A caller to our office had an accepted work comp claim. He had hurt his back while working in construction in Chicago. The insurance company was paying all of his medical bills and for all of his time off work. When his doctor recommended a back surgery, the insurance company exercised their right to send this worker to a doctor of their choosing.
These exams are called independent medical examinations or IME’s. They are very common, especially when you have a serious injury. You are required to attend the exam as long as the insurance company provides written notice as well as a check for travel expenses from your house to the exam and back.
This worker was ready to attend, but had to cancel at the last minute after a parent died and their funeral was scheduled for the same day. That sounds like a reasonable excuse, right? Well after this happened, the insurance company stopped paying his weekly checks and said that they won’t start them up again until he goes to a new IME. Unfortunately the next available date is more than two months away.
He wanted to know if they can get away with this?
Generally speaking, if you blow off an IME, you can have your work comp benefits cut off. That would be someone who just refuses to go. In this case, the worker had a very reasonable excuse to miss the exam. There is no way that his benefits should be cut off at all. But I also don’t think you need that extreme of an excuse. Life sometimes gets in the way. For example, if the worker was scheduled to be out of town for a vacation or a wedding, that would be a legit excuse too.
The key is to communicate ASAP with the insurance company, offer alternative available dates and do it in writing (as well as verbally) so you can prove your attempts to cooperate.
What you can’t do is say that you refuse to see their doctor because you know they are a hired gun. That may be true (probably is) but it’s part of the Illinois workers compensation system. So you are going to have to go and while legit excuses work, you can’t miss one and then another if they send you a check for travel expenses.
If they don’t send you a check, you technically don’t have to go. That doesn’t mean a slimy insurance adjuster might not temporarily cut off or delay your benefits. If that happens to an injured worker that I’m working with, I typically would suggest we call the insurance company and let them know a check hasn’t been received and that you won’t attend unless they pay up. What I don’t want to do is have a worker go without a TTD check when we can avoid that problem.
Note that while the insurance company can send you to an IME, they can’t send you to a second one typically unless it’s addressing a new issue. If you think that’s happening, you should talk to a lawyer ASAP before you decide to attend or not attend.
And as always, if you have any questions and want to speak with an experienced attorney for free, you can call us any time at 312-346-5578.
