor agreed surgery was needed. After the first surgery didn’t go well, they wanted to do a follow-up procedure. Before the insurance company approved that, they sent him to a different IME doctor. That one also found against them. They insanely used a third IME when a spinal cord stimulator was requested and now want to go back to the first IME for a question about if the conditions are work-related.
It’s a bit of insanity. But back to the question.
You have to go to an IME if it’s scheduled. The only reason you’d have to go to a second one is if there is a new condition or question to be asked. That technically happened here, but not really. Had we been representing him, we’d have pushed back on the third one for sure and maybe even the second.
The bigger issue is that they are doctor shopping. It’s unique that all the IME’s found for the worker. Even with that, they are delaying another procedure that is now needed which is a joke. While technically they can choose a new doctor for a new situation, to just about every work comp Judge it’s going to look super shady. Once the first exam didn’t go their way it showed that the treating doctor is credible and attempts to later say he is doing things that shouldn’t be done are in bad faith.
Simply this is a worker who got bullied because he didn’t have a lawyer. Sadly, it affected his health which ironically cost the insurance company even more money.
The bottom line is that every case is different, but if you are being asked to go to more than one IME it’s at least suspicious and potentially against the law. If you want to discuss your unique case in confidence, you can contact us for free at 312-346-5578. We cover all of Illinois.
