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Independent Medical Exams
7066931124 • November 3, 2022
The Illinois Workers Compensation Act
gives your employer the right to request an independent medical examination under Section 12 of the Illinois Workers compensation Statute entitled “Independent Medical Examinations.” The Illinois Workers Compensation Independent Medical Examination is a procedure that allows an employer to clarify or question your doctor’s treatment, diagnosis. or may be used for other issues. The Illinois Independent Medical examination in a workers compensation claim
is initiated when the insurance company sends you a letter with a request that you attend an exam at the insurance company doctor’s office on a date, time and place. These requests are likely to follow some question posed by the workers compensation adjuster or attorney
about your treatment or disability. Section 12 of the Illinois Workers Compensation Act
specifically allows the insurance company to have you examined by the company doctor. A scheduled independent medical examination event can be a sign or symbol that you may be entering into a dispute phase in your workers compensation insurance claim. These exams are requested for a number of reasons including, but not limited to, questions about whether your doctor’s treatment plan is correct, whether the interpretation of radiographic films are correct, or whether the treatment recommended is reasonable and necessary. If you are representing yourself and you think you are in control of your car, the Illinois section 12 independent medical examination is the way for the insurance company to take the steering wheel over. The examinations are more often than not a sign or symbol that you may be entering a dispute phase in your medical treatment. Your right to receive treatment by a doctor of your choice under Section 8A of the statute is now being questioned. A dispute regarding your case may follow the exam.
Because the right to Independent Medical Examinations in Illinois Workers Compensation are codified by statute, there are not many defenses or reasons you can refuse to attend the examination, when requested by the insurance company. Section 12 of the Workers Compensation Act in Illinois, requires the insurance company to advance (before the exam) mileage and travel expenses. If the letter does not contain a check for exam expenses you may refuse to attend the examination. The two most common objections to a request for an independent medical examination under Illinois Workers Compensation laws, are abuse and inconvenience. Most of the time, but not always, the Illinois workers compensation adjusters choose company doctors that are out of state and involve significant travel. The statute requires that the exam be convenient to the injured worker. The second objection is the exam is an abuse of section 12. An abuse occurs under section 12 if the workers compensation adjuster schedules multiple exams when there has not been interim medical developments with treatment. A proper motion or objection. to the Illinois workers compensation independent medical examination must be filed and a hearing on the objection must be heard by an arbitrator.
Gaps in medical treatment — whether your treatment is not regular and continuous or whether the symptoms resolved. Regular and ongoing treatment is often referred to as a chain.
Inconsistent descriptions or statements you made to the treating doctor about your symptoms from the injury.
Prior injuries or treatment in the past to the body parts you injured. If you signed medical authorizations, the insurance company may have requested your medical records including your complete chart of past treatment records to investigate your past medical history.
In multiple body part injuries, delay in the onset of symptoms recorded by your doctor in the records. The problem is that many doctors only treat one body part but not others. It is important to always insist that your neck doctor document symptoms of your knee.
The mechanism of injury — whether the history of your accident in how it happened could have caused the condition you were diagnosed with by the treating doctor.
Inconsistencies in the level of your complaints of pain and whether they are out of proportion to the nature and extent of your injury.
Other questions requested by the workers compensation insurance adjuster or it’s attorney. This is not an exhaustive list.
What can you expect at the Section 12 Illinois Workers Compensation Independent Medical Examination ? After you arrive at the doctors office, you will be asked to fill out forms for the doctor. The form should be accurate and complete. You should review your medical records before the examination. Then you will be taken to the examination room and asked questions by the doctor and his nurse about your injury. This is known as the history taking part of the examination. You will be asked personal questions about your age, address, occupation, past occupations, prior injuries and about the treatment you received for your work injury. Then you will be asked specific questions about the accident, where it happened, how it happened and what happened at the time of your work injury. You should give general statements. You should make sure your answers are consistent. You then will be asked about your injuries in the accident. You should give detailed descriptions of your injuries and your symptoms. Then you will be asked about your disability and your function. You should give the company doctor detailed description on how the injury affects you every day life. After the history taking part of the independent medical examination is completed, the doctor will perform a physical examination.
The physical examination will be conducted by the company doctor of your injured body parts. The physical examination may include standard orthopedic evaluations such as touch your toes, measurements of motion and strength. The company doctor will record his observations of your actions and movements while performing these tests, and he will compile the results and his observations in a report and send the report to the insurance company. The insurance company will use this report as medical evidence in your case.
