What to Expect If You Are Scheduled for an Independent Medical Examination
Section 12 of the Illinois Workers’ Compensation Act gives employers a right to request that injured employees submit to an independent medical examination (IME) by a physician or surgeon of their choice. The employer or insurer will pay for the costs of the IME and is also required to provide the injured employee with a mileage check and reimburse the employee for travel expenses (i.e. parking, meals). The injured employee is required to attend the IME. Failure to do so will result in the suspension of workers’ compensation benefits.
A common question asked by many of my clients is – What should I expect at an IME? Like a visit to your own doctor’s office, upon arriving you may be required to complete paperwork asking you to provide a history of your accident, describe your subjective complaints, list your current medication and give a rundown of your treatment history. The IME examiner will also ask you to describe your accident or give a description of the type of work you perform. It is important to give an accurate history of your accident and complaints.
Often times the physical exam takes no more than 10 minutes. Common complaints I get from clients are that the examiner was standoffish and had poor bedside manner. Don’t let this discourage you! In reality, IMEs are never truly “independent.” Insurance companies hire these physicians to issue opinions and often use the same doctors over and over again because they know what to expect. The insurance companies pay the doctors anywhere between $1000-$1500 for an exam. It’s also important to note that a doctor-patient relationship is not established by way of an IME. This should be made clear by the examining physician from the outset. This also means that there is no confidentiality privilege and the IME physician can, and very likely will, report anything you do or say during the exam to the employer/insurance company.
Following the IME the physician will write a report. The report will address causal connection, whether additional treatment is needed and whether the employee is able to return to work. It is common for a doctor performing an independent medical examination to determine that your condition is not work-related and/or that you can go back to work without any restrictions. Many even find no evidence of injury or determine that your condition is part of the “natural aging process.”
The insurance company can deny workers’ compensation based on the opinions of the IME physician, regardless of what your own treating physician says. Keep in mind however; the IME physician’s opinion is not the final word! Your treating physician will likely have a very different opinion than the IME physician. At that point it becomes a “battle of the experts.” Depending on the situation your attorney may want to take an evidence deposition of both doctors and the matter may need to be litigated in the Illinois Workers’ Compensation Commission. If you do not have an attorney at this point, it is highly recommended that you hire one. Otherwise your chances of getting your benefits reinstated are slim.
Remember that you may be observed from the time you arrive the office until the time that you get in your car to leave the appointment. This is important because often times the IME report will state how you got in and out of your car, how you opened the door, how you sat in the chair, how you walk, how you were able to get on the examining table etc. The examiner will be on the lookout for any inconsistencies between your reported disabilities and their observations of these seemingly mundane activities. For example the report the doctor might note on the report -“The claimant stated that he has difficulty lifting, pushing or pulling more than 10 pounds. However, on his arrival he was observed pulling open the door with no difficulty. The door requires 15 pounds of force to pull open.” IMEs are not only used to deny workers’ compensation benefits, but also used to chip away at the injured worker’s credibility.
Knowing what to expect during an IME can alleviate a lot of the anxiety associated with this experience. Below are some helpful tips that I give all of my clients who are scheduled for an IME:
- Get there on time! Most IME physicians’ office will cancel your appointment if you are late. Although the IME can be rescheduled, the insurance company will treat this as if you no-showed your appointment and suspend your benefits. If you do not have a means of getting to the IME, transportation should be provided to you by the insurance company or employer, but you must arrange for this well ahead of the exam.
- Be honest and cooperative with the examining doctor. There are times where one may come across an IME physician who has an unsympathetic or even hostile attitude. The best way to handle this situation is to not react. Cooperate with the exam and answer the questions as best as you can.
- Most importantly, do not exaggerate your complaints or symptoms. Some injured workers feel they have to convince the IME physician that there complaints are “real” and as a result, intentionally or unintentionally, embellish their subjective complaints and exaggerate their reactions to clinical tests. This always backfires! Most physicians can easily tell when an examinee is malingering. In fact, IME physicians incorporate a series of tests in their exam, called Waddell Signs, which purportedly correlate with symptom magnification. Exaggerating your symptoms and complaints can only hurt your case.