The Independent Medical Examination in a Workers Comp Case

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Today I’m going to explain something that has to do with your workers compensation case that 99% of people filing a claim run into. I’m talking about an IME otherwise known as an Independent Medical Examination.

Let me start of by explaining to you as a workers compensation attorney in Belleville, IL.  What this is not really an independent medical examination because this is an examination set up for you by the insurance company or your employer, and this means essentially that it is their doctor performing the examination on you the claimant.   What does that mean? That means that this is not an independent doctor who is examining you. You always have to remember that this doctor is not there for treatment, he’s just there to examine you and nine times out of ten he’s there to give the employer or the insurance company the opinion that they want.

Generally, the opinion that they want is that you weren’t hurt at work that your condition was a terrible degenerative condition that you were going to be in the same condition now with or without any accident. They want to hear that your able to return to work full-duty.

Generally these exams are set up at a time when the insurance company is tired of paying either medical bills or your temporary total disability benefits. With that said

what these examinations are are essentially examinations that the workers compensation act allows. The employer is allowed to have these “Section 12” exams because that name refers to the section of the Illinois Workers Compensation Act that they arise from.

I want to explain to you how I tell my clients to handle these medical examinations when the insurance company sends them to one. I should tell you first of all that if

you’re represented by another lawyer you need to address this issue with that lawyer because sometimes we attorneys have differing opinions on how we want our clients to do things.

The first thing that I tell my clients is to be honest. Be honest with this doctor who is examining you. Don’t go in and tell the doctor that you haven’t had any symptoms in your low back or your shoulder or whatever it may be and that you haven’t had any previous treatment on that particular part of your body if, in fact, you have. If you have had prior treatment, I can almost guarantee you that the insurance company already knows and has already discovered those medical records and already sent them to their examining doctor.

He will be prepared to ask you questions to trap you if you are dishonest. So, the best approach in my opinion is to be honest if you’ve had prior symptoms. List those previous symptoms and treatments.

The last thing you or your attorney want is for an arbitrator to look at a report from one of these doctors who has caught you lying. Your honesty in a worker’s

compensation case, if it has to go to arbitration, goes a long way.

The next thing that I tell my clients is to not feel like they have to exaggerate their symptoms. I have had people take canes to the examining doctor, walking in with their cane and then after the exam they are caught by the doctor walking out without the cane. You don’t need to do that. The last thing you want to do is exaggerate your injury because the doctors will catch you.

These examining doctors are trained to identify whether or not your complaints are consistent with the diagnosis you’ve previously been given.  Certain injuries will present certain symptoms and not others. Don’t go into the doctor complaining that you can’t walk or you can’t sit if it’s not true. The doctor will see that while you’ve said you can’t sit for 10 minutes, you’ve in fact sat in his office for 30 minute. Don’t exaggerate your complaints.

I’ve started telling my clients to show interest in the doctor‘s suggested treatment options for you. I tell them to sit there and listen with an open mind and then at the end of the examination to politely tell the examining doctor that they’ll take the considerations of that doctor to their treating doctor and see what he wants to do. The reason for this is I find that some of these doctors like the idea of having the opportunity to actually help heal people instead of just doing the exams. While it might not be true all of the time,  probably 50 percent of the time, depending on the doctor it is true. And if his suggestions are met with interest and gratitude it might have him think of you favorably when he is writing his report.

Many of my clients are very likable people. I don’t want that likable person to go in and be a defensive jerk just because they think the insurance company’s doctors is a bad guy, there to take advantage of them. Be the likable you who respects the opinions of a trained physician. Don’t come across like a jerk because then the doctor is going to be a jerk to you.

Having said that, be aware that a lot of these examining doctors are rude. They can be very short with you. You may get the impression that they don’t care about you, and that’s fine they’re not supposed to necessarily care about you too much. Again they are hired by the insurance company to protect the interests of the insurance company.

Your examining doctor is going to ask you a lot of questions. This is the basic rule I always tell my clients: if you’re asked what time it is, don’t tell the doctor how to build a clock. Tell the doctor only the answer to the question you’re asked. If he’s asking about symptoms you have in your right leg, don’t worry about expanding on that and telling him what symptoms you have in your left shoulder. Answer his or her question, be thorough, be exact and to the point. Don’t tell him or her anything else.

Again, what you what you need to remember about these exams is that they are generally only for the insurance company’s benefit. If you’re not represented by an attorney don’t be fooled into thinking that the insurance company cares about you and that’s why they’re sending you to a doctor. Sometimes that might actually be the case but it’s probably not. Usually, they want to get a doctor’s opinion in order to shut your case down. That’s generally the intent of these section 12 exams.

Clients often hear the term “independent medical exam” and think that actually is independent but it’s not. If you’re represented on a case where you’ve been sent to the doctor, your lawyer will already tell you that this isn’t the end of the road if the examining doctor comes back and says that in his opinion you’re not entitled to temporary total disability benefits anymore or that you can go back to work full-duty or that your problem isn’t causally related to your accident. Your lawyer will know and explain to you that the option is that you then go to arbitration and the arbitrator will decide between the examining doctor’s opinion and your doctor’s opinion on whether or not you’re entitled to the continued benefits.

Questions? Call a Workers Compensation Attorney in Belleville, IL

Finally, and this is directed to people who are not represented: know your rights. If that doctor says that you are not temporarily and totally disabled anymore, or if he says your condition is not related to your work, and you believe that it is, there’s an arbitrator out there that ultimately makes those decisions. You need to be aware of that and not just take the section 12 examiner’s opinion as the gospel truth.

You have rights, and at that point if you’re not represented and get your benefits terminated then I suggest you contact a lawyer.

If you have any questions, please contact the Kirkpatrick Law Offices at: (618) 239-6070