Have you been injured at work? When you file a workers’ compensation claim in Illinois, your employer’s insurance company may require you to undergo an independent medical examination (IME). This is a critical step in your claim, and it’s essential to understand what an IME is and how to prepare so you can protect your rights for compensation.
The purpose of an IME
An independent medical examination is an evaluation performed by a doctor chosen by your employer’s insurance company. The reason for this visit is not to treat your injury. Instead, the doctor’s role is to evaluate your condition, determine if it is work-related and assess your progress. After an IME, also often called a “Section 12 exam” in Illinois, the doctor writes a report for the insurance company.
Why was it requested?
Insurers often request a third-party exam when they have a dispute or question about your claim – a common tactic they use to challenge your case and limit their financial responsibility. Your employer or their insurance company may request an IME for these reasons:
- The insurer doubts your injury is work-related, even if it seems obvious.
- The insurer disagrees with your treating doctor’s opinion on the severity of your condition or the recommended treatment.
- The insurance company believes you have reached maximum medical improvement (MMI), meaning you have recovered as much as you can, and they want to end your temporary disability benefits.
It’s crucial to remember that an IME is a tool used by the insurance company to minimize costs or deny your claim altogether.
What to expect and how to prepare
Be aware that the doctor will document every word you say and every action you take during the exam. Your answers must be concise and truthful. Avoid exaggerating your symptoms or being overly talkative. Stick to the facts. The doctor is not your friend and does not work for you. You should not expect treatment or personalized medical advice during this visit.
Here’s what you can expect during the exam:
- The doctor will review your medical records.
- The doctor will ask questions about your injury and symptoms.
- The doctor will conduct a physical exam.
You have rights during this process. You are entitled to reimbursement for travel expenses to and from the appointment. Before the exam, it’s wise to seek legal advice. A skilled workers’ compensation attorney can help you prepare for the questions and protect your rights to receive the compensation you deserve.