Is the company doctor hired by the insurance company to perform an independent medical examination under Illinois Workers Compensation laws an independent medical examiner? Many times the insurance company hires the same out of state doctors over and over again to perform independent medical examinations in Illinois workers compensation claims. The best Illinois Workers Compensation lawyers know who these doctors are because they repeatedly write reports and testify. Leading Illinois workers compensation lawyers will track these doctors, through their reports and testimony in other workers compensation claims, and be able to effectively cross examine them on the nature of their IME exam practice, and the number and frequency of the referrals the company doctor receives from the insurance company in Illinois Workers Compebsatokn claims. More often than not, many IME doctors are retired from practice and devote 100 percent of their time to writing reports at the request of insurance companies. The payment some of these doctors receive is out of proportion to the amount of time spent examining the injured worker and writing a few page report. Thousands of dollars for 10 minutes of examination is not unusual compensation paid to some IME doctors. Many of the company doctors performing workers compensation independent medical examinations in Illinois claims are not licensed to practice in Illinois and have never held an Illinois license to practice or had staff privileges at any hospital in the state of Illinois. The company hired independent medical examination doctor may seem brisk, uncaring, businesslike, unsympathetic and impersonal. That’s because the doctor may be on a mission for the insurance company. The doctor has already received your medical records with a list of questions to answer in his report. The company doctor may not tell you his opinions or offer you any encouragement and may even mislead you about his role in your case. You should never submit to any treatment by a company doctor. You should never allow him to send you for diagnostic tests. He is not your doctor. The company doctor may even try to convince you that your injuries are not serious and the symptoms will resolve over time — nothing to worry about. This may be to discourage you from seeking medically necessary treatment from your treating doctor. Don’t be discouraged by the abruptness or attitude of the company doctor. Don’t be discouraged or influenced by his medical opinions or what he says to you about your medical condition or examination findings If the examination caused you to experience pain, insist that he stop. If he persists then you should terminate the exam and leave. If he exhibits an attitude and shouts or is rude or abrasive to you, leave his office. Most IME doctors are reasonable and professional. You should record the amount of time he spends conducting the physical examination and write down the questions he asks you. Also be sure to make a note of what tests he performs in the examination. This information will serve as a basis for a fact check later when his report is produced.
If you have further questions, you should consult with highly experienced Illinois Workers Compensation lawyers — workers compensation attorneys in Illinois who regularly practice in Illinois Workers Compensation claims, The best Illinois Workers Compensation attorneys will know who these doctors are and may have taken their depositions in other cases and be familiar with their IME practices and medical opinions. Ron D. Coffel has successfully handled thousands of Illinois workers compensation claims for nearly 35 years and has never represented an insurance company.
Because the right to Independent Medical Examinations in Illinois Workers Compensation are codified by statute, there are not many defenses or reasons you can refuse to attend the examination, when requested by the insurance company. Section 12 of the Workers Compensation Act in Illinois, requires the insurance company to advance (before the exam) mileage and travel expenses. If the letter does not contain a check for exam expenses you may refuse to attend the examination. The two most common objections to a request for an independent medical examination under Illinois Workers Compensation laws, are abuse and inconvenience. Most of the time, but not always, the Illinois workers compensation adjusters choose company doctors that are out of state and involve significant travel. The statute requires that the exam be convenient to the injured worker. The second objection is the exam is an abuse of section 12. An abuse occurs under section 12 if the workers compensation adjuster schedules multiple exams when there has not been interim medical developments with treatment. A proper motion or objection. to the Illinois workers compensation independent medical examination must be filed and a hearing on the objection must be heard by an arbitrator.
What can you expect from the Illinois independent medical examination
under Section 12 of the Illinois Workers Compensation statute? You must first recognize that so called workers compensation independent company doctor may not be independent. The workers compensation company doctor is not your treating doctor. He is not hired to render treatment. He is hired to conduct an examination and write a report to an insurance company. The independent medical examination report will be offered into evidence in a hearing on your case. The company doctor has already received your medical records and a letter from the insurance company or it’s lawyer with a list of medical-legal questions to answer. The company doctor is considered an agent or employee of the insurance company —- a doctor who has been hired under section 12 of the Illinois Workers Compensation Act to review your medical records, interpret your diagnostic medical evidence including radiographic films such as x-rays and MRI’s., and answer the specific questions posed by the adjuster or defense lawyer.
