How Independent Medical Examinations (IMEs) Impact Your Wisconsin Workers’ Comp Case

Independent Medical Examinations, often called IMEs, play a significant role in many Wisconsin Worker’s Compensation cases. After a work injury, treatment usually begins with a trusted treating doctor who knows the medical history and follows the recovery process. At some point, the insurance company or employer may schedule an IME with a doctor they choose. That appointment can create anxiety because the report can affect benefits, work restrictions, and even long-term outcomes in the case. We want injured workers to understand what an IME is, why it happens, and how the results may be used under Wisconsin law.

Under Wisconsin Statutes § 102.13(1)(a), an injured employee must submit to a reasonable examination by a physician, chiropractor, psychologist, or podiatrist chosen by the employer or insurance carrier. The law allows these exams to assess medical conditions, temporary or permanent disability, and treatment needs. These exams are not for treatment purposes. They are evaluations requested for litigation or claim handling. Refusal to attend can carry consequences, so knowing the rules before the exam is important.

What An Independent Medical Examination Really Is

An IME is not independent in the everyday sense of the word. The doctor is selected and paid by the employer or insurance company. The goal of the IME is usually to obtain a medical opinion about one or more disputed issues, such as:

• Whether the injury is work-related.
• Whether further medical treatment is necessary.
• Whether the employee has reached the end of healing.
• Whether permanent disability exists.
• What work restrictions apply.

The treating doctor may hold different opinions. We often see conflicts between IME reports and treating physician opinions regarding causation, disability, or the need for surgery or therapy. Those differences matter because they influence whether the worker’s compensation insurance carrier continues to pay benefits.

Legal Effects Of Refusing Or Missing An IME

Wisconsin law requires cooperation with reasonable examination requests. Under Wisconsin Statutes § 102.13(1)(b), refusal to submit to an IME or obstruction of the exam may result in suspension of compensation for the period of refusal. Rescheduling for legitimate reasons is usually allowed, but ignoring the notice can severely damage a case. We advise injured workers about preparation and attendance because compliance protects benefit rights.

How IME Reports Influence Benefits And Disputes

IME reports are often used by insurance companies to:

• Stop temporary disability checks.
• Deny additional medical treatment.
• Dispute permanent disability ratings.
• Challenge work restrictions or time off work.
• Dispute causation.

The insurer may rely on the IME opinion to issue a denial, even when the treating doctor supports continued care. Disputes that arise from IME reports are resolved through the Wisconsin Worker’s Compensation Division and ultimately before an administrative law judge if needed. The hearing process is governed by Wisconsin Statutes § 102.17, which addresses how claims are heard and decided.

We prepare to counter IME reports with detailed medical records, testimony, and supportive opinions from treating physicians. The credibility of the treating doctor and the quality of medical evidence often determine the outcome.

Preparing For An Independent Medical Examination

Preparation does not mean rehearsing answers. It means understanding what will happen and being truthful and consistent. We guide clients on practical steps such as:

• Arriving early with identification and medication lists.
• Explaining how the injury occurred in clear and accurate terms.
• Describing symptoms honestly without exaggeration or minimization.
• Not speculating about issues outside medical knowledge.

Everything said to the examiner may appear in the report. Accuracy matters. We also review IME reports carefully for errors, omissions, and unsupported conclusions.

When A Second Opinion Or Additional Exam May Be Appropriate

If an IME is unfavorable, that does not end the case. Treating physicians can respond in writing, additional testing can be performed, and in some cases, additional medical opinions are obtained. Wisconsin law allows submission of competing medical opinions, and administrative law judges weigh that evidence when deciding disputed claims under Wisconsin Statutes Chapter 102. We build the medical record so decision makers see the full picture of injury and recovery.

Wisconsin Worker’s Compensation Independent Medical Examination FAQs

What Is An Independent Medical Examination In A Wisconsin Worker’s Compensation Case?

An IME is a medical evaluation requested by an employer or insurance company to obtain an opinion about the work injury. It is permitted under Wisconsin Statutes § 102.13. The doctor conducting the IME does not treat the patient. The exam focuses on diagnosis, cause, disability rating, treatment needs, and work capacity. The IME report often becomes part of the evidence used to decide benefits.

Do Workers Have To Attend An IME?

Yes, in most cases, attendance is required. Wisconsin Statutes § 102.13(1)(b) allows suspension of compensation if a worker refuses a reasonable examination. There are limits on the frequency and reasonableness of exam requests. If scheduling or medical hardships exist, they should be communicated promptly. We often assist with resolving these issues before problems arise.

Can Benefits Stop After An IME?

Yes, insurers sometimes stop temporary disability or deny treatment after receiving an IME report that disputes the treating doctor. That denial is not final. Disputes can be litigated, and treating doctor opinions carry significant weight when they are well supported. We challenge adverse IME findings through the hearing process when warranted.

Is The IME Doctor Really Independent?

The term can be misleading. The doctor is selected and paid by the employer or insurer. That relationship can influence how injuries are viewed. Administrative law judges understand this context and evaluate credibility accordingly. We highlight weaknesses, incomplete histories, or unsupported medical conclusions in IME reports to protect clients.

How Should Someone Prepare For An IME Appointment?

Preparation includes reviewing the injury history, bringing medication lists, and being ready to describe symptoms accurately. Consistency between medical records and statements during the exam is important. No exaggeration and no minimization is the best approach. We often review expectations with clients so the appointment is less stressful and the information presented is clear.

What Happens If The IME Conflicts With The Treating Doctor’s Opinion?

Conflicts are common. Both opinions may go before an administrative law judge under Wisconsin Statutes § 102.17. The judge decides which opinion is more credible based on reasoning, examination, testing, and medical records. Strong treating doctor support often helps overcome unfavorable IME findings when detailed and medically sound.

Call Gillick, Wicht, Gillick & Graf For Help With Wisconsin Worker’s Compensation IMEs

IME results can change the direction of a Wisconsin Worker’s Compensation case. Strong legal representation can make the difference in how those reports are challenged or used.

For guidance from experienced Milwaukee attorneys, contact our Milwaukee worker’s comp attorneys at Gillick, Wicht, Gillick & Graf by calling 414-257-2667 to receive a free consultation. Offices are located in Milwaukee, and the firm represents injured workers throughout all of Wisconsin.