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What Happens if an IME Doctor Finds Nothing Wrong?

Doctor

In some Illinois workers’ compensation cases, the insurance company may ask for an independent medical examination (IME). They’ll send a doctor to examine you and either confirm or deny the nature of your work injury.

Given that IME doctors are hired by the insurance company, there’s a fairly good chance that they’ll try to give a report that either minimizes your injury or else claims that it wasn’t related to your employment. In these cases, it’s important to know what to do.

Ways an IME Doctor May Try to Limit Coverage

If you have been injured in a work-related incident, one of the first things you should do is see a doctor. Your physician can establish whether your injury resulted from your work duties, determine how serious it is, and place limitations on whether you can return to work or not.

An IME doctor, however, has only one role in a workers’ compensation claim: to verify what your own doctor has stated about your injury. The goal here is to save on the costs your injury might incur for the insurance company, so they are likely to be biased against you in their assessment.

Underplaying the Injury

For instance, an IME doctor may decide that your injury isn’t as serious as you claim. This can save on costs the insurance company might pay out for additional medical treatment or disability benefits.

Not Work Related

The IME doctor may also find reasons to decide that your injury wasn’t related to work at all, and therefore allow the insurance company to deny coverage.

What to Do After a Failed IME Assessment

If the IME doctor decides that your injury either doesn’t warrant workers’ compensation or else deserves less than you are actually owed, it’s time to take action. Here’s what you can do.

Contact an Attorney

If you haven’t done so already, get an attorney. You’ll want an experienced workers’ compensation lawyer to review your case and put pressure on the insurance company. Typically, you’ll get better results with legal help than you would on your own.

Get a Copy of the Report

In addition, you’ll want to make sure your attorney has a copy of the IME report. That way, you won’t have to rely on verbal information from the adjuster, which could misrepresent the findings in the IME. Your attorney will typically request a copy from the insurance company.

Get a Response from Your Doctor

Finally, it may be a good idea to have your doctor review the IME report and (along with your attorney) determine whether any errors were made. They can then write a response to the report in order to clarify any areas where your injury may have been misrepresented. Note that your doctor may charge you for his or her time in doing this, so make sure the owed compensation is worth it.

Hire a Workers’ Comp Attorney ASAP

Throughout the process of securing workers’ compensation benefits, you’ll want an attorney on your side. If you have been injured in the course of fulfilling your work-related duties, contact a lawyer to help you through the process.

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