Getting hurt on the job can be a frustrating and painful experience. Workers’ compensation is there to help compensate you for your injuries, but you may have to take some steps to get that compensation. A common step is an Independent Medical Exam (IME). These are performed by the workers’ compensation insurer, and may be used to challenge your doctor’s findings or to try to limit your benefits. Understanding what it is, and what to expect, can help you move forward in this process.
The Wisconsin workers’ compensation lawyers at Axis Legal, LLC are ready to help you. We know that this process can be frustrating, but we’re here to seek the compensation you deserve.
What Is an IME in Wisconsin?
Under Wisconsin workers’ compensation law, insurance companies have the right to request that an injured worker attend an IME. The purpose is to obtain a medical opinion about:
- The cause of your injury
- Whether your condition is work-related
- Your work restrictions
- Whether you need additional treatment
- Whether you have reached maximum medical improvement (MMI)
- Whether you have a permanent disability
The IME doctor does not treat you. Their role is to evaluate you and issue a report that the insurer may use to approve, deny, or limit benefits.
Why Insurance Companies Request IMEs
IMEs are most commonly used when:
- Your treating doctor recommends surgery or ongoing treatment
- There is a dispute about whether your injury is work-related
- The insurer believes you can return to work sooner than your doctor says
- The insurer wants to close your claim by declaring you at MMI
- There are questions about permanent disability ratings
What to Expect Before the IME
Scheduling and Notice
You will receive written notice of the exam, including:
- The date, time, and location
- The doctor’s name and specialty
- Any documents you should bring
Wisconsin law requires the insurer to reimburse you for mileage and lost wages related to attending the IME.
Review of Your Medical Records
Before the exam, the IME doctor receives your medical records, often hand-selected by the insurance company. These records may include:
- Prior injuries
- Diagnostic tests
- Treatment notes
- Work restrictions
The IME doctor may rely heavily on these records when forming their opinion.
What Happens During the IME
Interview and History
The doctor will ask questions about:
- How the injury occurred
- Your symptoms
- Your job duties
- Your medical history
- Your current limitations
Be honest, concise, and consistent. Avoid exaggerating symptoms, but do not minimize them either.
Physical Examination
The exam may include:
- Range-of-motion testing
- Strength testing
- Neurological checks
- Pain response evaluation
Observation
IME doctors often observe you before and after the exam, including:
- How you walk into the building
- How you sit, stand, or move
- Whether your behavior is consistent with your reported symptoms
Assume you are being observed at all times.
After the IME: What Workers Should Expect
The IME Report
After the exam, the doctor issues a written report. This report may address:
- Whether your injury is work-related
- Whether additional treatment is necessary
- Whether you can return to work
- Whether you have permanent restrictions
- Whether you have a permanent disability rating
The insurer often relies heavily on this report when making decisions about your claim.
Possible Outcomes
Depending on the IME findings, the insurer may:
- Continue paying benefits
- Reduce or stop temporary disability payments
- Deny recommended medical treatment
- Dispute your permanent disability rating
- Attempt to close your claim
If the IME contradicts your treating doctor’s opinion, a dispute may arise.
Get Help With Your Workers’ Compensation Claim in Wisconsin
An IME can feel kind of intimidating. You may not have known what to expect or what it will do. Remember, workers can challenge IME findings, especially if they try to limit your coverage. Having an attorney can make a big difference in the outcome of your case.Worn down at work? Let the experienced Wisconsin workers’ compensation lawyers at Axis Legal, LLC review your case. Contact us today for a free, no-risk evaluation.