An injured worker with a bad shoulder injury while working in Illinois called us. He had an accepted case and had been receiving physical therapy and injections over a period of six months or so. His orthopedic doctor now wants to do surgery. That is a logical next step after conservative treatment has failed.

Of course the work comp insurance company is not concerned about logical next steps. They are wanting to avoid paying for an expensive surgery and more months of rehab and TTD benefits. I get it. That is how they make billions of dollars every year. It’s not by doing the right thing.

As a result, they have scheduled this injured worker for an IME. It is with a well known hired gun type doctor who does hundreds of exams like this every year. He problem makes over a million dollars a year of these exams alone. As you can imagine, he does not want to lose that gravy train so almost every time he sees an injured worker, he sides with what the insurance company wants him to say. As a result, this caller is nervous.

Do You Have To Worry About An IME In An Illinois Work Comp Case?

Generally speaking you should be cautious and pro-active about an IME. It’s not designed to help you get healthy. Even though you are seeing a doctor, it is not medical care. The goal of it is to help the insurance company fight your case. Sometimes that means saying you were not hurt at work or that you are all better even if your doctor disagrees. Other times they will say that surgery is not needed or that you can work even with your injury.

The way to be pro-active is to make sure that you officially have a case on file with the Illinois Workers’ Compensation Commission before the IME happens. That way if the doctor’s report goes against you, you will have an attorney lined up who can file a motion for a hearing with an Arbitrator faster. In other words, getting a lawyer before the IME speeds up you getting justice if something goes wrong.

The other thing a good lawyer can do is prepare you for the exam. This includes:

  • Telling you about the doctor.
  • Discussing what to wear.
  • Telling you what to say and what not to say.
  • Discussing things you might not think of. For example, the doctor might have a nurse whose job it is to watch you as you leave your car to see if your behavior matches what you show in the office.
  • Behavioral do’s and dont’s.
  • Bringing someone to the exam with you if you want.
  • Understanding the timeline of when the report will be available and what happens next.
  • Discussing whether to bring with you diagnostic tests like x-rays or MRI results.

So yes, it is smart and sensible to be concerned. More likely than not this exam is going to be used against you to try to delay or deny your benefits or give them leverage for a lower settlement.

The good news is that Arbitrators in Illinois work comp cases are not dumb. If a doctor makes a living by repeatedly writing bad reports, even when a credible doctor says otherwise, they are not looked upon favorably. So if you are prepared with a good attorney who cares about you and will fight for you, even a denial can be quickly pushed back on.

I’m sure the idea of an IME is frustrating, especially when you just want to get better and back to work. If you want to discuss your case, reach out to us any time for a free case review. We will connect you with an experienced lawyer in your area that can help if needed.