How Independent Medical Examinations (IMEs) Can Impact Your Worker’s Comp Case In Wisconsin
When you’re injured on the job in Wisconsin, filing a worker’s compensation claim can provide essential benefits such as medical care, lost wages, and ongoing support. But the process isn’t always straightforward. One significant part of many claims is the Independent Medical Examination, or IME. If your employer or their insurance company has requested an IME, it’s crucial that you understand what’s at stake. As attorneys who represent injured workers across Wisconsin, we’ve seen how these examinations can greatly affect the outcome of a claim, for better or worse.
An IME is not the same as a regular doctor visit. It is conducted by a physician chosen and paid for by the worker’s compensation insurance carrier. Under Wisconsin law, specifically Wis. Stat. § 102.13(1)(a), insurance companies have the right to request that an injured worker submit to an IME to evaluate the extent of the injury, necessity of treatment, and work restrictions. While this may seem like a routine part of the process, it often plays a pivotal role in whether your benefits are continued or denied. That’s why it’s important to prepare and know your rights before the exam.
What An IME Can—and Can’t—Do
An IME is meant to offer an independent opinion, but keep in mind the examining doctor does not have a doctor-patient relationship with you. They are there solely to evaluate your condition and report back to the insurance company. That report may be used to support a claim denial, reduce benefits, or argue that your injury was not work-related. The doctor may state that you’ve reached “maximum medical improvement” (MMI) or that your ongoing treatment is unnecessary.
While IMEs are legal, they are not infallible. If the IME contradicts your treating physician’s findings, your claim may be challenged. We often see IME reports used as grounds to stop wage loss benefits under Wis. Stat. § 102.43, or to dispute the need for ongoing treatment under Wis. Stat. § 102.42.
How To Protect Your Claim During The IME Process
The first thing we advise is preparation. Be honest and accurate about your symptoms, and don’t exaggerate or downplay anything. Bring notes with you if necessary. Make sure the IME doctor understands how the injury occurred and how it affects your daily life and ability to work. After the IME, document everything about the experience—how long the exam lasted, what the doctor asked, and whether they performed any physical tests.
If you receive an unfavorable IME report, you don’t have to accept it without question. Under Wis. Stat. § 102.17, you have the right to dispute the findings and present evidence at a hearing before an administrative law judge. This may include testimony from your own doctor or additional medical records. That’s where experienced legal counsel becomes essential.
Why Legal Representation Matters
The worker’s compensation process in Wisconsin can be complicated, especially when medical opinions differ. Insurance companies are known to rely on IMEs to save money, not necessarily to find the truth. We help our clients gather the right evidence, challenge flawed IME findings, and represent their interests before the Department of Workforce Development (DWD) or the Division of Hearings and Appeals. Our job is to ensure your rights are protected and that you get every benefit you are entitled to under Wisconsin law.
IME Frequently Asked Questions
What Should I Expect During An IME?
During an IME, you’ll be examined by a doctor chosen by the insurance company. The exam usually includes a review of your medical history, a physical evaluation, and questions about how the injury happened. The appointment is typically brief. The doctor’s goal is to issue a report that will be sent back to the insurance carrier.
Can I Bring Someone With Me To An IME?
You are allowed to bring a friend or family member to the appointment, but they may not be permitted in the exam room. However, their presence can be helpful for support and to document what happens before and after the exam.
What If The IME Report Says I Can Go Back To Work?
If the IME report contradicts your own doctor’s opinion, the insurance company might use it to stop your benefits. At that point, you may need to request a hearing with the Wisconsin Department of Workforce Development and present your doctor’s opinion and other medical evidence to support your claim.
Can I Challenge The IME Report?
Yes, under Wisconsin law, you have the right to challenge any decisions made based on an IME. This often involves submitting evidence from your treating physician and potentially testifying at a hearing. Legal help is strongly recommended at this stage.
Will I Be Under Surveillance Before Or After The IME?
It’s possible. Insurance companies sometimes conduct surveillance to see if your activity contradicts your reported injury. Be honest about your symptoms and avoid doing anything inconsistent with your restrictions, especially around the time of the IME.
How Long After An IME Will I Receive A Decision?
The IME doctor typically submits a report within two weeks. After that, the insurance company may quickly decide whether to continue or stop your benefits. If your benefits are reduced or denied, you should speak with a lawyer immediately to protect your rights.
Contact Our Milwaukee Worker’s Comp Lawyers For A Free Consultation
If your worker’s compensation claim has been scheduled for an IME—or you’ve already received an unfavorable report, we’re here to help. At Gillick, Wicht, Gillick & Graf, we understand how critical it is to protect your rights during every step of the claims process. We’ve been helping Wisconsin workers stand up to insurance companies for decades.
Contact our Milwaukee worker’s compensation lawyers at Gillick, Wicht, Gillick & Graf by calling 414-257-2667 to receive a free consultation. Our main office is in Milwaukee, and we proudly represent injured workers in Janesville and throughout the entire state of Wisconsin.
