Do You Need an Independent Medical Evaluation?

An injured employee may be required to undergo an independent medical evaluation to continue receiving workers’ compensation benefits from his or her employer. When an independent medical evaluation conflicts with the employee’s injury claim, his or her benefits may be stopped. A work injury attorney may be needed to help restore those benefits.

What is an Independent Medical Evaluation?

Under Section 12 of the Illinois Workers’ Compensation Act, employers and their insurance companies may require an injured employee to submit to an independent medical examination (IME). The purpose of this evaluation is to determine the cause, severity, and expected duration of the injury. If an employee refuses to submit to an IME, his or her workers’ compensation payments can be suspended temporarily until the exam takes place.

The employer or insurer will select a doctor for the IME and pay for the examination. The company must provide the injured employee with notice of the time and place where the IME will occur. The employer is required to cover travel expenses for the employee to attend the examination, along with any necessary meals during the trip, and reimbursement for any lost wages because of the trip.

After the IME, the employer’s doctor will issue a report that provides his or her expert opinion on:

  • The diagnosis of the injury
  • How the injury occurred
  • Whether a pre-existing condition was involved with the injury
  • What medical treatment is needed
  • Work restrictions (temporary/permanent)

An exact copy of the IME that is given to the employer must also be provided to the injured employee and his or her work injury attorney.

Countering a Bad IME Report

The purpose of an IME is to weed our false injury claims. However, workers who are legitimately injured may be refused further medical treatment or compensation for their injuries. Because IME doctors regularly work for insurance companies, they do not always have the best interests of claimants at heart. When an unfair or inaccurate report has been issued, the injured worker can point out inaccuracies to the insurance adjuster. His or her treating physicians may also counter the report with their opinions regarding the injury and treatment thereof. In cases of extremely inaccurate IME reports, it may be necessary to prove that the examining doctor could be set on denying a fair settlement to the injured worker.