Surviving Section 12 Independent Medical Exams (IMEs) in Illinois Workers' Comp
A Section 12 Independent Medical Exam is not actually independent. It is a medical evaluation scheduled, directed, and paid for by your employer's insurance company to find a reason to reduce or terminate your benefits.
During a workers' compensation claim, everything might seem to be going smoothly until you receive a letter in the mail demanding you attend an Independent Medical Examination (IME). The term "independent" is highly misleading. This doctor is not there to treat you or help you heal; their job is to evaluate your current condition and write a report for the insurance adjuster. If you are facing an upcoming exam, browsing our United States lawyer directory for a local attorney can help you prepare and protect your benefits.
The Reality of Section 12 Exams in Illinois
Under the 820 ILCS § 305/12, an employer has the right to require an injured worker to submit to an examination by a doctor of the employer's choosing. If you refuse to go to this appointment, the insurance company has the legal right to suspend your medical and wage benefits immediately until you comply. You must attend, but you must also be on your guard.
Factory Workers: Countering a Pre-Existing Condition Report
Factory and warehouse workers often have years of physically demanding labor under their belts. When they suffer a new injury, the IME doctor will aggressively review their past medical records. It is extremely common for the IME report to claim that your back pain is just "age-related degeneration" or a pre-existing condition, rather than a result of lifting heavy pallets at work. The precedent set in Ghere v. Industrial Commission, 278 Ill. App. 3d 840 (IL Appellate Court 1996) highlights how aggressively IME reports can be used in court, emphasizing why your own treating doctor must clearly document how the specific workplace incident aggravated any prior conditions.
Truck Drivers: Handling the Rushed 5-Minute Exam
Truck drivers and logistics workers often travel long distances, only to arrive at an IME office and spend a mere five minutes with the doctor. These doctors are hired guns who see dozens of patients a day. If a doctor barely examines your injured knee, asks three rapid-fire questions, and then writes a 10-page report declaring you fully healed, you must have evidence to fight back. Taking detailed notes about the exact start and end times of the exam is critical.
Preparing for an IME Involving a Traumatic Brain Injury (TBI)
If you suffered a concussion or TBI on a construction site, a standard orthopedic IME will not suffice. The insurance company might send you for a neuropsychological IME. These exams can last up to eight hours and involve complex puzzles, memory tests, and psychological profiling. They are designed to test if you are "faking" your cognitive deficits. It is vital to get plenty of rest before this exam and answer every question honestly, without exaggerating your symptoms.
Rules Regarding Mileage Reimbursement and Recording
The law provides some strict rules that the insurance company must follow when ordering a Section 12 exam.
- Advance Payment of Travel Expenses: The insurance company must send you a check for your travel expenses (mileage, tolls, parking) before the day of the exam. If they fail to provide advance payment, you generally have the right to refuse to attend until they pay.
- Location Restrictions: The exam must be held at a reasonable time and place, usually within a practical driving distance from your home. If you live in Carbondale, they cannot force you to drive to Chicago for a 15-minute exam.
- Recording the Exam: Unlike some states, Illinois law does not grant injured workers a blanket right to secretly audio-record an IME or bring a videographer without mutual consent or a court order. However, you are absolutely allowed to bring a trusted friend or spouse to sit in the waiting room, and you should bring a notepad to document everything said in the exam room.
How to Protect Your Rights After the Exam
Once the IME report is generated, the insurance company will likely use it to deny further medical care. When this happens, your case will become highly contested. Your attorney will need to file Form IC01, Illinois, Workers' Compensation Commission, Application for Adjustment of Claim to get your case on the trial docket, so an arbitrator can weigh your treating doctor's opinion against the IME doctor's opinion. Hearings are held at various venues, such as the Illinois Workers' Compensation Commission, Peoria or the Illinois Workers' Compensation Commission, Springfield.
Frequently Asked Questions (FAQ)
Do I have to attend the Section 12 IME?
Yes. By law, if you refuse to attend a properly scheduled IME, the insurance company can suspend your workers' compensation benefits.
What happens if they don't send my mileage check in advance?
If the insurance company fails to pay your reasonable travel expenses before the date of the exam, you typically have the legal right to cancel or reschedule the appointment without penalty.
Can I secretly record the doctor during the exam?
It is highly discouraged. State eavesdropping laws are strict, and secretly recording the doctor without permission can lead to the recording being thrown out or even result in legal trouble.
What if the IME doctor says I am fully healed, but my doctor disagrees?
This creates a dispute. Your benefits may be temporarily cut off, but your lawyer can request an immediate hearing before an arbitrator to prove that your treating doctor's opinion is more accurate.
Is the IME doctor allowed to prescribe me medication?
No. The IME doctor is solely there to perform an evaluation for the insurance company. They will not provide you with medical treatment, prescriptions, or a healing plan.
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