Do Independent Medical Examinations Affect Workers’ Compensation?

 Posted on July 29,2024 in Workers' Compensation

Private industry employers reported 112,500 nonfatal workplace injuries and illnesses in Illinois in 2022, or about 2.7 cases per 100 full-time equivalent workers. Sixty-two percent of occupational injuries and illnesses occurred in trade, transportation, utilities, education, and health services industries. Dealing with a workplace injury can be difficult at best. Doctor’s appointments, treatments, tests, and perhaps an inability to return to work because of the severity of the injuries can all create challenges.

Once a workers’ compensation claim is filed, it may feel like there are even more complications, along with a mountain of red tape. An independent medical examination (IME) is one of these challenges that can potentially result in a denial of benefits. Those facing an IME should speak to a workers’ compensation attorney who has experience dealing with these medical examinations and fighting for the rights of injured workers.  

Is an Independent Medical Evaluation Mandatory?

An IME is usually requested by the employer or by the employer’s workers’ compensation insurance. If an injured worker is asked to participate in an IME, it is mandatory, even though the evaluation can sometimes negatively affect a workers’ compensation claim. Some employers may even use independent medical evaluations (IMEs) to challenge benefit eligibility.

Refusing or delaying the exam can result in suspension of benefits. During an IME, a doctor reviews the injured worker’s medical records and submits a report on the extent of the injury, the recommended treatment, and the target date for maximum medical improvement. The doctor will assess the cause of the injury and provide any necessary work restrictions. While an IME is mandatory, there are ways to make the process easier and ensure it does not hurt your chances of receiving benefits.

 What Is the Process for an IME?

A formal request for the IME will be made, which includes why the IME is being requested, what medical issues are at hand, and whether the injured worker needs to provide medical records or test results. The physician for the IME is chosen by the party requesting the IME, and while it is assumed the examiner will be neutral, this may not always be the case. The worker and the party requesting the IME will work together to set a mutually agreeable appointment time and place.

 The examiner will review the worker’s current medical records, perform a physical examination, and conduct any necessary diagnostic procedures or medical tests. Following the examination, the IME physician will prepare a report that details the opinions, findings, and conclusions. The IME report will then be given to the requesting party. If you are asked to have an IME examination, you should remember the following:

• Arrive at the appointment early.
• Always be honest regarding injuries but cautious when answering questions.
•  Have a good understanding of your medical history, work injury, and necessary treatments.
• Provide a detailed accounting of how the work injury occurred.
• Consider bringing another person to the IME.
• After the IME, write down everything you remember regarding what was said during the examination and interview.

 How Could an IME Affect Your Workers’ Compensation Claim?

Every interaction during the IME examination is crucial; even the most innocent statement can potentially be used against you. Any statement that is less than accurate or slightly exaggerated can undermine your compensation claim for benefits. Being truthful yet cautious is imperative to safeguard claims. Discussing the issue with a highly skilled workers’ compensation attorney before the IME appointment can ensure that no accidental missteps are made that could jeopardize your workers’ compensation benefits.

Contact a Will County, IL Workers’ Compensation Lawyer

The result of the IME examination is extremely important. If you lose your workers’ compensation due to the results of your IME, you can dispute the results, but you need an experienced Plainfield, IL, workers’ compensation attorney to guide you through the process. A skilled lawyer from Flaherty Law, LLC will be determined to stand up against an insurance company that does not want to take your injuries seriously. Contact Flaherty Law, LLC today at 815-577-7500 to schedule a free consultation to discuss your workers’ compensation claim for benefits.