What is the company doctor in the section 12 examination of the Workers Compensation Act
looking for during the Illinois independent medical examination? What follows is a partial list of possible inquiry by the company doctor:
Inconsistencies in your medical history — your medical history is what your treating doctors, hospital staff, nurses, physical therapists or other doctors have recorded in your medical records about your injury and accident.
Gaps in medical treatment — whether your treatment is not regular and continuous or whether the symptoms resolved. Regular and ongoing treatment is often referred to as a chain.
Inconsistent descriptions or statements you made to the treating doctor about your symptoms from the injury.
Prior injuries or treatment in the past to the body parts you injured. If you signed medical authorizations, the insurance company may have requested your medical records including your complete chart of past treatment records to investigate your past medical history.
In multiple body part injuries, delay in the onset of symptoms recorded by your doctor in the records. The problem is that many doctors only treat one body part but not others. It is important to always insist that your neck doctor document symptoms of your knee.
The mechanism of injury — whether the history of your accident in how it happened could have caused the condition you were diagnosed with by the treating doctor.
Inconsistencies in the level of your complaints of pain and whether they are out of proportion to the nature and extent of your injury.
Other questions requested by the workers compensation insurance adjuster or it’s attorney. This is not an exhaustive list.
What can you expect at the Section 12 Illinois Workers Compensation Independent Medical Examination ? After you arrive at the doctors office, you will be asked to fill out forms for the doctor. The form should be accurate and complete. You should review your medical records before the examination. Then you will be taken to the examination room and asked questions by the doctor and his nurse about your injury. This is known as the history taking part of the examination. You will be asked personal questions about your age, address, occupation, past occupations, prior injuries and about the treatment you received for your work injury. Then you will be asked specific questions about the accident, where it happened, how it happened and what happened at the time of your work injury. You should give general statements. You should make sure your answers are consistent. You then will be asked about your injuries in the accident. You should give detailed descriptions of your injuries and your symptoms. Then you will be asked about your disability and your function. You should give the company doctor detailed description on how the injury affects you every day life. After the history taking part of the independent medical examination is completed, the doctor will perform a physical examination.
The physical examination will be conducted by the company doctor of your injured body parts. The physical examination may include standard orthopedic evaluations such as touch your toes, measurements of motion and strength. The company doctor will record his observations of your actions and movements while performing these tests, and he will compile the results and his observations in a report and send the report to the insurance company. The insurance company will use this report as medical evidence in your case.
Is the company doctor hired by the insurance company to perform an independent medical examination under Illinois Workers Compensation laws an independent medical examiner? Many times the insurance company hires the same out of state doctors over and over again to perform independent medical examinations in Illinois workers compensation claims. The best Illinois Workers Compensation lawyers know who these doctors are because they repeatedly write reports and testify. Leading Illinois workers compensation lawyers will track these doctors, through their reports and testimony in other workers compensation claims, and be able to effectively cross examine them on the nature of their IME exam practice, and the number and frequency of the referrals the company doctor receives from the insurance company in Illinois Workers Compebsatokn claims. More often than not, many IME doctors are retired from practice and devote 100 percent of their time to writing reports at the request of insurance companies. The payment some of these doctors receive is out of proportion to the amount of time spent examining the injured worker and writing a few page report. Thousands of dollars for 10 minutes of examination is not unusual compensation paid to some IME doctors. Many of the company doctors performing workers compensation independent medical examinations in Illinois claims are not licensed to practice in Illinois and have never held an Illinois license to practice or had staff privileges at any hospital in the state of Illinois. The company hired independent medical examination doctor may seem brisk, uncaring, businesslike, unsympathetic and impersonal. That’s because the doctor may be on a mission for the insurance company. The doctor has already received your medical records with a list of questions to answer in his report. The company doctor may not tell you his opinions or offer you any encouragement and may even mislead you about his role in your case. You should never submit to any treatment by a company doctor. You should never allow him to send you for diagnostic tests. He is not your doctor. The company doctor may even try to convince you that your injuries are not serious and the symptoms will resolve over time — nothing to worry about. This may be to discourage you from seeking medically necessary treatment from your treating doctor. Don’t be discouraged by the abruptness or attitude of the company doctor. Don’t be discouraged or influenced by his medical opinions or what he says to you about your medical condition or examination findings If the examination caused you to experience pain, insist that he stop. If he persists then you should terminate the exam and leave. If he exhibits an attitude and shouts or is rude or abrasive to you, leave his office. Most IME doctors are reasonable and professional. You should record the amount of time he spends conducting the physical examination and write down the questions he asks you. Also be sure to make a note of what tests he performs in the examination. This information will serve as a basis for a fact check later when his report is produced.
