The Role of Independent Medical Examinations (IMEs) in Indiana Workers’ Compensation Cases
When you file a workers’ compensation claim in Indiana, medical evidence becomes the backbone of your case. Insurance companies rely heavily on physician opinions and medical records to evaluate your diagnosis, treatment plan, and ability to work. During this process, many injured workers are asked to attend an Independent Medical Examination, or IME. While the term “independent” suggests impartiality, IMEs are typically requested by the insurance company, and the conclusions can significantly influence the outcome of your claim.
Understanding what an IME is, why it is conducted, and how it can affect your benefits is essential for any injured worker. At Lee Cossell & Feagley, LLP, our Indianapolis workers’ compensation lawyers help our clients prepare for these examinations, ensuring their rights are protected and their claims are fairly evaluated.
What Is an Independent Medical Examination?
An IME is a medical evaluation performed by a physician who is not involved in your treatment. The doctor’s primary role is to provide an expert opinion on the nature and severity of your injury, your physical capabilities, and any work restrictions you may require. Unlike your treating physician, the IME doctor will not prescribe treatment or follow up after the exam; their report is sent to the insurance company and can influence the management of your claim.
Because the insurance company selects and pays the IME doctor, their conclusions can sometimes favor the insurer. However, IMEs carry legal weight and are considered official medical opinions in the workers’ compensation process. Understanding how to approach the IME is critical to preserving your benefits.
Why Insurance Companies Request IMEs
In Indiana, insurers may request an IME for a variety of reasons. Often, it is because the insurance company disagrees with the recommendations of your treating physician, believes you have reached Maximum Medical Improvement (MMI), or questions whether your injury is as severe as reported. IMEs may also be requested when there is a dispute about the cause of your condition, such as in cases of gradual injuries or when pre-existing conditions are involved.
The IME can also play a key role in evaluating permanent impairments. These examinations help the insurance company determine whether you qualify for permanent partial or permanent total disability benefits, and if so, the extent of those benefits. Because IMEs can influence wage replacement, treatment approval, and settlement negotiations, attending the examination seriously is essential.
What to Expect During an IME
The structure of an IME is often more formal and focused than a typical doctor’s visit. The examining physician will review your medical records, ask detailed questions about your injury and symptoms, and conduct a physical examination. They may assess your range of motion, functional limitations, and ability to perform work-related tasks. Finally, the doctor will form an opinion about whether your injury is work-related, if you have reached MMI, and what your disability rating or work restrictions should be.
While you are not allowed to have your attorney present during the examination, you can work with your lawyer beforehand to ensure you understand what to expect and how to communicate clearly and accurately about your symptoms. The way you describe your injury and limitations can significantly affect the doctor’s conclusions.
The Impact of IMEs on Your Workers’ Compensation Claim
IME reports can strongly influence the trajectory of your claim. For example, if the IME concludes that you are able to return to work or have reached MMI, the insurance company may reduce or stop your temporary disability payments, even if your treating physician disagrees. Similarly, if the IME assigns a lower impairment rating than expected, your permanent disability compensation could be reduced.
Returning to work based on an IME that understates your limitations can also jeopardize your recovery. If you attempt tasks beyond your capabilities and reinjure yourself, the insurance company may argue that the new injury is unrelated to your original workplace accident, complicating your claim.
At the same time, IMEs are not always detrimental. In some cases, the IME doctor may confirm the need for additional treatment, support your work restrictions, or even assign a higher permanent impairment rating than initially assessed. The key is to approach the process informed and prepared.
Preparing for an IME
Preparation is critical for protecting your claim. Before the examination, review the timeline of your injury, the treatments you have received, and your current symptoms. Be ready to explain clearly how your injury affects your daily life and your ability to work. Providing accurate, consistent information without exaggeration is important, as IME doctors evaluate both your medical condition and your credibility.
You should also gather any relevant documentation, such as medical records, diagnostic imaging, or accident reports. While you cannot bring your attorney into the exam, you can discuss strategy and practice describing your limitations with them beforehand. This preparation ensures that you present your case effectively and minimizes the risk of misunderstandings or misinterpretations.
Handling Conflicting Medical Opinions
It is common for an IME report to differ from your treating physician’s opinion. When this happens, the insurance company may rely on the IME to justify reducing or denying benefits. Fortunately, you are not without recourse. Your attorney can challenge the IME by presenting additional medical evidence, requesting a second independent opinion, or asking the Indiana Workers’ Compensation Board to resolve the dispute.
In some cases, the Board may appoint a neutral physician to provide a third opinion. Testimony from your treating doctor, combined with supporting documentation, can counter an IME report that is inaccurate or biased. The goal is to ensure that your permanent impairment is properly evaluated and that your workers’ compensation benefits reflect your actual limitations.
Your Rights Regarding IMEs
Indiana law protects workers by ensuring they cannot be penalized for attending an IME when it is properly scheduled. Failing to appear for an examination without a valid reason can result in suspended benefits. However, you have the right to receive advance notice of the exam, know the qualifications of the examining physician, and request a copy of the IME report. You also have the right to challenge any findings that are inaccurate or inconsistent with your medical history.
These protections, combined with legal representation, help ensure that the IME process is fair and that your benefits are not unfairly reduced.
Why Legal Representation Matters
Because IMEs can be pivotal in the outcome of a workers’ compensation claim, it is crucial to have an experienced attorney guiding you. A skilled lawyer can help you prepare for the examination, communicate effectively with the insurance company, and challenge any findings that threaten your benefits.
At Lee Cossell & Feagley, LLP, our attorneys have extensive experience handling IMEs in Indiana workers’ compensation cases. We review every report, gather supporting evidence, and advocate for our clients before the Workers’ Compensation Board to ensure that they receive the benefits they deserve. Our goal is to help injured workers navigate the complexities of the system while minimizing stress and maximizing financial recovery.
Contact Lee Cossell & Feagley, LLP
Independent Medical Examinations are a critical part of the workers’ compensation process, and their findings can significantly impact your benefits. If you have been asked to attend an IME or are facing disputes over a report, the attorneys at Lee Cossell & Feagley, LLP can provide guidance and representation to protect your rights.
We have decades of experience helping Indiana workers secure fair compensation for their injuries. Call our Indianapolis office today to schedule a free consultation and learn how we can help you prepare for an IME and safeguard your workers’ compensation benefits.