If you have further questions, you should consult with highly experienced Illinois Workers Compensation lawyers — workers compensation attorneys in Illinois who regularly practice in Illinois Workers Compensation claims, The best Illinois Workers Compensation attorneys will know who these doctors are and may have taken their depositions in other cases and be familiar with their IME practices and medical opinions. Ron D. Coffel has successfully handled thousands of Illinois workers compensation claims for nearly 35 years and has never represented an insurance company.
The injured worker or the best repetitive trauma lawyers may file a repetitive trauma claim for cumulative trauma disorders in Illinois.
Ron D. Coffel has been a recipient of the Leading Personal Injury award nominated by other lawyers every year since 2016.
Consult an experienced Illinois Workers Compensation law firm if you have questions about workers compensation claim, act, commission, fraud statute, attorney and more in Illinois
For a disease to be recognized as an occupational disease under the Illinois Occupational Disease Act , the connection of the disease to the workplace is proved by establishing a link between the exposure to the alleged disease causing substance and the work activities of the contracted worker. The best Illinois workers compensation and occupational disease lawyers will know that there is a higher incidence or frequency of disease contraction and disorders in certain occupations. The disease or illness, in higher incident type employments are considered “germane” to certain types of workers in this occupations. What follows is a list of some occupational diseases; Coal workers pneumoconiosis . This obstructive lung disease is coming among underground coal miners who are exposed to dusty conditions in the coal mines. Meat cutters tendon disorders . These are common upon meat cutters who must us various joint postures in cutting meat. Electricians tendon disorders, nerve entrapments, trigger fingers, joint dysfunction, and asbestos exposures. Pipe fitters and industrial plumbers, tendon disorders, asbestos exposures, and chemical exposures to compounds and glue substances. Firefighters, EMT, and first responders : post traumatic stress disorders, infectious disease exposures from emergency treatment. Hearing loss and tinnitus is common among factory workers and among workers who are exposed at work to loud noise of sufficient level and duration. In 2010, a new rare disease of bronchialitis obliterates (cement lung) was recognized as an occupation disease among workers who inhaled fumes of popcorn butter flavoring. Asbestos exposure is a known cause of lung diseases. Chemical exposures are a known cause of asthma and lung diseases and skin diseases such as dermatitis. Cancer and other lung diseases are common in workers exposed to asbestos. There is no specific limitation on what diagnosed disease constitutes an occupational disease under Illinois law. If you have contracted a disease and suspect it may have been caused by exposures at work, then follow the steps in our section “What to do if you contract an occupational disease.” Ron D Coffel is a peer reviewed workers compensation lawyer that has been awarded the distinction of leading lawyer that regularly handles Illinois workers compensation and occupational disease claims in Illinois.
Filing Workers Compensation claims pursuant to the Illinois Workers Compensation Act must meet the deadline of the statute of limitations.
Ron D. Coffel has represented workers with occupational disease claims for nearly 35 years. He is among the highest rated and leading Illinois occupational disease lawyers.
Special rules may apply to Illinois workers compensation settlements under the Workers Compensation Act. To learn more about workers compensation Illinois,workers compensation commission, act and more.
Generally, the employee must file a workers compensation claim within 3 years after the injury, death or disablement, or within 2 years of the last payment of temporary total disability of a medical bill, whichever is later. In the event of minority, the statute does not start until the minor reaches the age of 18. A disability may toll the statute to extent it beyond these dates. The Illinois Administrative Code establishes different deadlines for some specific conditions. Asbestos exposure must be filed within 25 years of the last date of exposure. If the injury is fatal, the employee's representative must file within three years of the death, or within two years of the last date of payment of compensation.
The Workers Compensation Act requires the employer to pay for all medical care that is causally related to the injury that resulted in the claim, including: Any care that is required to diagnose, relieve, or cure the effects of the injury; Any first aid, and/or emergency treatment required as a result of the injury to the employee; All medical, surgical, and hospital expenses that are incurred by the employee in the course of curing or relieving the employee of the effects of the injury; Any treatment, instruction, or training required to rehabilitate the injured employee physically, mentally, or vocationally, including maintenance costs and incidental expenses.
Temporary total disability is the period of time beginning with the injury and ending when the employee reaches maximum medical improvement (MMI). MMI occurs when the employee is as far recovered or restored to his or her previous condition as the injury will allow. You are entitled to payment of TTD for the duration of the temporary total disability.
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